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. 2022 Dec;29(8):1890-1900.
doi: 10.1177/10731911211032285. Epub 2021 Aug 5.

Psychometric Validation of a Combined Assessment for Anxiety and Depression in Primary Care in Mozambique (CAD-MZ)

Jennifer M Belus  1 , Alberto Muanido  2 , Vasco F J Cumbe  3   4 , Maria Nelia Manaca  2 , Bradley H Wagenaar  5   6
Affiliations

Psychometric Validation of a Combined Assessment for Anxiety and Depression in Primary Care in Mozambique (CAD-MZ)

Jennifer M Belus et al. Assessment. 2022 Dec.

Abstract

This study sought to validate a combined assessment for major depression and generalized anxiety, administered by health providers in a primary care setting in Mozambique. Patients attending a primary care visit (N = 502) were enrolled in the study and completed the Patient Health Questionniare-9, the Generalized Anxiety Disorder-7, and six items identified in a global systematic qualitative review of depression that were not captured in existing measures (e.g., social isolation, "thinking too much," and "heart problems"). A separate trained mental health provider conducted the Mini International Neuropsychiatric Interview 5.0, adapted for Mozambique, to establish clinical diagnoses. Item response theory, factor analysis, and receiver operating characteristics were all used to identify the best screening items. Eight items were identified for the final screener: four items from the Patient Health Questionniare-9, two from the Generalized Anxiety Disorder-7, and two from the global depression literature. A cut-score of 7 was found to consistently increase the diagnostic likelihood of having a particular disorder. Overall, findings indicate good clinical utility of the screener in primary care in Mozambique.

Keywords: Mozambique; anxiety; common mental disorders; depression; global mental health; item response theory.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Information curves for all 22 initial screener items.
See this image and copyright information in PMC

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