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Administration mode of patient-reported outcome measures (PROMs) may influence responses. We assessed if Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale (EPDS) and Hospital Anxiety and Depression Scale - Depression subscale (HADS-D) item responses and scores were associated with administration mode. We compared (1) self-administration versus interview-administration; within self-administration (2) research or medical setting versus private; and (3) pen-and-paper versus electronic; and within interview-administration (4) in-person versus phone. We analysed individual participant data meta-analysis datasets with item-level data for the PHQ-9 (N = 34,529), EPDS (N = 16,813), and HADS-D (N = 16,768). We used multiple indicator multiple cause models to assess differential item functioning (DIF) by administration mode. We found statistically significant DIF for most items on all measures due to large samples, but influence on total scores was negligible. In 10 comparisons conducted across the PHQ-9, EPDS, and HADS-D, Pearson's correlations and intraclass correlation coefficients between latent depression symptom scores from models that did or did not account for DIF were between 0.995 and 1.000. Total PHQ-9, EPDS, and HADS-D scores did not differ materially across administration modes. Researcher and clinicians who evaluate depression symptoms with these questionnaires can select administration methods based on patient preferences, feasibility, or cost., Competing Interests: Declaration of competing interest All authors have completed the ICJME uniform disclosure form. Dr. Vigod declares that she receives royalties from UpToDate, outside the submitted work. Dr. Beck CT declares that she receives royalties for her Postpartum Depression Screening Scale published by Western Psychological Services. Dr. Bernstein declares that he has consulted to Abbvie Canada, Amgen Canada, Bristol Myers Squibb Canada, Eli Lilly, Ferring Canada, JAMP Pharmaceuticals, Janssen Canada, Pendopharm Canada, Pfizer Canada, Sandoz Canada, Takeda Canada. He has also received unrestricted educational grants from Abbvie Canada, Bristol Myers Squibb Canada, Eli Lilly, Ferring Canada, Organon Canada, Janssen Canada, Pfizer Canada, and Takeda Canada; as well as been on speaker's bureau of Abbvie Canada, Janssen Canada, Takeda Canada and Pfizer Canada, all outside the submitted work. Dr. Chan J CN is a steering committee member and/or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr. Chan LF declares personal fees and non-financial support from Otsuka, Lundbeck, and Johnson and Johnson; and non-financial support from Ortho-McNeil-Janssen, and Menarini, outside the submitted work. Dr. Hegerl declares that within the last three years, he was an advisory board member for Janssen and received a research grant from Medice, all outside the submitted work. Dr. Howard declares that she has received personal fees from NICE Scientific Advice, outside the submitted work. Dr. Inagaki declares that he has received personal fees from Meiji, Mochida, Takeda, Novartis, Yoshitomi, Pfizer, Eisai, Otsuka, MSD, Sumitomo Dainippon, Janssen, and Eli Lilly, all outside of the submitted work. Dr. Marrie declares that she is a co-investigator on a study funded in part by Biogen Idec and Roche (no funds to her), outside the submitted work. Dr. Pugh declares that she received salary support from Pfizer-Astella and Millennium, outside the submitted work. Dr. Sultan declares funding from Sanofi-Aventis Corporation, during conduct of the primary study. Dr. Sundström-Poromaa declares that she has served on advisory boards and acted as invited speaker at scientific meetings for MSD, Novo Nordisk, Bayer Health Care, and Lundbeck A/S. Dr. Lynne Wagner declares that she receives personal fees from Celgene, outside the submitted work. Dr. Yonkers declares that she receives royalties from UpTodate, outside the submitted work. All other authors declare no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Psychological distress is often used as a proxy measure for the mental health of a population. The Kessler Psychological Distress Scale (K-10) is a widely used brief screening tool for psychological distress, yet few studies have evaluated its utility in sub-Saharan Africa. We evaluated its construct validity and factor structure in Uganda., Methods: We used data from an ongoing case-control study. Participants in the present study were patients seeking general medical outpatient services and caretakers of mentally ill persons. Demographic data were collected using a structured questionnaire, and psychological distress was assessed using the K-10. K-10 construct validity and