Depression, Anxiety, and Stress Scale: Factor validation during the first COVID-19 lockdown in Mexico

Introduction: Globally, mental health problems have affected nearly 1 billion people and approximately 1 in 10 Mexicans. The detection and surveillance of depression, anxiety, and stress in Mexico requires more reliable and valid instruments. Objective: To determine the factor validity and internal consistency of the Depression, Anxiety, and Stress Scale-21 items (DASS-21) in a non-probabilistic national sample of Mexican adults. Method: Cross-sectional study by means of an online survey of 1 613 Mexican adults aged 18 years and older. The Spanish version of the DASS-21 was used, which evaluates the presence of depressive symptoms, anxiety, and stress. Factor validity was determined by comparing different confirmatory factor analysis models: one-dimensional, three factors (correlated and non-correlated), second order, and bifactor. Results: The application of the bifactor model to the DASS 21, supports its validity for identifying the presence of symptoms of depression, anxiety, and stress, as well as an altered general emotional state in a sample of Mexican adults. Conclusions: The DASS-21 is a theoretically robust instrument useful for research and clinical practice.

Introducción: A nivel global los problemas de salud mental han alcanzado a cerca de 1 billón de personas y aproximadamente a uno de cada diez mexicanos. La detección y vigilancia de depresión, ansiedad y estrés en México demandan instrumentos más confiables y válidos. Objetivo: Determinar la validez factorial y consistencia interna de la Escala de Depresión, Ansiedad y Estrés (DASS-21) en una muestra nacional no probabilística de adultos mexicanos. Método: Estudio transversal por medio de una encuesta en línea entre 1 613 adultos me-xicanos de 18 años o más. Se utilizó la versión en español del DASS-21 que evalúa la presencia de síntomas depresivos, ansiedad y estrés. La validez factorial se determinó mediante la comparación de distintos modelos del análisis factorial confirmatorio: unidimensional; tres factores (correlacionados y no), de segundo orden, y bifactor. Resultados: La aplicación del modelo bifactor al DASS-21 sustenta su validez para identificar la presencia de síntomas de depresión, ansiedad y estrés, así como de un estado general emocional alterado en una muestra de adultos mexicanos. Conclusiones: El DASS-21 es un instrumento teóricamente robusto útil para la investigación y la práctica clínica.

An assessment of mental health of Mexican and Colombian medical students during the COVID-19 pandemic / Una evaluación de la salud mental de estudiantes de medicina Mexicanos y Colombianos durante la pandemia de COVID-19

Abstract Introduction The COVID-19 pandemic caused the cessation of academic activities from the face-to-face format to confinement and virtual classes, in which little is studied about its effect on mental health. Objective Determine levels of depression, anxiety, and stress in medical students in Mexico and Colombia during the COVID-19 pandemic. Furthermore, depression, anxiety, and stress were compared by gender, education status, and country. Method A cross-sectional study was carried out with 426 medical students. Data was collected using an online survey containing the Depression, Anxiety, Stress Scale (DASS-21) questionnaire. Results Overall scores for depression, anxiety, and stress were 6.7 ± 1.2, 8.8 ± 1.2, and 5.6 ± 1.2, respectively. Females had significantly higher overall scores for depression (.24-fold increase), anxiety (.25-fold increase), and stress (.40-fold increase) than males (p ≤ .01). The risk for anxiety and stress by school year showed that basic years were associated with higher scores than advanced years (.25 and .38-fold increase, respectively). For females, starting medical school did show an increased risk of depression when compared to male students in their basic years (.38-fold increase). Lastly, students from Mexico had an increased risk for depression and anxiety (p ≤ .022 and p ≤ .004, respectively) but not for stress (p ≤ .402), when compared to students from Colombia. Discussion and conclusion Significant anxiety and depression were observed in medical students from Mexico and Colombia. Factors associated with an increased risk of depression and anxiety are students in their basic years as well as being female.

