Skip to main content

Advertisement

SpringerLink
Log in

Validation of the Self Reporting Questionnaire 20-Item (SRQ-20) for Use in a Low- and Middle-Income Country Emergency Centre Setting

  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

Abstract

Common mental disorders are highly prevalent in emergency centre (EC) patients, yet few brief screening tools have been validated for low- and middle-income country (LMIC) ECs. This study explored the psychometric properties of the SRQ-20 screening tool in South African ECs using the Mini Neuropsychiatric Interview (MINI) as the gold standard comparison tool. Patients (n = 200) from two ECs in Cape Town, South Africa were interviewed using the SRQ-20 and the MINI. Internal consistency, screening properties and factorial validity were examined. The SRQ-20 was effective in identifying participants with major depression, anxiety disorders or suicidality and displayed good internal consistency. The optimal cutoff scores were 4/5 and 6/7 for men and women respectively. The factor structure differed by gender. The SRQ-20 is a useful tool for EC settings in South Africa and holds promise for task-shifted approaches to decreasing the LMIC burden of mental disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Beck, A. T., & Steer, R. A. (1993). Beck depression inventory manual. San Antonio: Psychological Corporation.

    Google Scholar 

  • Becker, J., Dell, A., Jenkins, L., et al. (2012). Reasons why patients with primary health care problems access a secondary hospital emergency centre. South African Medical Journal, 102, 800–801.

    PubMed  Google Scholar 

  • Beusenberg, M., & Orley, J. (1994). A user’s guide to the self reporting questionnaire. Geneva: Division of Mental Health, World Health Organization.

    Google Scholar 

  • Bhagwanjee, A., Parekh, A., Paruk, Z., et al. (1998). Prevalence of minor psychiatric disorders in an adult African rural community in South Africa. Psychological Medicine, 28, 1137–1147.

    Article  PubMed  CAS  Google Scholar 

  • Booth, B., Walton, M., Barry, K., et al. (2011). Substance use, depression, and mental health functioning in patients seeking acute medical care in an inner-city ED. Journal of Behavioral Health Services and Research, 38, 358–372.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bower, P., Gilbody, S., Richards, D., et al. (2006). Collaborative care for depression in primary care: making sense of a complex intervention: systematic review and meta-regression. The British Journal of Psychiatry, 189, 484–493.

    Article  PubMed  Google Scholar 

  • Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1, 245–276.

    Article  Google Scholar 

  • Chen, S., Zhao, G., Li, L., et al. (2009). Psychometric properties of the Chinese version of the self-reporting questionnaire 20 (SRQ-20) in community settings. International Journal of Social Psychiatry, 55, 538–547.

    Article  PubMed  Google Scholar 

  • Cherian, V., Peltzer, K., & Cherian, L. (1998). The factor structure of the self report questionnaire (SRQ20) in South Africa. East African Medical Journal, 75, 654–656.

    PubMed  CAS  Google Scholar 

  • Cherpitel, C. J. (2007). Alcohol and injuries: a review of international emergency room studies since 1995. Drug and Alcohol Review, 26, 201–214.

    Article  PubMed  Google Scholar 

  • Chipimo, P. J., & Fylkesnes, K. (2010). Comparative validity of screening instruments for mental distress in zambia. Clin Practice Epidemiology Mental Health, 6, 4–15.

    Article  Google Scholar 

  • Cunningham, R. M., Murray, R., Walton, M. A., et al. (2009). Prevalence of past year assault among inner-city emergency department patients. Annals of Emergency Medicine, 53, 814–823.e815.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dale, J., Green, J., Reid, F., et al. (1995). Primary care in the accident and emergency department: I. Prospective identification of patients. BMJ (Clin Res Ed), 311, 423–426.

    Article  CAS  Google Scholar 

  • Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291, 2581–2590.

    Article  PubMed  Google Scholar 

  • Giang, K. B., Allebeck, P., Kullgren, G., et al. (2006). The Vietnamese version of the self reporting questionnaire 20 (SRQ-20) in detecting mental disorders in rural Vietnam: a validation study. International Journal of Social Psychiatry, 52, 175–184.

