Validation of an indigenous screening questionnaire for anxiety and depression in an urban squatter settlement of Karachi

ABSTRACT

Concern about the validity of screening instruments for anxiety and depression designed in the west and used in the east has long been a matter of debate. The Aga Khan University anxiety and depression scale is an indigenous screening instrument developed from the symptoms of patients with anxiety and depression coming to the community health center of the Aga Khan University hospital and validated in an urban squatter settlement of Karachi. Four trained CHWs verbally administered the questionnaire to 500 consenting adults who could understand urdu. 487 respondents were interviewed by psychiatrists who were blind to the questionnaire scores. At a cut off score of 19 the scale displayed a specificity of 81% sensitivity of 74% a positive predictive value of 63% a negative predictive value of 88% and an overall misclassification rate of 21%. It is suggested that this questionnaire could be used as a screening instrument in urdu understanding population in Pakistan and in countries with similar immigrant population