Resumen Introducción La pandemia de COVID-19 provocó el cese de las actividades académicas desde el formato presencial al confinamiento de las clases virtuales, de las que poco se ha estudiado sobre su efecto en la salud mental. Objetivo Determinar los niveles de depresión, ansiedad y estrés en estudiantes de medicina de México y Colombia durante la pandemia de COVID-19; además de comparar depresión, ansiedad y estrés por género, nivel educativo y país. Método Se realizó un estudio transversal con 426 estudiantes de medicina. Los datos se recopilaron mediante una encuesta en línea que contenía el cuestionario DASS-21. Resultados Las puntuaciones generales de depresión, ansiedad y estrés fueron 6.7 ± 1.2, 8.8 ± 1.2 y 5.6 ± 1.2, respectivamente. Las mujeres tuvieron puntajes generales significativamente más altos para depresión (.24-fold increase), ansiedad (.25-fold increase) y estrés (.40-fold increase). El riesgo de ansiedad y estrés por año escolar mostró que los años básicos se asociaron con puntajes más altos que los estudiantes en años los avanzados (.25 y .38-fold increase). Para las mujeres, cursar años básicos mostró un mayor riesgo de depresión en comparación con los estudiantes varones (.38-fold increase). Por último, los estudiantes mexicanos tuvieron un mayor riesgo de depresión y ansiedad (p ≤ .022 y p ≤ .004, respectivamente) pero no de estrés (p ≤ .402) en comparación con los estudiantes Colombianos. Discusión y conclusión Se observó ansiedad y depresión significativas en estudiantes de medicina mexicanos y colombianos. Los factores asociados a un mayor riesgo de depresión y ansiedad fueron; ser estudiante en años básicos además de ser mujer.

STUDY OF DEPRESSION, ANXIETY & STRESS AMONG FAMILY MEMBERS OF HOSPITALIZED COVID-19 PATIENTS IN A TERTIARY CARE HOSPITAL OF CENTRAL GUJARAT

Background: COVID-19 pandemic has caused mental health issues along with physical, social, and economic issues in both patients and their relatives.COVID-19-positive patients were hospitalized in isolation with no or limited access to relatives. These conditions may have contributed to signi?cant psychological distress in relatives and this study was designed to assess the same. To ?nd the prevalence of Depression, Anxiety, and Stress Objectives: among Relatives of hospitalized COVID-19 patients. A cross-sectional quantitative tertiary care hospital-based Methods: study was conducted after approval from Institutional Human Ethics Committee. Relatives of hospitalized COVID-19 patients were assessed by purposive sampling method using Semi-Structured Performa including socio-demographic details, illness- related details, and DASS-21 (Depression, Anxiety, and Stress scale-21) via a telephonic mode of interview. A total of Results: 200 relatives of COVID-19 positive turned negative patients were interviewed on the ?rst day of the COVID 19 negative report. Majority of participants were male,mean age 41 years,literate,married & having ?rst degree relation with the patient. The prevalence of Depression, Anxiety and Stress was 12%. On individual parameters, Depression, Anxiety and Stress was found 25%,21%,and 20% respectively. Female relatives were signi?cantly associated with depression (?2= 8.689,P=.003) & anxiety(?2= 5.790,P=.016) where as longer hospitalization was signi?cantly associated with anxiety(?2= 10.216,P=.006) and stress(?2= 8.936,P=.011). Relatives of COVID-19 patients had a signi?cant amount of psychological stress. Conclusions: Female gender of relatives and longer duration of hospitalization of patients were important predictors.

