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

Haney, Erica; Singh, Kavita; Nyamukapa, Constance; Gregson, Simon; Robertson, Laura; Sherr, Lorraine; Halpern, Carolyn Tucker

doi:10.1016/j.jad.2014.05.041

Cited by 9 publications

(9 citation statements)

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“…For example, 51.6% of HIV-infected adolescents aged 15–23 across 3 provinces in rural Zimbabwe, including Manicaland, reported an SSQ score ≥8 while 42% of adults aged 18 and over living in Harare reported an SSQ score >7 [ 8 , 36 ]. Some of these differences may be accounted for by dissimilarities in measurement including sampling methods, questionnaires and cut-off points used [ 37 ]. Differences in the timing of the studies may also be important: the data for the current study were collected between 2009 and 2011, a time of modest economic recovery and rapid scale-up of ART services in Zimbabwe, whereas some of the earlier studies took place in a period of political instability and economic decline which culminated in the collapse of the local currency in February 2009.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe

et al. 2017

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The correlation between mental health and sexual risk behaviours for HIV infection remains largely unknown in low and middle income settings. The present study determined the prevalence of psychological distress (PD) in a sub-Saharan African population with a generalized HIV epidemic, and investigated associations with HIV acquisition risk and uptake of HIV services using data from a cross-sectional survey of 13,252 adults. PD was measured using the Shona Symptom Questionnaire. Logistic regression was used to measure associations between PD and hypothesized covariates. The prevalence of PD was 4.5% (95% CI 3.9–5.1%) among men, and 12.9% (95% CI 12.2–13.6%) among women. PD was associated with sexual risk behaviours for HIV infection and HIV-infected individuals were more likely to suffer from PD. Amongst those initiated on anti-retroviral therapy, individuals with PD were less likely to adhere to treatment (91 vs. 96%; age- and site-type-adjusted odds ratio = 0.38; 95% CI 0.15, 0.99). Integrated HIV and mental health services may enhance HIV care and treatment outcomes in high HIV-prevalence populations in sub-Saharan Africa.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe

et al. 2017

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“…Third, SSQ-14 has not been specifically validated for use in adolescents younger than 18 years, therefore, the CMD prevalence in adolescents maybe underestimated. A cut-off of 5 or more has been found to be more effective than the original cut-off of 8 or more in capturing depression cases in adolescents [ 36 ]. Finally, it is difficult to be sure how widely our results can be generalized.…”

Section: Discussionmentioning

confidence: 99%

“…Our primary outcome was ‘probable Common Mental Disorder’ (CMD), measured by the 14-item Shona Symptom Questionnaire (SSQ-14) [ 35 , 36 ], which has been validated in a high HIV prevalence setting in Zimbabwe [ 37 ], and used in SSA as a robust and culturally relevant mental health measure [ 38 ]. The SSQ-14 asks whether participants have experienced a range of symptoms ever in the past seven days, including sleep disturbance, lack of concentration, irritability, slowness in activity, stomach ache, lack of energy, hopelessness and thoughts of suicide.…”

Section: Methodsmentioning

confidence: 99%

Common mental disorders and HIV status in the context of DREAMS among adolescent girls and young women in rural KwaZulu-Natal, South Africa

et al. 2021

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Background HIV affects many adolescent girls and young women (AGYW) in South Africa. Given the bi-directional HIV and mental health relationship, mental health services may help prevent and treat HIV in this population. We therefore examined the association between common mental disorders (CMD) and HIV-related behaviours and service utilisation, in the context of implementation of the combination DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) HIV prevention programme in rural uMkhanyakude district, KwaZulu-Natal. DREAMS involved delivering a package of multiple interventions in a single area to address multiple sources of HIV risk for AGYW. Methods We analysed baseline data from an age-stratified, representative cohort of 13–22 year-old AGYW. We measured DREAMS uptake as a count of the number of individual-level or community-based interventions each participant received in the last 12 months. CMD was measured using the validated Shona Symptom Questionnaire, with a cut off score ≥ 9 indicating probable CMD. HIV status was ascertained through home-based serotesting. We used logistic regression to estimate the association between CMD and HIV status adjusting for socio-demographics and behaviours. Results Probable CMD prevalence among the 2184 respondents was 22.2%, increasing steadily from 10.1% among 13 year-old girls to 33.1% among 22 year-old women. AGYW were more likely to report probable CMD if they tested positive for HIV (odds ratio vs. test negative: 1.88, 95% confidence interval: 1.40–2.53). After adjusting for socio-demographics and behaviours, there was evidence that probable CMD was more prevalent among respondents who reported using multiple healthcare-related DREAMS interventions. Conclusion We found high prevalence of probable CMD among AGYW in rural South Africa, but it was only associated with HIV serostatus when not controlling for HIV acquisition risk factors. Our findings highlight that improving mental health service access for AGYW at high risk for HIV acquisition might protect them. Interventions already reaching AGYW with CMD, such as DREAMS, can be used to deliver mental health services to reduce both CMD and HIV risks. There is a need to integrate mental health education into existing HIV prevention programmes in school and communities.

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“…The score range is 0–14 and scores ≥ 8 indicate risk of CMDs. The SSQ is especially sensitive in screening for depression and anxiety and has been extensively validated in the research setting [18, 19]. The Multidimensional Scale of Perceived Social Support (MSPSS), a 12-item outcome was used to measure SS.…”

Section: Main Textmentioning

confidence: 99%

A structural equation modelling of the buffering effect of social support on the report of common mental disorders in Zimbabwean women in the postnatal period

et al. 2019

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Objective Globally, 13–20% of women experience a common mental disorder (CMD) postnatally. Unfortunately, the burden of CMDs is disproportionally substantial in women from low-income countries. Nevertheless, there is a growing recognition of the buffering effect of social support (SS) on psychiatric morbidity and the need for mental well-being support services/interventions. This study evaluated the relationship between psychiatric morbidity and SS levels, and factors influencing the mental health functioning of Zimbabwean women postnatally. Data were collected from 340 mothers and were analysed through structural equation modelling. Results The mothers’ mean age was 26.6 (SD 5.6) years. The mean Multidimensional Scale of Perceived Social Support score was 42.7 (SD 10.8), denoting high levels of SS. Additionally, 29.1% of the population reported excessive psychiatric morbidity, the median Shona Symptoms Questionnaire score was 5 (IQR: 2–8). The structural equation model demonstrated the buffering effects of SS on psychiatric morbidity (r = − 0.585, p = 0.01), and accounted for 70% of the variance. Being unmarried, increased maternal age, lower educational and income levels were associated with poorer maternal mental health. There is a need for routine; surveillance and treatment of CMDs in women in the postnatal period, including integration of low-cost, evidenced-based and task-shifting SS interventions. Electronic supplementary material The online version of this article (10.1186/s13104-019-4151-1) contains supplementary material, which is available to authorized users.

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

Abstract: Not all depression scales are appropriate for use among adolescents given their unique developmental stage. An alternative cut point for depression classification could improve detection of depression among Zimbabwean adolescents.

Cited by 9 publications

References 58 publications

Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe

Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe

Common mental disorders and HIV status in the context of DREAMS among adolescent girls and young women in rural KwaZulu-Natal, South Africa

A structural equation modelling of the buffering effect of social support on the report of common mental disorders in Zimbabwean women in the postnatal period

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