This study underlines the necessity of validating instruments along with cultural context and gender. For men the cut-off point for the HSCL-25 is lower than usual (1.50) and for the SRQ-20 it was 10). For women the optimal cut-off points are higher than usual (2.25 for the HSCL-25 and 17 for the SRQ-20). The optimal cut-off points for this population are different from those often used in transcultural research.
All instruments were administered to a sample of 116 Pashto-speaking patients (53 men, 63 women) attending primary health care facilities in Eastern Afghanistan.īoth HSCL-25 and SRQ-20 had modest properties to correctly identify mental disorders, with an AUC (area under the curve) of 0.73 and 0.72 respectively. The two mental health questionnaires were compared against a 'gold standard' semi-structured psychiatric interview, the Psychiatric Assessment Schedule (PAS). To explore the validity in the Afghan cultural context of two mental health questionnaires, the Hopkins Symptom Checklist-25 (HSCL-25) and the Self-Reporting Questionnaire-20 (SRQ-20). Recent epidemiological studies in Afghanistan using mental health questionnaires yielded high prevalence rates for anxiety and depression.
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