Mental Health of University Students in Northern Malaysia

Context/Background: Today, poor mental health is one of the most neglected diseases although it is one of the leading causes of disabilities in both developed and developing countries. This mental health issue be-comes a problem among university students too. This study was aimed to determine the prevalence and asso-ciated factors of depression, anxiety, and stress (DAS) among university students. Methodology: A cross-sectional study was carried out in a private university of northern Malaysia during 2020. A random sample of 161 students were included and DASS-21 was used to determine the prevalence of DAS. Multiple logistic regression analysis was performed to examine the associated factors. Results: The prevalence of DAS among students were 34.8%, 42.2%, and 33.5%, respectively. In contrast to years 2 and 4, the prevalence of all types of mental disorders were lower in years 1 and 3. The students’ living area, residence, academic year, and parental income were significantly associated with anxiety whereas the age group of the students and parent’s income did so for depression. The variables; age group, academic year and parent’s income were identified as significant determinants for the presence of stress among students. Conclusions: The significant extent of the mental health problems was detected among university students in Malaysia. Despite the small sample, this analysis indicates that opportunities exist to improve campus-based mental health education and psychological support among university students.

Assessment of psychological distress pattern & its correlates among people receiving COVID-19 vaccination during the COVID-19 pandemic: A cross-sectional study

Background & objectives: There is a possibility that vaccinated people may experience lesser psychological distress due to the sense of safety felt by them against getting the COVID-19 infection as compared to those who are not vaccinated. However, there is a paucity of research examining the mental health status of this important sub-group of population. Thus, the present study was aimed to examine the pattern of psychological distress and its correlates among people receiving COVID-19 vaccine. Methods: This cross-sectional study assessed individuals receiving COVID-19 vaccine at a tertiary care hospital. Psychological distress and COVID-19-related anxiety were assessed using the Depression Anxiety Stress Scale (DASS-21) and the COVID-19 Anxiety Scale-7, respectively. Results: The study comprised 728 individuals with a mean age of 44.8 yr. Moderate levels of depression, anxiety and stress were reported by about 50, six and 15 per cent of the participants, respectively, as assessed on DASS-21. Generalized linear model and quantile regression analyses revealed COVID-19-related anxiety, and being a healthcare worker or front-line worker as significant correlates of psychological distress. Interpretation & conclusions: About half of the study participants receiving COVID-19 vaccine reported moderate to severe symptoms of depression. Strategies focusing on alleviation of COVID-19-related fear and anxiety might be effective in improving the symptoms of psychological distress

Escala de Depressão, Ansiedade e Estresse (EDAE-21): propriedades psicométricas em gestantes brasileiras / Depression, Anxiety and Stress Scale (DASS-21): psychometric properties in brazilin pregnant women / Escala de Depresión, Ansiedad y Estrés (EDAE-21): propiedades psicométricas en mujeres embarazadas brasileñas

Apesar do crescente avanço no uso de instrumentos para a avaliação da saúde emocional nos períodos perinatal e puerperal, destaca-se que a maioria das ferramentas utilizadas não possui evidências psicométricas para a população de gestantes. A Escala de Depressão, Ansiedade e Estresse (EDAE-21) possibilita a mensuração simultânea de níveis de ansiedade, estresse e depressão. O estudo objetivou avaliar a consistência interna da EDAE-21, a validade convergente da escala em relação ao IDATE, à EEP e ao BDI-II, e a estabilidade das avaliações em um intervalo de até 12 semanas. Participaram da pesquisa 53 gestantes (primeira avaliação) e 35 gestantes (segunda avaliação). A escala apresentou índices de consistência interna, estabilidade e convergência adequados à população investigada. A EDAE-21 pode auxiliar profissionais e pesquisadores da saúde, proporcionando agilidade no diagnóstico de indicadores emocionais desfavoráveis em diferentes períodos gestacionais.

