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Soc Psychiatry Psychiatr Epidemiol. 2006 Mar;41(3):248-50. Epub 2006 Feb 28.

Cross-cultural use of the predetermined scale cutoff points in refugee mental health research.

Author information

1
Dept. of Community Health, School of International Health Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bukyo-ku Tokyo, Japan. masao@m.u-tokyo.ac.jp

Abstract

BACKGROUND:

Cross-cultural use of the cutoff points determined in Indo-Chinese refugees of the Hopkins Symptom Checklist-25 (HSCL-25) and the Harvard Trauma Questionnaire (HTQ) is common in refugee mental health research but it might have caused misclassifications.

METHODS:

We assessed the validity of the predetermined cutoff points in identifying depression and post-traumatic stress disorder (PTSD) cases among Afghan refugees, with the algorithm method as a gold standard. We estimated the prevalence of depression and PTSD, using the HSCL-25 and the HTQ with the cutoff points and the algorithm method, and calculated sensitivity, specificity, positive and negative predictive values of the cutoff points.

RESULTS:

Nine in ten PTSD cases/non-cases were correctly identified as cases/non-cases, and nine in ten respondents classified as PTSD cases/non-cases were actually cases/non-cases. In contrast, only one in three non-depression cases was correctly identified as a non-case, and three in five respondents who were classified as depression cases was actually a case. The prevalence of depression was estimated to be 86% with the cutoff points and 53% with the algorithm method, and that of PTSD 46% and 44%, respectively.

CONCLUSIONS:

The cutoff point approach might have low specificity and positive predictive value particularly for depression in our study. Cross-cultural use of the scale cutoff points determined in one cultural group to another needs to be reconsidered.

PMID:
16518569
DOI:
10.1007/s00127-005-0016-2
[Indexed for MEDLINE]

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