Validation of the Client Diagnostic Questionnaire to Assess Mental Health in South African Caregivers of Children

Claude A. Mellins, Shuaib Kauchali, Danielle F. Nestadt, Dan Bai, Angela Aidala, Nonhlahla Myeza, Murray H. Craib, Jane Kvalsvig, Cheng Shiun Leu, Justin Knox, Stephen Arpadi, Meera Chhagan, Leslie L. Davidson

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Given the high prevalence of mental health (MH) and substance abuse problems in low-to-middle income countries, the scarcity of MH professionals and the negative impact of psychiatric disorders on caregivers of young children, there is significant need for brief evidence-based screening tools for lay counselors to assist with MH assessment. This study aimed to validate a brief screening tool to assess psychiatric and substance use disorders, the Client Diagnostic Questionnaire (CDQ), in South Africa (SA). Methods: Data are from a longitudinal study of health and psychosocial needs in preschool children in SA. Participants included 322 Zulu-speaking, female caregivers. Following procedures of the US CDQ validation study, lay counselors interviewed participants using the translated Zulu CDQ. Subsequently a psychologist conducted a full psychiatric assessment guided by the CDQ questions. Analyses examined sensitivity, specificity and overall accuracy, comparing lay counselor and psychologist assessment. Results: Sensitivity (73%), specificity (81%) and overall accuracy (79%) were good for the variable indicating presence of ‘any diagnosis.’ Among those cases identified by the psychologist as having any psychiatric diagnosis, over 70% were correctly identified by lay counselors using the CDQ (i.e., positive predictive value was greater than 70%). The false positive rate was relatively low (19%). Specificity for ‘any disorder’ (including substance use) and ‘any psychiatric disorder’ were 81% and 79%. Conclusions: The isiZulu CDQ is a sensitive and valid MH diagnostic screener that can be used by lay counselors with limited MH training to identify those in need of treatment and target extremely scarce MH professionals.

Original languageEnglish (US)
Pages (from-to)245-254
Number of pages10
JournalClinical Psychology and Psychotherapy
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Keywords

  • Child Caregivers
  • HIV/AIDS
  • Mental health
  • Psychiatric Diagnostic Screener
  • South Africa
  • Task Shifting

ASJC Scopus subject areas

  • Clinical Psychology

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