Despite the increasing progress in the use of instruments to assess emotional health in the perinatal and puerperal periods, it is emphasized that most of the tools used do not have psychometric evidence for the population of pregnant women. The Depression, Anxiety and Stress Scale (DASS-21) enables the measurement of anxiety, stress, and depression levels, simultaneously. The study aimed to assess the internal consistency of the DASS-21, the convergent validity of the scale in relation to the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory ­ second edition (BDI-II), and the Perceived Stress Scale (PSS) and the stability of the evaluations in a range of up to 12 weeks. Fifty-three (first evaluation) and 35 pregnant women (second evaluation) participated in the research. The scale showed adequate internal consistency, stability, and convergence rates for the investigated population. The DASS-21 can help practitioners and researchers of health, providing agility in the diagnosis of unfavorable emotional indicators in different gestational periods

A pesar del creciente progreso en el uso de instrumentos para evaluar la salud emocional en el período perinatal y puerperal, se destaca que la mayoría de las herramientas utilizadas no tienen evidencia psicométrica para mujeres embarazadas. La Escala de Depressión, Ansiedad y Estrés (EDAE-21) mide simultáneamente los niveles de ansiedad, estrés y depresión. El estudio evaluó la consistencia interna del EDAE-21, la validez convergente de la escala en relación con el STAI, el BDI-II y el EEP y la estabilidad de las evaluaciones en un intervalo de hasta 12 semanas. 53 mujeres embarazadas (primera evaluación) y 35 mujeres embarazadas (segunda evaluación) participaron en la investigación. La escala presentó valores de consistencia interna, estabilidad y convergencia adecuados para la población investigada. El EDAE-21 puede ayudar a los profesionales de la salud y a los investigadores, proporcionando agilidad en el diagnóstico de indicadores emocionales desfavorables en diferentes períodos de gestación.

A Study to Assess the Psycho-Social Implications of the COVID-19 Pandemic in India

Background: In response to the COVID-19 pandemic, the Indian Government called for a nation-wide quarantine or ‘Lockdown’ from 21st March 2020. While initially planned for 21days, satisfactory disease control was not achieved and cases continued to rise till November 2020. It is well established, that a Pandemic is associated with a decline in mental health of the population. This study was conducted in order to assess the prevalence, as well as to understand the causative factors for Depression, Anxiety and Stress in the population. Methodology: An online questionnaire including a consent form, semi-structured proforma, and the DASS- 21 was administered via various platforms. All subjects above 18 years of age, willing to give informed consent were included, while those with pre-existing psychiatric illness were excluded from the study. A total of 504 responses were thus analysed. Results: According to this study, 48.4% of the participants showed signs of psychiatric morbidity; younger age groups and females were more severely affected. Isolation and loneliness, fear of infection and death were reported as major causative factors. Conclusions: Thus, during a disease pandemic, another pandemic of mental illness may also be present. It is important to recognize and take measures to prevent such ill-effects of otherwise protective measures like quarantine.

Level of Depression, Anxiety, Stress, and Coping Strategies among Filipino Healthcare Workers (HCW) with Confirmed Covid-19 Infection using the Filipino-translated Depression Anxiety Stress Scale (DASS) 21 and Filipino Coping Strategies Scale in Perpetual Succour Hospital from March 2020 to September 2020: A One-Center Descriptive Study

@#INTRODUCTION: COVID 19 has become the most important public health issue today. It has the potential to significantly affect the mental health of frontline healthcare workers (HCW) putting them at a higher risk of developing psychological problems especially to those who acquired COVID19 infection. OBJECTIVES: To determine the level of depression, stress, anxiety and coping strategies among Filipino HCWs with confirmed COVID-19 infection and its association with demographic and clinical profiles. STUDY DESIGN: Single center Descriptive study materials and methods consisted of 114 Filipino HCW with COVID 19 infection. Data were collected utilizing the Filipino translation of DASS 21 and Filipino Coping Strategy scale. RESULTS: There was a significant increase of HCWs with moderate depression, anxiety, and stress. A large proportion of the HCWs were also severely depressed, severely anxious and severely stress. Majority of the COVID19 positive HCWs were nurses accounting to 35%. More likely, the occupation was significantly associated with their degree of depression and stress. Hypertension associated significantly with elevated stress while having diabetes was instrumental for the depression, anxiety and stress. Moreover, appreciation was more felt at the workplace, then at home. While discrimination was prevalent in the community, workplace and social media. Religiosity ranked the most sought coping strategy. CONCLUSION: The study has found that a large percentage of HCWs had moderate level and a notable portion of respondents had severe to extremely severe level in each of the psychological domains in which factors such as gender, occupation, comorbidities, area of assignment and disease severity have brought significant impact. Discrimination is prevalent in the community and surprisingly in the workplace. In contrast, appreciation was felt more at home and in the workplace. Religiosity was shown to be the top coping strategy among HCWs who tested positive.