    Article  PubMed  Google Scholar 

  • Gonçalves, D. M., Stein, A. T., & Kapczinski, F. (2008). Avaliação de desempenho do self-reporting questionnaire Como instrumento de rastreamento psiquiátrico: um estudo comparativo com o structured clinical interview for DSM-IV-TR. Cadernos de Saúde Pública, 24, 380–390.

    Article  PubMed  Google Scholar 

  • Grant, B. F., Stinson, F. S., Dawson, D. A., et al. (2004). Prevalence and co-occurrence of substance use disorders and independentmood and anxiety disorders: results from the national epidemiologic survey on alcohol and relatedconditions. Archives of General Psychiatry, 61, 807–816.

    Article  PubMed  Google Scholar 

  • Guttman, L. (1954). Some necessary conditions for common factor analysis. Psychometrika, 19, 149–161.

    Article  Google Scholar 

  • Harding, T. W., De Arango, V., Baltazar, J., et al. (1980). Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychological Medicine, 10, 231–241.

    Article  PubMed  CAS  Google Scholar 

  • Harpham, T., Reichenheim, M., Oser, R., et al. (2003). Measuring mental health in a cost-effective manner. Health Policy and Planning, 18, 344–349.

    Article  PubMed  Google Scholar 

  • Hodkinson, P. W., & Wallis, L. A. (2009). Cross-sectional survey of patients presenting to a South African urban emergency centre. Emergency Medicine Journal, 26, 635–640.

    Article  PubMed  CAS  Google Scholar 

  • Iacoponi, E., & Jair de Jesus, M. (1989). Reliability and factor structure of the Portuguese version of self-reporting questionnaire. International Journal of Social Psychiatry, 35, 213–222.

    Article  PubMed  CAS  Google Scholar 

  • Kaiser, H. F. (1960). The application of electronic computers to factor analysis. Educational and Psychological Measurement, 20, 141–151.

    Article  Google Scholar 

  • Kakuma, R., Minas, H., van Ginneken, N., et al. (2011). Human resources for mental health care: current situation and strategies for action. The Lancet, 378, 1654–1663.

    Article  Google Scholar 

  • Kessler, R., Andrews, G., Colpe, L. J., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32, 959–976.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., Angermeyer, M., Anthony, J. C., et al. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry, 6, 168–176.

    PubMed  PubMed Central  Google Scholar 

  • Kohn, R., Saxena, S., Levav, I., et al. (2004). The treatment gap in mental health care. Bulletin of the World Health Organization, 82, 858–866.

    PubMed  PubMed Central  Google Scholar 

  • Mari, J. J., & Williams, P. (1986). A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo. The British Journal of Psychiatry, 148, 23–26.

    Article  PubMed  CAS  Google Scholar 

  • Parry, C. D. H., Pluddemann, A., Donson, H., et al. (2005). Cannabis and other drug use among trauma patients in three South African cities, 1999–2001: original article. 95:429–432.

  • Patel, V., Araya, R., Chowdhary, N., et al. (2008). Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychological Medicine, 38, 221–228.

    Article  PubMed  CAS  Google Scholar 

  • Plüddemann, A., Parry, C., Donson, H., et al. (2004). Alcohol use and trauma in Cape Town, Durban and Port Elizabeth, South Africa: 1999–2001. Injury Control and Safety Promotion, 11, 265–267.

    Article  PubMed  Google Scholar 

  • Richmond, T. S., Hollander, J. E., Ackerson, T. H., et al. (2007). Psychiatric disorders in patients presenting to the emergency department for minor injury. Nursing Research, 56, 275–282.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rumble, S., Swartz, L., Parry, C., et al. (1996). Prevalence of psychiatric morbidity in the adult population of a rural South African village. Psychological Medicine, 26, 997–1007.

    Article  PubMed  CAS  Google Scholar 

  • Saliou, V., Fichelle, A., McLoughlin, M., et al. (2005). Psychiatric disorders among patients admitted to a French medical emergency service. General Hospital Psychiatry, 27, 263–268.

