Measuring community mental health in developing societies: evaluation of a checklist format in Nepal.
BACKGROUND
There is growing recognition of the importance of mental health problems in developing countries. In large part, however, we have very limited epidemiological data at national and/or community levels about the prevalence of mental illnesses.


OBJECTIVE
The purpose of this paper is to describe the reliability and validity characteristics of an assessment tool that may be useful for conducting community-level surveys (particularly in rural communities of developing countries) to obtain prevalence rates of mental illnesses.


METHODS
We used a sample of adults residing in a rural village in Nepal to assess disorders with a modified version of the DSM-III-R Checklist. We evaluated construct validity, scale reliability, convergent validity and discriminant validity.


RESULTS
There is strong evidence for the construct validity of generalized anxiety and depression in our sample. By contrast, the symptoms associated with mania and schizophrenia were not empirically distinct. Convergent validity is acceptable. As a test of validity characteristics, the pattern of sociodemographic correlations suggests that the specific social origins of disorder in Nepal will require further investigation.


CONCLUSIONS
The first step in obtaining high quality information on the distribution of mental illness in developing countries is to establish some reliable and valid indicators of disorder. The checklist format for assessing disorder appears to meet this objective and offers the possibility that community-level prevalence studies can be reasonably conducted.
Tausig
Mark
M
Department of Sociology, University of Akron, USA. mtausig@uakron.edu
Subedi
Sree
S
Broughton
C L
CL
Subedi
Janardan
J
Williams-Blangero
Sarah
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health; D003906:Developing Countries; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012423:Rural Health / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires