Psychiatric case finding in Ethiopia: shortcomings of the Self Reporting Questionnaire

Attenders of health care facilities usually present somatic complaints. It is important to identify the psychiatric patients among them, especially the neurotic complainers. They are at risk for being exposed to expensive somatic investigations and being prescribed useless and sometimes harmful drug treatment. The World Health Organization designed the Self Reporting Questionnaire (SRQ), to be a universally applicable psychiatric case finding instrument, for use in medical clinics. A feasibility study with this instrument was carried out with 110 respondents in Ethiopia. A moderate criterion validity was found, limitations being partly due to the sensitivity of the SRQ to help-seeking behavior, even in the absence of any mental illness. This study also revealed problems in transcultural communication because many of the diagnostic concepts used in this instrument were too western to be transposed unchanged to the Ethiopian culture. Items need fairly extensive modification to be applicable there.