Department of Psychiatry, Makerere University, Kampala, Uganda.
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
J Affect Disord. 2022 Aug 15;311:143-147. doi: 10.1016/j.jad.2022.05.022. Epub 2022 May 11.
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.
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).
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.
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.
The K-10 had good psychometric properties in this population and may be useful for measuring broad psychological distress in general medical settings.
心理困扰常被用作人群心理健康的替代指标。Kessler 心理困扰量表（K-10）是一种广泛用于心理困扰的简短筛查工具，但在撒哈拉以南非洲地区，对其效用的评估很少。我们在乌干达评估了它的结构效度和因子结构。
我们使用了一项正在进行的病例对照研究的数据。本研究的参与者是寻求普通医疗门诊服务的患者和精神疾病患者的照顾者。使用结构化问卷收集人口统计学数据，并用 K-10 评估心理困扰。通过探索性因子分析（EFA）和验证性因子分析（CFA）评估 K-10 的结构效度和因子结构。
共有 2104 名参与者纳入本分析，这些参与者是普通医疗环境中的对照组。K-10 的平均得分为 2.34，内部一致性为 0.86。EFA 得出了一个两因素解决方案，解释了 78.37%的方差。CFA 显示，心理困扰的单维模型与 K-10 项目之间的某些相关误差更为优越，其比较拟合指数为 0.95，塔克-刘易斯指数为 0.93，均方根误差逼近值为 0.08。
该研究仅限于评估内部一致性和结构效度。未来的研究需要检验标准效度并确定心理困扰的截止值。
K-10 在该人群中具有良好的心理测量学特性，可能有助于在普通医疗环境中测量广泛的心理困扰。
