Evaluation of the psychometric properties of the Self-Reporting Questionnaire (SRQ-20) in a sample of Vietnamese adults.

PURPOSE: There are significant gaps in the literature on the prevalence of mental health problems and associated needs in Vietnam. A thorough understanding of culture-specific expressions of psychiatric distress is vital for the identification of the mental health needs of a community, and more research on the development and evaluation of culturally-sensitive mental health assessments is warranted. This study aims to evaluate the psychometric properties of the World Health Organization 20-item Self-Reporting Questionnaire (SRQ-20) in an epidemiologic study of Vietnamese adults. METHODS: A latent variable modeling approach investigated the underlying factor structure of the SRQ-20 items. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted on SRQ-20 item-level data gathered from 4980 participants. RESULTS: Based on scree plots and EFA results, two latent structures were deemed plausible and were subsequently subjected to further modeling. A bi-factor model (BFM) and a correlated three-factor model solution (Negative Affect, Somatic Complaints, and Hopelessness) provided reasonable fits. The BFM specifies a single dominant General Distress factor (all SRQ-20 items) with orthogonal group factors for the subsets of items: Negative Affect (9 items), Somatic Complaints (8 items), and Hopelessness (3 items). This model fit the data as well or better than the three-factor model. Results also showed differences in endorsement rates of SRQ-20 items among males and females. CONCLUSIONS: Study results provide an evaluation of the psychometric properties of a commonly used screening tool and offer insight into the presentation of mental distress in a representative sample of Vietnamese adults.

Estimating mental distress in Vietnam: the use of the SRQ-20.

BACKGROUND: Community-based estimates of psychopathology prevalence in developing countries such as Vietnam, are needed to reduce presumed significant burden of poor mental health. AIMS: This study derived population-based prevalence estimates of mental distress, as measured by the SRQ-20, in a community sample of 4,981 adults living in Vietnam. This study also examined correlates of mental distress based on SRQ-20 caseness indications. Risk and protective factors were identified in terms of their unique contribution to caseness. RESULTS: Using a cut-off of 7/8, 19.2% of the sample was considered to be a probable case (n = 954), with females endorsing more items than males. Marital status and employment status were not associated with mental health distress. Higher wealth, endorsing religious affiliation, and self-reports of good health were associated with lower SRQ-20 scores. Age and being female were associated with higher SRQ-20 scores. CONCLUSIONS: A single item was as adequate a measure of wealth as multi-item rating scales. Our estimate of mental distress using the SRQ-20 is much greater than that of other studies, and in contrast to western prevalence studies, age was not a protective factor in this study. The SRQ-20 is a brief, cost-effective and reasonably valid measure of both community and individual mental distress.

Does Interviewer Status Matter? An examination of Lay Interviewers and Medical Doctor Interviewers in an Epidemiological Study in Vietnam.

In 2006, typhoon Xangsane disrupted a large-scale multi-agency mental health study of 4,982 individuals in the DaNang province of Vietnam. Following this disaster, 795 of the original 4,982 participants were randomly assigned to be re-interviewed by either a medical doctor or a lay interviewer using structured clinical interviews to determine prevalence of lifetime and post-typhoon post-traumatic stress disorder (PTSD), major depressive disorder (MDD), panic disorder (PD), and generalized anxiety disorder (GAD) according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (APA, 1994). The aim of the present study was to determine if prevalence of disorders differed by interviewer type. Bivariate analyses and multivariable analyses, as well as internal reliability estimates, all indicated no significant differences between the medical doctor interviewers versus the lay interviewers. This held for both lifetime prevalence as well as post-typhoon prevalence of disorders. This study has implications for epidemiologic studies, as it indicates that with adequate training, the use of lay interviewers may be a valid means of data collection.

Posttyphoon prevalence of posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder in a Vietnamese sample.

In 2006, typhoon Xangsane disrupted a multiagency health needs study of 4,982 individuals in Vietnam. Following this disaster, 798 of the original participants were reinterviewed to determine prevalence and risk factors associated with posttraumatic stress disorder (PTSD), major depressive disorder (MDD), panic disorder (PD), and generalized anxiety disorder (GAD). Posttyphoon prevalences were PTSD 2.6%, MDD 5.9%, PD 9.3%, and GAD 2.2%. Of those meeting criteria for a disorder, 70% reported only one disorder, 15% had two, 14% had three, and 1% met criteria for all four disorders. Risk factors for posttyphoon psychopathology differed among disorders, but generally were related to high typhoon exposure, prior trauma exposure, and in contrast to Western populations, higher age, but not gender.

A Pre-/Post-Disaster Epidemiological Study of Mental Health Functioning in Vietnam's Da Nang Province Following Typhoon Xangsane.

In 2006, typhoon Xangsane struck Vietnam and disrupted a large-scale mental health needs analysis in the Da Nang province of Vietnam. Recruitment of new participants was halted, and the design of study was altered to that of a pre-/post-event investigation in which 798 of the original 4,982 participants were re-interviewed. This produced the first pre-post disaster epidemiological study. Specifically, risk and protective factors were evaluated with respect to probable mental health "caseness" on the bases of the World Health Organization Short Response Questionnaire (SRQ-20) 7/8 cutoff (i.e., scores of 8 or more). Caseness prevalence was 20.7% pre-disaster and 27.1% post-disaster. Specific risk factors associated with mental health caseness included poor health, extreme peri-disaster fear, and experienced injury. Religious affiliation appeared to be a protective factor. In contrast to US samples, gender was not predictive of outcome.