Validity study of Kessler's psychological distress scales conducted among patients admitted to French emergency department for alcohol consumption-related disorders.
BACKGROUND
Alcohol-related disorders (ARD) encountered in emergency departments (ED) have a high prevalence and are underestimated. It is necessary to provide professionals with a tool to identify patients in whom there is a risk that alcohol-related and mental health problems may be associated. Kessler's K6/10 psychological distress scales are fast, easy-to-use, and have been shown to achieve a good performance in the identification of psychological distress associated with ARD.


OBJECTIVE
The aim of this study was to evaluate the psychometric properties of the Kessler scales, version 6 and 10, with a sample of patients admitted to EDs for alcohol consumption.


METHODS
On the day after their admission, with a zero "blood" alcohol concentration, 71 patients were randomly assigned to be assessed using 6 or 10 items version. The internal consistency and factor structure of the K6/10 versions were examined. Convergent validity was measured using the Hospital Anxiety and Depression Scale (HADS) and the Hamilton Depression Rating Scale (HDRS).


RESULTS
The prevalence of psychological distress in our sample was approximately 60%. The selected threshold scores were 10 for K6 (Sensitivity: 0.92; Specificity: 0.62) and 14 for K10 (Sensitivity: 0.95; Specificity: 0.54). The Cronbach coefficients for K6 and K10 were 0.76 and 0.84, respectively. The factor analyses indicated the multidimensional nature of K6/10. The 2 versions, containing 6 and 10 items respectively, correlated better with the HADS (0.83 and 0.70, respectively) than with the HDRS (0.51 and 0.49, respectively). The areas under the ROC Curve indicated a high level of accuracy for both the K6 (0.87) and the K10 (0.77). The difference was not statistically significant.


CONCLUSIONS
This study confirms the good psychometric characteristics of Kessler's psychological distress scale. Even though similar performances were observed for K6/10, the brevity of the K6 makes it more suitable for use in EDs.
Arnaud
Benjamin
B
CHU Clermont Ferrand, Unité Urgences Psychiatriques, France.
Malet
Laurent
L
Teissedre
Frédérique
F
Izaute
Marie
M
Moustafa
Fares
F
Geneste
Julie
J
Schmidt
Jeannot
J
Llorca
Pierre-Michel
PM
Brousse
Georges
G
D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D017831:Diagnosis, Dual (Psychiatry); D004636:Emergency Service, Hospital / Q000592:standards; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D010343:Patient Admission / Q000592:standards; D011569:Psychiatric Status Rating Scales / Q000592:standards; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards