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Measuring common mental disorders in women in Ethiopia: reliability and construct validity of the comprehensive
Charlotte Hanlon1, Girmay Medhin, Atalay Alem
1Health Services and Population Research Dept., King's College London, Institute of Psychiatry, P.O. Box 60, De Crespigny Park, Camberwell, London, SE5 8AF, UK. charlotte.hanlon@iop.kcl.ac.uk
Background:
There is a dearth of methodological studies critically evaluating reliability, validity and feasibility of measures of common mental disorders (CMD) in low-income countries.
Methods:
Test-retest and inter-rater reliability of categorisation of CMD caseness, according to locally agreed criteria using the Comprehensive Psychopathological Rating Scale (CPRS), was measured in 99 women from out-patient clinics (inter-rater) and 99 women from a primary healthcare centre (test-retest) in Ethiopia. The construct validity of CMD as measured with CPRS was assessed with exploratory factor analysis using maximum likelihood with varimax rotation.
Results:
Test-retest reliability was fair (kappa = 0.29). Subsequent assessment of inter-rater reliability found excellent agreement (kappa = 0.82). The construct of CMD appeared unidimensional, combining depressive, anxiety and somatic symptoms.
Conclusions:
Detection of socioculturally meaningful cases of CMD in Ethiopia can be reliably achieved with local psychiatrist assessment using CPRS, although thorough training is essential.
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