The Psychological Impact and Functional Disability of Patients With Acne Vulgaris in Hospital Serdang, Malaysia: A Cross Sectional Analysis

@#Introduction: Acne vulgaris is not only associated with physical morbidity, but also associated with significant psychosocial disturbances, such as depression and suicide. The objective of this study was to examine the functional disability and psychological impact of acne vulgaris. Methods: A cross-sectional study of 55 acne patients, aged more than 12, was conducted in the dermatology clinic of Serdang Hospital from January to March 2017. Data on demographics, clinical features, current treatment modalities were collected. Acne severity was graded using Comprehensive Acne Severity Scale (CASS), Cardiff Acne Disability Index (CADI) was used to assess functional disability, while DASS-21 was used to assess three related states of depression, anxiety and stress. Statistical analysis was done using SPSS software. A p value ≤ 0.05 considered significant. Results: The mean age was 23.2 (14-46), majority were females (39, 70.9%), Malays (44, 80%) and students (34, 61.8%). 53 (96.4%) subjects had almost clear (CASS = 1) to moderate (CASS = 3) acne severity. Majority had facial acne with or without truncal involvement, 53 (96.3%). The average age of disease onset was 17.8 (9-45). 45 (81.8%) patients found their acne mild to moderately disabling. 69.1%, 45.8% and 41.8% reported feeling anxious, depressed and stressed out. CADI was found to be significantly related with depression (p=0.012), anxiety (p= 0.015) and stress (p=0.001). Relationship between CASS with CADI (p=0.07), stress (p=0.09), anxiety (p=0.13) and depression (p=0.12) were insignificant. Conclusion: Although acne vulgaris is not hazardous, it is associated with psychosocial disturbances. Early and effective treatments are necessary, especially when dealing with facial lesions

Factores asociados a los trastornos temporomandibulares en adultos de Cuenca, Ecuador / Factors associated with temporomandibular disorders in adults. Cuenca, Ecuador

Objetivos: Determinar el factor asociado más relevante para los trastornos temporomandibulares en pacientes que acuden a las Clínicas de la Facultad de Odontología de la Universidad de Cuenca en el periodo 2015. Materiales y métodos: Diseño descriptivo de corte transversal, con un muestreo de 316 pacientes, 239 mujeres y 77 hombres distribuidos en dos rangos 20 a 40 años y de 41 años en adelante. Los síntomas subjetivos y signos clínicos de los TTM se evaluaron utilizando un cuestionario de criterios de diagnóstico de trastornos temporomandibulares (DC/TTM) y el cuestionario de auto informe la escala de depresión ansiedad y estrés (DASS 21) para detectar el estrés emocional, posteriormente los datos fueron introducidos al sistema estadístico SPSS vs 21 para ser analizados por el cálculo de razón de prevalencia y la regresión múltiple logística. Resultados: La prevalencia de los trastornos temporomandibulares fue del 65,8%, en el análisis de regresión con la variable estrés emocional presentó un Oddsratio de 17.96 (IC 95% 8,59 - 37,56), en cuanto al grupo de edad OR=1,72 (IC 95%: 1,057 - 2,798) y para el sexo masculino un OR = 0,994 (IC 95% 0,872 - 1,134). Conclusiones: La prevalencia de los trastornos temporomandibulares en la muestra recolectada fue representativa y su relación con el factor estrés emocional tiene relevancia significativa. El factor sexo y edad no tienen correlación significativa con los TTM.

