BackgroundThere is a lack of screening tools for common mental disorders that can be applied across cultures, languages and levels of education in people with diabetes and hypertension.AimTo develop a visual screening tool for depression and anxiety disorders that is applicable across cultures and levels of education.SettingParticipants were purposively recruited from two not-for-profit organisations and two public health facilities – a maternal mental health unit and a primary health care centre.MethodThis was a qualitative cross-sectional study. Thirteen drawings based on the Hospital Anxiety and Depression Scale depicting symptoms of anxiety disorders and depression were drawn. Participants described emotions and thoughts depicted in the drawings. Data were analysed through content analysis.ResultsThirty-one women (66%) and 16 men (34%) participated in the development of the visual screening tool. The mean age was 34 (standard deviation [SD] 12.46). There were 32 (68%) black participants, 11 (23%) mixed race participants and 4 (9%) white participants. Two participants (4%) had no schooling, 14 (31%) primary schooling, 8 (18%) senior schooling, 13 (29%) matric qualification and 8 (18%) had post-matric qualification. Participants correctly described 10 out of the 13 visual depiction of symptoms as associated with depression and anxiety disorders, with no differences between levels of education and cultural groups.ConclusionTen drawings were appropriate for inclusion in the visual screening tool for anxiety disorders and depression (VISTAD). The VISTAD will be validated against the mini international neuropsychiatric interview (MINI) in a primary care population with hypertension and/or diabetes.
BackgroundDepression and anxiety disorders remain poorly detected at primary health care, particularly in patients with hypertension and/or diabetes. A visual screening tool for anxiety disorders and depression (VISTAD) has been developed, but not validated.AimTo validate the VISTAD in primary health care participants diagnosed with hypertension and/or diabetes.SettingParticipants were recruited from five primary health care centres in the Eastern Cape, South Africa (urban, peri-urban and rural).MethodsThe study used a cross-sectional study design to validate the VISTAD. The VISTAD was validated against the International Neuropsychiatric Interview (M.I.N.I) using field testing. A demographic questionnaire was used to collect data on socio-economic variables.ResultsSixty-nine (87%) females and 10 (13%) males with a mean age of 49 (SD 8.6844) participated in the study. Fifty black people (63%), 16 mixed race people (20%) and 13 white people (16%) participated in the study. The majority of the participants (77%) did not complete high school. The area under curve score (AUC) for the VISTAD in screening for depression was 0.91, and for anxiety disorders, 0.87 post-traumatic stress disorder, 0.87 panic disorder, 0.85 social phobia, 0.88 agoraphobia, and 0.83 generalised anxiety disorder revealing acceptable psychometric properties.ConclusionThe use of the VISTAD as a screening tool at primary health care in people living with hypertension and/or diabetes is recommended. The VISTAD could, therefore, play a key role in the prevention and early treatment of individuals diagnosed with hypertension and/or diabetes across cultures and levels of education. The VISTAD needs to be validated in a large population representative of primary care patients diagnosed with hypertension and/or diabetes.
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