    Article  PubMed  Google Scholar 

  • Scholte, W., Verduin, F., van Lammeren, A., et al. (2011a). Psychometric properties and longitudinal validation of the self-reporting questionnaire (SRQ-20) in a Rwandan community setting: a validation study. BMC Medical Research Methodology, 11, 116.

    Article  PubMed  PubMed Central  Google Scholar 

  • Scholte, W. F., Verduin, F., van Lammeren, A., et al. (2011b). Psychometric properties and longitudinal validation of the self-reporting questionnaire (SRQ-20) in a Rwandan community setting: a validation study. BMC Medical Research Methodology, 11, 116.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sen, B. (1987). An analysis of the nature of depressive phenomena in primary care using multivariate statistical techniques. Acta Psychiatrica Scandinavica, 76, 28–32.

    Article  PubMed  CAS  Google Scholar 

  • Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl 20), 22–33. quiz 34–57.

    PubMed  Google Scholar 

  • Sorsdahl, K., Myers, B., Ward, C., et al. (2013). Screening and brief interventions for substance use in emergency departments in the Western Cape province of South Africa: Views of health care professionals. International Journal of Injury Control and Safety Promotion.

  • Stevens, J. P. (2002). Applied multivariate statistics for the social sciences (4th ed.). Hillsdale: Erlbaum.

    Google Scholar 

  • Stratton, K. J., Aggen, S. H., Richardson, L. K., et al. (2013). Evaluation of the psychometric properties of the self-reporting questionnaire (SRQ-20) in a sample of Vietnamese adults. Comprehensive Psychiatry, 54, 398–405.

    Article  PubMed  Google Scholar 

  • Thom, R., Zwi, R., & Reinach, S. (1993). The prevalence of psychiatric disorders at a primary care clinic in Soweto, Johannesburg. South African Medical Journal, 83, 653–655.

    PubMed  CAS  Google Scholar 

  • Tuan, T., Harpham, T., & Huong, N. T. (2004). Validity and reliability of the self-reporting questionnaire 20 items in Vietnam. Hong Kong Journal of Psychiatry, 14, 15–18.

    Google Scholar 

  • Ventevogel, P., De Vries, G., Scholte, W. F., et al. (2007). Properties of the Hopkins symptom checklist-25 (HSCL-25) and the self-reporting questionnaire (SRQ-20) as screening instruments used in primary care in Afghanistan. Social Psychiatry and Psychiatric Epidemiology, 42, 328–335.

    Article  PubMed  Google Scholar 

  • World Health Organization. (2008). The global burden of disease: 2004 update. Geneva: World Health Organization.

    Google Scholar 

  • Zwick, W. R., & Velicer, W. F. (1986). Comparion of five rules for determining the number of factors to retain. Psychological Bulletin, 99, 432–442.

    Article  Google Scholar 

Download references

Acknowledgments

This study was funded by Phodiso Program, Fogarty International (grant number 1 D43 TW007278). The financial assistance of the National Research Foundation (NRF) towards this research is hereby acknowledged. Opinions expressed and conclusions arrived at, are those of the author and are not necessarily attributed to the NRF.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa

    Claire van der Westhuizen & Katherine Sorsdahl

  2. Department of Psychiatry and Biobehavioral Science, University of California Los Angeles, Los Angeles, CA, USA

    Gail Wyatt & John K. Williams

  3. Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

    Dan J. Stein

Authors
  1. Claire van der Westhuizen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gail Wyatt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John K. Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dan J. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Katherine Sorsdahl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claire van der Westhuizen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

van der Westhuizen, C., Wyatt, G., Williams, J.K. et al. Validation of the Self Reporting Questionnaire 20-Item (SRQ-20) for Use in a Low- and Middle-Income Country Emergency Centre Setting. Int J Ment Health Addiction 14, 37–48 (2016). https://doi.org/10.1007/s11469-015-9566-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11469-015-9566-x

Keywords

Search

Navigation