马拉维感染和未感染艾滋病毒的青少年抑郁症筛查的PHQ-A认知访谈

IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY
Ashland C. Thompson , Melissa A. Stockton , Steven Mphonda , Jerome Nyirenda , Maureen Matewere , Michael Udedi , Kazione Kulisewa , Bradley N. Gaynes , Nivedita L. Bhushan
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引用次数: 0

摘要

背景:抑郁症对低收入和中等收入国家(LMICs)的青少年,尤其是感染艾滋病毒(ALWH)的青少年有显著影响。在撒哈拉以南非洲(SSA), ALWH的抑郁症患病率为26%至29% %,尽管面临资源有限的挑战,但仍有必要对抑郁症状进行筛查。青少年患者健康问卷(PHQ-A)是一种广泛使用的抑郁症筛查工具,但其对马拉维青少年的有效性尚未得到彻底探索。本研究认知访谈测试了马拉维青少年的PHQ-A,目的是确保文化适宜性,提高工具对整个青少年群体的敏感性和特异性。方法:采用认知访谈法,探讨马拉维ALWH (n = 10)和未感染HIV的青少年(n = 10)的抑郁概念,评估PHQ-A项目的可接受性和理解程度,并使PHQ-A适应当地使用。这项研究涉及青少年(13-19岁 岁),其中一半是艾滋病毒携带者,他们是从利隆圭的两个公共卫生中心招募的。结果:调查结果显示,被试能够回答所有PHQ-A问题,但在理解问题2和问题5、使用李克特量表、回答时间和如实回答有关自杀的问题方面存在挑战。此外,马拉维青少年通过涉及心脏问题、过度思考和对家人和朋友的关注等文化表达来感知抑郁。ALWH对PHQ-A的一些症状的解释不同,但他们对问题的理解和回答与未感染艾滋病毒的青少年相似。结论:虽然PHQ-A是一种广泛使用的工具,但其在马拉维青少年中的应用需要进一步探索和适应,以确保抑郁症筛查的文化相关性和准确性。这项研究强调了文化敏感的心理健康评估对准确筛选青少年并将他们与适当的心理健康服务联系起来的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cognitive interviewing of the PHQ-A for depression screening among adolescents living with and without HIV in Malawi

Background

Depression significantly affects adolescents in low- and middle-income countries (LMICs), particularly adolescents living with HIV (ALWH). In sub-Saharan Africa (SSA), where depression prevalence among ALWH ranges from 26 to 29 %, it is essential to screen for depressive symptoms despite the challenges of limited resources. The Patient Health Questionnaire-Adolescent (PHQ-A) is a widely used tool for depression screening, but its effectiveness for adolescents in Malawi has not been thoroughly explored. This study cognitive interview tested the PHQ-A for adolescents in Malawi with the goal of ensuring cultural appropriateness and improving the tool's sensitivity and specificity for the entire adolescent population.

Method

The study conducted cognitive interviews to explore conceptualizations of depression among both ALWH (n = 10) and adolescents without HIV (n = 10) in Malawi, assess the acceptability and comprehension of PHQ-A items, and adapt the PHQ-A for local use. The study involved adolescents (age 13–19 years), half of whom were living with HIV, who were recruited from two public health centers in Lilongwe.

Results

Findings showed that participants were able to answer all PHQ-A items, but faced challenges comprehending questions 2 and 5, using Likert scales, the response period, and truthfully answering questions about suicidality. Additionally, Malawian adolescents perceive depression through cultural expressions involving heart issues, excessive thinking, and a focus on family and friends. ALWH interpreted some symptoms of the PHQ-A differently, yet they generally understood and responded to the questions similarly to adolescents without HIV.

Conclusion

While the PHQ-A is a widely used tool, its application among adolescents in Malawi requires further exploration and adaptation to ensure cultural relevance and accuracy in depression screening. This study underscores the importance of culturally sensitive mental health assessments to accurately screen adolescents and connect them with appropriate mental health services.
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来源期刊
Journal of affective disorders
Journal of affective disorders 医学-精神病学
CiteScore
10.90
自引率
6.10%
发文量
1319
审稿时长
9.3 weeks
期刊介绍: The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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