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International Journal of Methods in Psychiatric Research logoLink to International Journal of Methods in Psychiatric Research
. 2009 Aug 21;18(3):159–168. doi: 10.1002/mpr.288

Psychometric properties of an interviewer‐administered version of the Kessler Psychological Distress scale (K10) among Dutch, Moroccan and Turkish respondents

T Fassaert 1,2,✉, MAS De Wit 1, WC Tuinebreijer 3, H Wouters 4, AP Verhoeff 1,5, ATF Beekman 6,7, J Dekker 6,8
PMCID: PMC6878421  PMID: 19701920

Abstract

The Kessler Psychological Distress scale (K10) is an instrument that is widely used to screen for mental disorders, but information is lacking on its psychometric qualities in non‐Western samples. This study used a population‐based sample (N = 725) to assess the reliability and validity of the K10 across ethnic groups in an urban area. The results were generally supportive of the K10 as a reliable and valid instrument to screen for anxiety and depression in all three groups. Cronbach's alpha was high (0.93) and the results indicated the existence of a solid single factor structure. Item bias in relation to ethnic background was minor. In each group, there was good criterion validity with respect to one‐month DSM‐IV diagnosis for depressive and/or anxiety disorder. The results nevertheless highlight the importance of cross‐cultural validation, as we found different cut‐off values for ethnic subgroups to obtain optimal sensitivity and specificity for detecting depressive and/or anxiety disorders. Copyright © 2009 John Wiley & Sons, Ltd.

Keywords: ethnic groups, psychometrics, mass screening, anxiety disorders, depressive disorders

