One size does not fit all: Psychometric properties of the Shona Symptom Questionnaire (SSQ) among adolescents and young adults in Zimbabwe

摘要

Background: Depression is a major contributor to the global burden of disease. Onset commonly occursduring the adolescent period. Understanding how depression tools are functioning among adolescentshas been relatively overlooked.Methods: Using cross-sectional survey data among a sample of 2768 adolescents (aged 15-19) and 2027young adults (aged 20-24) living in Zimbabwe this paper calibrated the Shona Symptom Questionnaire(SSQ) against the Self Report Questionnaire (SRQ-20) and examined the performance indices of the SSQbased on various cut points for classification. Using a multivariate logistic regression model we isolatedparticular characteristics to test their association with the odds of being misclassified as non-depressedby the SSQ.Results: A modified cut point of five or more substantially increases the depression estimates for bothage groups. The prevalence of depression increased from 3.5% to 13.2% among adolescents and from 5.1%to 16.2% among young adults based on these revisions. Adolescents who were orphaned or ever had sexhad significantly a greater odd of being misclassified. When retested using the modified cut point of fiveor greater, associations with misclassification disappeared.Limitations: Scales were not administered separately or in their entirety but rather overlapping itemswere only asked once, utilizing exclusively SRQ-20 phrasing rather than the culturally-emic language inthe SSQ.Conclusions: Not all depression scales are appropriate for use among adolescents given their uniquedevelopmental stage. An alternative cut point for depression classification could improve detection ofdepression among Zimbabwean adolescents.