Objectives: To determine the most relevant for temporomandibular disorders in patients attending clinics of the Faculty of Dentistry at the University of Cuenca in the 2015 period associated factor. Materials and methods: a descriptive study, with a sample of 316 patients, 239 women and 77 men divided into two ranges 20 to 40 years and 41 years and older. Subjective symptoms and clinical signs of TMD were evaluated using a questionnaire diagnostic criteria for temporomandibular disorders (DC / TMD) and self-report questionnaire Depression Scale anxiety and stress (DASS 21) to detect emotional stress. Results: The prevalence of temporomandibular disorders was 65.8%, with female predominance in 75.6% aged from 20 to 40 years; and 59.2% of 40 years and older; factors related to the presence of TMD were age = 40 years OR = 1.72 (95% CI: 1057-2798) emotional stress OR = 17.96 (95% CI 8.59 - 37.56) and the male OR = 0.994 (95% CI 872-1134) Conclusions: The prevalence of temporomandibular disorders in the collected sample was representative and its relationship with stress and age have significant relevance factor below 0.005. The male factor is in line with significant correlation for TTM.

Construct validity and internal consistency reliability of the Malay version of the 21-item depression anxiety stress scale (Malay-DASS-21) among male outpatient clinic attendees in Johor

Background: The 21-item English version of the Depression Anxiety Stress Scale (DASS-21) has been proposed as a method for assessing self-perceived depression, anxiety and stress over the past week in various clinical and nonclinical populations. Several Malay versions of the DASS-21 have been validated in various populations with varying success. One particular Malay version has been validated in various occupational groups (such as nurses and automotive workers) but not among male clinic outpatient attendees in Malaysia. Objective: To validate the Malay version of the DASS-21 (Malay-DASS-21) among male outpatient clinic attendees in Johor. Methods: A validation study with a random sample of 402 male respondents attending the outpatient clinic of a major public outpatient clinic in Johor Bahru and Segamat was carried out from January to March 2016. Construct validity of the Malay-DASS-21 was examined using Exploratory Factor Analysis (KMO = 0.947; Bartlett’s test of sphericity is significant, p<0.001) through Principal Component Analysis and orthogonal (varimax) rotation with Kaiser Normalization to confirm the psychometric properties of the Malay-DASS21 and the internal consistency reliability using Cronbach’s alpha. Results: Construct validity of the Malay-DASS-21 based on eigenvalues and factor loadings to confirm the three factor structure (depression, anxiety, and stress) was acceptable. The internal consistency reliability of the factor construct was very impressive with Cronbach’s alpha values in the range of 0.837 to 0.863. Conclusions: The present study showed that the MalayDASS-21 has acceptable psychometric construct and high internal consistency reliability to measure self-perceived depression, anxiety and stress over the past week in male outpatient clinic attendees in Johor. Further studies are necessary to revalidate the Malay-DASS-21 across different populations and cultures, and using confirmatory factor analyses.

Depression anxiety and stress scale (dass-21) - short form: adaptação e validação para adolescentes brasileiros / Depression anxiety and stress scale (dass-21) - short form: adaptation and validation for brazilian adolescents / Depression anxiety and stress scale (dass-21) - short form: adaptación y validación para los adolescentes brasileños

