Validity of the Hopkins Symptom Checklist-25 amongst HIV-positive pregnant women in Tanzania.
OBJECTIVE
To validate the Hopkins Symptom Checklist-25 (HSCL-25) for use as a depression screen amongst human immuno-deficiency virus (HIV) positive pregnant women.


METHODS
Amongst 903 (mean age 24.8 years) HIV-positive pregnant women, a two-phased design included measures for health-related quality of life, perceived social support, and the HSCL-25 screen for depressive (HSCL-15 subscale) and anxiety symptoms. The Structured Clinical Interview for DSM-IV (SCID) was independently administered on a stratified random subsample.


RESULTS
Internal consistency of the HSCL-25 (alpha 0.93) and HSCL-15 (alpha 0.9) was adequate, with expected findings demonstrated in discriminant validity analysis. A depression-anxiety construct explained nearly 40% of the variance. Eight individual HSCL-25 items demonstrated an area under the curve (AUC) greater than 0.6 for DSM-IV major depression and the HSCL-25 and HSCL-revised had an optimal depression cut-off score of 1.06 and 1.03 for the HSCL-15.


CONCLUSIONS
The HSCL-25 demonstrated utility as a screen for depression; its inability to gauge severity of symptoms in this cultural context is discussed.
Kaaya
S F
SF
Department of Psychiatry, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. skaaya@muchs.ac.tz
Fawzi
M C S
MC
Mbwambo
J K
JK
Lee
B
B
Msamanga
G I
GI
Fawzi
W
W
D000293:Adolescent; D000328:Adult; D001007:Anxiety; D003466:Cultural Characteristics; D003863:Depression / Q000175:diagnosis*; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000208:ethnology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life; D012944:Social Support; D013636:Tanzania / Q000208:ethnology