Abstract
BackgroundDepression and anxiety are recognised increasingly as serious public health problems among women in low- and lower-middle income countries. The aim of this study was to validate the 21-item Depression Anxiety and Stress Scale (DASS21) for use in screening for these common mental disorders among rural women with young children in the North of Vietnam.MethodsThe DASS-21 was translated from English to Vietnamese, culturally verified, back-translated and administered to women who also completed, separately, a psychiatrist-administered Structured Clinical Interview for DSM IV Axis 1 diagnoses of depressive and anxiety disorders. The sample was a community-based representative cohort of adult women with young children living in Ha Nam Province in northern Viet Nam. Cronbach’s alpha, Exploratory Factor Analyses (EFA) and Receiver Operating Characteristic (ROC) analyses were performed to identify the psychometric properties of the Depression, Anxiety, and Stress subscales and the overall scale.ResultsComplete data were available for 221 women. The internal consistency (Cronbach’s alpha) of each sub-scale and the overall scale were high, ranging from 0.70 for the Stress subscale to 0.88 for the overall scale, but EFA indicated that the 21 items all loaded on one factor. Scores on each of the three sub-scales, and the combinations of two or three of them were able to detect the common mental disorders of depression and anxiety in women with a sensitivity of 79.1% and a specificity of 77.0% at the optimal cut off of >33. However, they did not distinguish between those experiencing only depression or only anxiety.ConclusionsThe total score of the 21 items of the DASS21-Vietnamese validation appears to be comprehensible and sensitive to detecting common mental disorders in women with young children in primary health care in rural northern Vietnam and therefore might also be useful to screen for these conditions in other resource-constrained settings.
Highlights
Depression and anxiety are recognised increasingly as serious public health problems among women in low- and lower-middle income countries
The aim of this study was to establish the comprehensibility and psychometric properties including internal reliability and criterion validity of the Depression, Anxiety and Stress Scale as a screening instrument for depression and / or anxiety in women with young children living in rural northern Vietnam
Following the SCID interview, 26/221 (11.8%) women were diagnosed with depression; 24/221 (10.9%) with an anxiety disorder, 7/221 (3.2%) with comorbid depression and an anxiety disorder
Summary
Depression and anxiety are recognised increasingly as serious public health problems among women in low- and lower-middle income countries. Depression and anxiety are the common non-psychotic mental disorders experienced most frequently by women living in resource-constrained low and lower-middle income countries [1,2]. Detection of these problems in primary health care is essential to identifying. Clark and Watson [4] proposed a tripartite model of anxiety and depression. This model suggests that both conditions share several symptoms of elevated negative effect (e.g. distress and irritability). Even though depression and anxiety are conceptually distinct, there is substantial overlap between the two states that makes them difficult to distinguish in screening
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