Este estudo teve como objetivo adaptar e validar a Depression Anxiety and Stress Scale (DASS-21) - Short Form para adolescentes brasileiros. Participaram do estudo 426 adolescentes de 12 a 18 anos (M = 14,91; DP = 1,66), sendo 264 meninas (62%) e 162 meninos (39%), de escolas públicas da cidade de Porto Alegre-RS, que responderam a uma versão adaptada, nomeada Escala de Depressão, Ansiedade e Estresse para Adolescentes (EDAE-A). As subescalas demonstraram níveis adequados de consistência interna, variando entre 0,83 e 0,90. A análise fatorial confirmatória indicou que o melhor modelo foi o de três fatores, confirmando o modelo original com as dimensões depressão, ansiedade e estresse. No escore total e por fatores, houve diferença por sexo, com maior média entre as meninas em todos os escores. Conclui-se que a EDAE-A apresenta qualidades psicométricas favoráveis, mostrando-se um simples e adequado instrumento de levantamento de sintomas de depressão, ansiedade e estresse para adolescentes brasileiros.

This study aimed to adapt and validate the short form of the Depression Anxiety and Stress Scale (DASS-21) for Brazilian adolescents. The participants were 426 adolescents aged 12 to 18 years (M = 14.91, SD = 1.66), 264 girls (62%) and 162 boys (39%), of public schools in the city of Porto Alegre-RS, who answered an adapted version named Escala de Depressão, Ansiedade e Estresse para Adolescentes (EDAE-A). The subscales showed suitable levels of internal consistency, ranging between 0.83 and 0.90. Confirmatory factor analysis indicated that the best model was the three factors confirming the original model with depression, anxiety and stress dimensions. In the total score and factors, there were differences by sex, with highest average to girls in all scores. We concluded that the EDAE-A presents favorable psychometric qualities, being a simple and suitable survey instrument for identifying symptoms of depression, anxiety and stress in Brazilian adolescents.

Este estudio tuvo como objetivo adaptar y validar la Depression Anxiety and Stress Scale (DASS-21) - Short Form para adolescentes brasileños. Participaron del estudio 426 adolescentes entre 12 y 18 años (M = 14,91, SD = 1,66), siendo 264 de sexo femenino (62%) y 162 de sexo masculino (39%), de escuelas públicas de la ciudad de Porto Alegre-RS, que respondieron a una versión adaptada nominada Escala de Depresión, Ansiedad y Estrés para Adolescentes (EDAE-A). Las sub-escalas demostraron niveles adecuados de consistencia interna, oscilando entre 0,83 y 0,90. El análisis factorial confirmatorio indicó que el mejor modelo fue el de los tres factores, lo que confirma el modelo original con las dimensiones depresión, ansiedad y estrés. En el resultado total y por factores hubo diferencia con relación al sexo, con mayores medias entre el sexo femenino en todos los resultados. La EDAE-A presenta cualidades psicométricas favorables, siendo un simple y adecuado instrumento de levantamiento de síntomas de depresión, ansiedad y estrés para adolescentes brasileños.

Uso de las Escalas de Depresión Ansiedad Estrés (DASS-21) como Instrumento de Tamizaje en Jóvenes con Problemas Clínicos / Use of the Depression Anxiety Stress Scales (DASS-21) as Screening Tests in Clinical Youngsters

Resumen: Este estudio determinó los puntajes de corte de las Escalas abreviadas de Depresión, Ansiedad y Estrés (DASS-21) para detectar jóvenes en riesgo de problemas de salud mental. Se utilizó una muestra de 393 jóvenes no consultantes y una muestra clínica de 77 jóvenes consultantes en fase inicial de tratamiento. La presencia de sintomatologia fue utilizada como gold standard para determinar puntajes de corte entre jóvenes de población general asintomáticos y consultantes con sintomatologia clínica. Mediante análisis de curvas ROC se examinó la capacidad de discriminación de cada escala, y a través de análisis de sensibilidad y especificidad se determinaron puntajes de corte. El área bajo la curva para cada una de las escalas del DASS-21 fue mayor a 0.90. Para la escala de Depresión, se seleccionó un punto de corte de 6 (>5), con una sensibilidad de 88,46 y especificidad de 86,77. Para la escala de Ansiedad, el punto de corte correspondió a 5 (>4), con sensibilidad de 87,50 y especificidad de 83,38. En la escala Estrés, se seleccionó un punto de corte de 6 (>5), con una sensibilidad de 81,48 y especificidad de 71,36. Las escalas de Depresión, Ansiedad y Estrés (DASS-21) demostraron una adecuada utilidad como instrumento de tamizaje.