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REFERENCES

  1. Agyemang C., Ujcic‐Voortman J., Uitenbroek D., Foets M., Droomers M. (2006) Prevalence and management of hypertension among Turkish, Moroccan and native Dutch ethnic groups in Amsterdam, the Netherlands: The Amsterdam Health Monitor Survey. Journal of Hypertension, 24, 2169–2176. [DOI] [PubMed] [Google Scholar]
  2. Ali O.M., Milstein G., Marzuk P.M. (2005) The Imam's role in meeting the counselling needs of Muslim communities in the United States. Psychiatric Services, 56, 202–205. [DOI] [PubMed] [Google Scholar]
  3. Al‐Krenawi A. (2005) Mental health practice in Arab countries. Current Opinion in Psychiatry, 18, 560–564. [DOI] [PubMed] [Google Scholar]
  4. Alonso J., Angermeyer M.C., Lépine J.P. (2004) The European Study of the Epidemiology of Mental Disorders (ESEMeD) project: an epidemiological basis for informing mental health policies in Europe. Acta Psychiatrica Scandinavica, 109(Suppl. 420), 5–7. [DOI] [PubMed] [Google Scholar]
  5. Andrews G., Slade T. (2001) Interpreting scores on the Kessler Psychological Distress Scale (K10). Australian and New Zealand Journal of Public Health, 25, 494–497, DOI: 10.1111/j.1467‐842X.2001.tb00310.x [DOI] [PubMed] [Google Scholar]
  6. Aydin I.O., Uluşahin A. (2001) Depression, anxiety comorbidity, and disability in tuberculosis and chronic obstructive pulmonary disease patients: applicability of GHQ‐12. General Hospital Psychiatry, 23, 77–83, DOI: 10.1016/S0163‐8343(01)00116‐5 [DOI] [PubMed] [Google Scholar]
  7. Azocar F., Aréan P., Miranda J., Muños R.F. (2001) Differential item functioning in a Spanish translation of the Beck Depression Inventory. Journal of Clinical Psychology, 57, 355–365, DOI: 10.1002/jclp.1017 [DOI] [PubMed] [Google Scholar]
  8. Beck A.T., Ward C.H., Mendelson M., Mock J., Erbaugh J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571. [DOI] [PubMed] [Google Scholar]
  9. Bengi‐Arslan L., Verhulst F.C., Crijnen A.A. (2002) Prevalence and determinants of minor psychiatric disorder in Turkish immigrants living in the Netherlands. Social Psychiatry and Psychiatric Epidemiology, 37, 118–124, DOI: 10.1007/s001270200003 [DOI] [PubMed] [Google Scholar]
  10. Bhugra D. (2004) Migration, distress and cultural identity. British Medical Bulletin, 69, 129–141, DOI: 10.1093/bmb/ldh007 [DOI] [PubMed] [Google Scholar]
  11. Boufous S., Silove D., Bauman A., Steel Z. (2005) Disability and health service utilization associated with psychological distress: the influence of ethnicity. Mental Health Services Research, 7, 171–179, DOI: 10.1007/s11020‐005‐5785‐2 [DOI] [PubMed] [Google Scholar]
  12. Cairney J., Veldhuizen S., Wade T.J., Kurdyak P., Streiner D.L. (2007) Evaluation of 2 measures of psychological distress as screeners for depression in the general population. Canadian Journal of Psychiatry, 52, 111–120. [DOI] [PubMed] [Google Scholar]
  13. Chwastiak L.A., Von Korff M. (2003) Disability in depression and back pain. Evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting. Journal of Clinical Epidemiology, 56, 507–514, DOI: 10.1016/S0895‐4356(03)00051‐9 [DOI] [PubMed] [Google Scholar]
  14. Crane P.K., Gibbons L.E., Jolley L., van Belle G. (2006) Differential item functioning analysis with ordinal logistic regression techniques. DIFdetect and difwithpar. Medical Care, 44(Suppl. 3), 115–123. [DOI] [PubMed] [Google Scholar]
  15. de Wit M.A.S., Tuinebreijer W.C., Dekker J., Beekman, A.T.F. , Gorissen W.H.M., Schrier A.C., Penninx B.W.J.H., Komproe I.H., Verhoeff, A.P. (2008) Depressive and anxiety disorders in different ethnic groups: A population based study among native Dutch, and Turkish, Moroccan and Surinamese migrants in Amsterdam. Social Psychiatry and Psychiatric Epidemiology, 43, 905–912, DOI: 10.1007/s00127‐008‐0382‐5 [DOI] [PubMed] [Google Scholar]
  16. Fischer G.H., Molenaar I.W. (1995) Rasch Models: Foundations, Recent Developments, and Applications, Springer Verlag. [Google Scholar]
  17. Furukawa T.A., Kessler R.C., Slade T., Andrews G. (2003) The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well‐Being. Psychological Medicine, 33, 357–362, DOI: 10.1017/S0033291702006700 [DOI] [PubMed] [Google Scholar]
  18. Hansson S.L., Svanström Röjvall A., Rastam M., Gillberg C., Gillberg C., Anckarsäter H. (2005) Psychiatric telephone interview with parents for screening of childhood autism – tics, attention‐deficit hyperactivity disorder and other comorbidities (A‐TAC): preliminary reliability and validity. British Journal of Psychiatry, 187, 262–267. [DOI] [PubMed] [Google Scholar]
  19. Hides L., Lubman D.I., Devlin H., Cotton S., Aitken C., Gibbie T., Hellard M. (2007) Reliability and validity of the Kessler 10 and Patient Health Questionnaire among injecting drug users. Australian and New Zealand Journal of Psychiatry, 41, 166–168. [DOI] [PubMed] [Google Scholar]