factorial structure were assessed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)., Results: A total of 2104 participants were included in this analysis, these were controls from a general medical setting. The mean K-10 score was 2.34 with an internal consistency of 0.86. EFA resulted in a two-factor solution that accounted for 78.37% of the variance. CFA revealed that a unidimensional model of psychological distress with correlated errors between some of K-10 items was superior, with a comparative fit index of 0.95, Tucker-Lewis index of 0.93, and a root mean square error of approximation of 0.08., Limitations: The study was limited to evaluating internal consistency and construct validity. Future studies are warranted to examine criterion validity and establish cut-offs for psychological distress., Conclusions: The K-10 had good psychometric properties in this population and may be useful for measuring broad psychological distress in general medical settings., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Self-reporting of psychotic symptoms varies significantly between cultures and ethnic groups. Yet, limited validated screening instruments are available to capture such differences in the African continent., Methodology: Among 9,059 individuals participating as controls in a multi-country case-control study of the genetic causes of psychosis, we evaluated the psychometric properties of the Psychosis Screening Questionnaire (PSQ). We applied multi-group confirmatory factor analysis and item response theory to assess item parameters., Results: The overall positive endorsement of at least one item assessing psychotic symptoms on the PSQ was 9.7%, with variability among countries (Uganda 13.7%, South Africa 11%, Kenya 10.2%, and Ethiopia 2.8%). A unidimensional model demonstrated good fit for the PSQ (root mean square error of approximation = 0.009; comparative fit index = 0.997; and Tucker-Lewis Index = 0.995). Hypomania had the weakest association with single latent factor (standardized factor loading 0.62). Sequential multi-group confirmatory factor analysis demonstrated that PSQ items were measured in equivalent ways across the four countries. PSQ items gave more information at higher levels of psychosis, with hypomania giving the least discriminating information., Limitations: Participants were recruited from general medical facilities, so findings may not be generalizable to the general population., Conclusion: The PSQ demonstrated a unidimensional factor structure in these samples. Items were measured equivalently across all study settings, suggesting that differences in prevalence of psychotic symptoms between countries were less likely to represent measurement artifact. The PSQ is more reliable in screening for psychosis in individuals with higher degrees of psychotic experiences-hypomania excluded-and might decrease the false-positive rate from mild nonspecific psychotic experiences., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Depression is one of the commonest neuropsychiatric disorders in patients with diabetes mellitus (DM) and is associated with poor glycaemic control, vascular complications, a low quality of life and increased health care expenditure. Co-morbid DM and depression remains poorly identified and inadequately treated in sub-Saharan Africa., Methods: We conducted a cross-sectional survey of 437 patients with DM at 3 DM clinics in Uganda. Participants were assessed for depression, blood sugar levels, diabetic neuropathy, quality of life, and health care expenditures., Results: The prevalence of depression was 34.8%. Depressed participants were more likely to be suicidal [OR=3.81, (CI 2.87-5.04)], younger [OR=3.98 CI (1.20-13.23)], un-employed [OR=1.99(CI 1.04-3.81)], and having lost a spouse [OR=2.36 (CI 1.29-4.31)]. Overall quality of life was poor [OR=0.67 (CI 0.47-0.96)], they scored poorer in the physical [OR=0.97, (CI 0.95-0.99)], psychological [OR=1.05 (CI 1.03-1.07)], and environmental [OR=0.97, (CI 0.95-0.99)] domains. They had an increased likelihood of incurring direct out-of-pocket payments for health care services [OR=1.56 (CI 1.03-2.36)], and were more likely to be impoverished [OR=1.52 (CI 1.01-2.28)]., Limitation: The cross sectional nature of this study makes it difficult to examine causation. More studies are required in order to better understand the associations and impact of the factors examined above on patient outcomes., Conclusions: Depression is highly prevalent among patients with DM in Uganda, and is associated with a number of adverse outcomes. A holistic approach that focuses on the depression management among patients with diabetes is recommended., (Copyright © 2014 Elsevier B.V. All rights reserved.)