Abstract: The short version of Depression, Anxiety and Stress Scales (DASS-21; Lovibond y Lovibond, 1995) has been shown to have appropriate psychometric properties among Chilean adolescents and undergraduates. The current study was aimed at determining the cut-off scores of the Depression, Anxiety and Stress Scales (DASS-21) for screening Chilean youngsters at risk of mental health problems and requiring mental health treatment. The sample comprised 393 non-patients youngsters aged 15-24 and 77 youngsters at early stage of psychotherapy. The presence of symptoms was used as gold standard for estimating the cut-off betWeen non-symptomatic youngsters and symptomatic patients. Receiving Operating Characteristic (ROC) analyses allowed examining accuracy of each scale and sensitivity and specificity analysis was performed for determining the cut-off points. The area under the receiver operating characteristics curve (AUC) was higher than 0.9 for each scale of the DASS-21. The optimal cut-off score for the Depression scale was 6 and above, which resulted in sensitivity=88,46 and specificity=86,77, and a cut-off of 5 and above was optimal for the anxiety scale, with a sensitivity of 87,50 and specificity of 83,38.The Stress Scale had sensitivity of 81,48 and specificity of 71,36 at the optimal cut-off score of 6 and above. These findings suggest that the DASS-21 performs adequately as a screening tool to identify Chilean young people at risk of mental health problems.

Psychological Determinants Of Pre-Hypertension Among First Year Undergraduate Students In A Public University In Malaysia

Pre-hypertension increased the risk of morbidity and mortality from non-communicable diseases. Whereas, psychological factors such as depression, anxiety and stress have been associated with increased in blood pressure. However, previous studies more focuses on psychological determinants of hypertension than prehypertension. Thus, this study aims to determine the association between these psychological factors with pre-hypertension. A cross-sectional study was conducted in 2012 among first year students of a public Malaysian university. A random cluster sampling was used to select 5 out of 15 faculties and a total of 495 students participated in this study. The Malay version of DASS-21 was used to elicit their levels of depression, anxiety and stress. Blood pressures were measured twice using sphygmomanometer and the averages were taken. Data analyses used chi-square test and binary multiple logistic regression. The prevalence of pre-hypertension was 30.1%. The percentage of severe and extremely severe depression was 3.8% and 1.2%; both severe and extremely severe anxiety was 16.4%; and severe and extremely severe stress was 4.2% and 0.2% respectively. Severe/extremely severe depression had more than 3 times higher in getting pre-hypertension than no depression. In conclusions, almost one third of respondents had pre-hypertension and only severe/extremely depression was associated with pre-hypertension.

Stress and Its Associated Factors amongst Ward Nurses in A Public Hospital Kuala Lumpur

Occupational stress exists in all professions, but the nursing profession appears to experience more stress at work compared to other health care workers. Stressful conditions at the workplace may cause the high turnover and burnout among nurses. This study objective was to determine the level of stress and its associated factors among in-patient ward nurses. A cross sectional study using the stratified random sampling method was carried out among 114 staff nurses from 5 different departments in a public hospital in Kuala Lumpur. Respondents were requested to complete a single set of validated and self-administered questionnaire, the Depression, Anxiety, Stress Scale (DASS) . Data was analysed using SPSS 17. In general, the prevalence of stress at the department of Medicine was found to be higher compared to other departments studied. There was also a statistical significant relationship between the prevalence of stress and types of department (p 0.05). In conclusion, stress had no significant association with socio-demographic factors (age, marital status and financial status) and working environment except for type of department nurses work in. There might be some other possible confounders that have a bigger potential in becoming stressors compared to those independent variables in this study.