  20. Karam E.G., Yabroudi P., Nasser‐Karam A., Mansour C., Sabah S., Al Atrash R. (1995) The Arabic Composite International Diagnostic Interview (CIDI). Arabic Journal of Psychiatry, 6, 19–29. [Google Scholar]
  21. Kessler R.C. (2007) The global burden of anxiety and mood disorders: putting ESEMeD findings into perspective. Journal of Clinical Psychiatry, 68(Suppl. 2), 10–19. [PMC free article] [PubMed] [Google Scholar]
  22. Kessler R.C., Andrews G., Colpe L.J., Hiripi E., Mroczek D.K., Normand S.‐L.T., Walters E.E., Zaslavsky A.M. (2002) Short screening scales to monitor population prevalences and trends in non‐specific psychological distress. Psychological Medicine, 32, 959–976, DOI: 10.1017/S0033291702006074 [DOI] [PubMed] [Google Scholar]
  23. Kessler R.C., Barker P.R., Colpe L.J., Epstein J.F., Gfroerer J.C., Hiripi E., Howes M.J., Normand S.L., Manderscheid R.W., Walters E.E., Zaslavsky A.M. (2003) Screening for serious mental illness in the general population. Archives of General Psychiatry, 60, 184–189. [DOI] [PubMed] [Google Scholar]
  24. Kirmayer L.J. (2001) Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62(Suppl. 13), 22–28. [PubMed] [Google Scholar]
  25. Kojima M., Furukawa T.A., Takahashi H., Kawai M., Nagaya T., Tokudome S. (2002) Cross‐cultural validation of the Beck Depression Inventory‐II in Japan. Psychiatry Research, 110, 291–299. [DOI] [PubMed] [Google Scholar]
  26. Marwaha S., Livingston G. (2002) Stigma, racism or choice. Why do depressed ethnic elders avoid psychiatrists? Journal of Affective Disorders, 72, 257–265, DOI: 10.1016/S0165‐0327(00)00381‐5 [DOI] [PubMed] [Google Scholar]
  27. Muthén L.K., Muthén B.O. (2007) Mplus User's Guide, 4th ed., Muthén & Muthén. [Google Scholar]
  28. O&S website . (2007) Available: http://www.os.amsterdam.nl/ [29 May 2007].
  29. Radloff L.S. (1977) The CES‐D scale: a self‐report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. [Google Scholar]
  30. Rodgers B., Parslow R., Degenhardt L. (2007) Affective disorders, anxiety disorders and psychological distress in non‐drinkers. Journal of Affective Disorders, 99, 165–172, DOI: 10.1016/j.jad.2006.09.006 [DOI] [PubMed] [Google Scholar]
  31. Sartorius N., Jablensky A., Gulbinat W., Ernberg G. (1980) WHO collaborative study: assessment of depressive disorders. Psychological Medicine, 10, 743–749. [DOI] [PubMed] [Google Scholar]
  32. Schrier A.C., de Wit M.A.S., Dekker J., Kupka R.W., Beekman A.T.F. (2007) Similar depressive symptom patterns in a population based study of immigrants from Turkey and Morocco and Dutch natives, Abstract presented at the American Psychiatric Association Annual Meeting, San Diego.
  33. Simon G.E., Goldberg D.P., Von Korff M., Üstün T.B. (2002) Understanding cross‐national differences in depression prevalence. Psychological Medicine, 32, 585–594, DOI: 10.1017/S0033291702005457 [DOI] [PubMed] [Google Scholar]
  34. SPSS Inc . (2006) SPSS for Windows, Version 14.0.2, SPSS Inc.
  35. Streiner D.L., Norman G.R. (2003) Health Measurement Scales. A Practical Guide to their Development and Use, Oxford University Press. [Google Scholar]
  36. Uluğ B., Ertuğrul A., Göğüs A., Kabakci E. (2001) Reliability and validity of the Turkish version of the World Health Organization disability assessment schedule (WHO–DAS‐II). Turkish Journal of Psychiatry, 12, 121–130. [Google Scholar]
  37. van der Wurff F.B., Beekman A.T.F., Dijkshoorn H., Spijker J.A., Smits C.H.M., Stek M.L. Verhoeff A. (2004) Prevalence and risk‐factors for depression in elderly Turkish and Moroccan migrants in the Netherlands. Journal of Affective Disorders, 83, 33–41, DOI: 10.1016/j.jad.2004.04.009 [DOI] [PubMed] [Google Scholar]
  38. Verhelst N.D., Glas C.A.W. (1995) The one parameter logistic model In: Rasch Models: Foundations, Recent Developments, and Applications (eds Fischer G.H., Molenaar I.W.), pp. 215–238, Springer Verlag. [Google Scholar]
  39. Watters C. (2002) Migration and mental health care in Europe: report of a preliminary mapping exercise. Journal of Ethnic and Migration Studies, 28, 153–172. [Google Scholar]
  40. World Health Organization (WHO) . (1997) Composite International Diagnostic Interview (CIDI), version 2.1, WHO. [Google Scholar]
  41. WHO World Mental Health Survey Consortium . (2004) Prevalence, severity, and unmet need for treatment of Mental Disorders in the World Health Organization World Mental Health Surveys. JAMA, 291, 2581–2590. [DOI] [PubMed] [Google Scholar]
  42. WHODAS Website . (2007) Available: http://www.who.int/icidh/whodas/ [accessed 16 August 2007].
  43. Zung W.W. (1965) A self rating depression scale. Archives of General Psychiatry, 12, 63–70. [DOI] [PubMed] [Google Scholar]

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