The validation of the visual screening tool for anxiety disorders and depression in hypertension and/or diabetes

Zimbini Ogle,Liezl Koen,Dana J.H Niehaus

doi:10.4102/phcfm.v10i1.1722

Abstract

BackgroundDepression and anxiety disorders remain poorly detected at primary health care, particularly in patients with hypertension and/or diabetes. A visual screening tool for anxiety disorders and depression (VISTAD) has been developed, but not validated.AimTo validate the VISTAD in primary health care participants diagnosed with hypertension and/or diabetes.SettingParticipants were recruited from five primary health care centres in the Eastern Cape, South Africa (urban, peri-urban and rural).MethodsThe study used a cross-sectional study design to validate the VISTAD. The VISTAD was validated against the International Neuropsychiatric Interview (M.I.N.I) using field testing. A demographic questionnaire was used to collect data on socio-economic variables.ResultsSixty-nine (87%) females and 10 (13%) males with a mean age of 49 (SD 8.6844) participated in the study. Fifty black people (63%), 16 mixed race people (20%) and 13 white people (16%) participated in the study. The majority of the participants (77%) did not complete high school. The area under curve score (AUC) for the VISTAD in screening for depression was 0.91, and for anxiety disorders, 0.87 post-traumatic stress disorder, 0.87 panic disorder, 0.85 social phobia, 0.88 agoraphobia, and 0.83 generalised anxiety disorder revealing acceptable psychometric properties.ConclusionThe use of the VISTAD as a screening tool at primary health care in people living with hypertension and/or diabetes is recommended. The VISTAD could, therefore, play a key role in the prevention and early treatment of individuals diagnosed with hypertension and/or diabetes across cultures and levels of education. The VISTAD needs to be validated in a large population representative of primary care patients diagnosed with hypertension and/or diabetes.

Highlights

Depression and anxiety disorders remain poorly detected at primary health care, in patients with hypertension and/or diabetes
Eighty-one participants from primary health care participated in the validation of the VISTAD
Out of the 81 participants, one declined to continue with completing the interview reporting that the VISTAD depicted his life, and it was painful to look at the images

Summary

Introduction

Depression and anxiety disorders remain poorly detected at primary health care, in patients with hypertension and/or diabetes. Current literature demonstrates that hypertension and diabetes have emerged as a major medical and public burden globally.[1,2,3,4] South Africa is burdened with a high prevalence of hypertension and diabetes. There are 2.3 million people living with diabetes in South Africa,[5] and 30% of the adult population is living with hypertension.[6] hypertension and diabetes account for 17 million visits to health facilities in South Africa every year.[1]. The diabetes and hypertension burden is further complicated by the increasingly high comorbidity with depression and anxiety disorders. Inadequate levels of mental health literacy, for both health care workers[12] and patients, have been well established in research.[13]

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