Ziegel Leo, da Silva Cristina Espinosa, Bulamba Robert, Daama Alex, Kigozi Grace, Miller Amanda P, Kigozi Godfrey, Kyasanku Emmanuel, Mugamba Stephen, Hammarberg Anders, Ekström Anna Mia, Nalugoda Fred, Hollander Anna-Clara
Department of Global Public Health, Karolinska Institutet, Solna, Stockholm, 17177, Sweden.
Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
BMC Psychiatry. 2025 May 19;25(1):502. doi: 10.1186/s12888-025-06944-8.
Locally validated measures are required for robust clinical and epidemiological assessments of anxiety symptoms and disorders. Few studies on the African continent have examined the psychometric properties of the Generalized Anxiety Disorder-7 scale (GAD-7). We aimed to investigate certain psychometric properties of GAD-7 translated into Runyoro and Luganda, two Ugandan languages, and to measure the prevalence of anxiety symptoms in a Ugandan population sample.
Data were collected in 2021-22 through the African Medical and Behavioural Sciences Organization (AMBSO) Population Health Surveillance (APHS), a population cohort study in Uganda. GAD-7, Patient Health Questionnaire-9 (PHQ-9), and questions on socio-demographic factors were administered during individual face-to-face interviews. Construct validity, internal consistency, and concurrent validity of the Runyoro- and Luganda-translated GAD-7 were examined using confirmatory factor analysis (CFA), two internal consistency coefficients (Revelle's omega total and Cronbach's alpha), and Pearson's correlation coefficient, respectively. The prevalence of anxiety symptoms and likely anxiety disorders was also estimated.
A total of 4107 individuals aged 13-80 participated, with 2206 and 1901 speaking Runyoro and Luganda, respectively. The Runyoro-translated GAD-7 retained its one-factor structure (RMSEA = 0.097, CFI = 0.977, TLI = 0.966), had good internal consistency (omega total = 0.85), and correlated moderately with the PHQ-9 (r = 0.67, p < 0.01). The Luganda-translated GAD-7 also fit a one-factor structure (RMSEA = 0.097, CFI = 0.989, TLI = 0.983), exhibited excellent internal consistency (omega total = 0.90), and strong concurrent validity with PHQ-9 (r = 0.71, p < 0.01). Overall, participants reported low levels of anxiety symptoms. Using GAD-7 ≥ 10 binary cut-offs, the total prevalence of likely anxiety disorders was 1.5% (0.5% among males, 2.2% among females).
GAD-7 was translated into Runyoro and Luganda, two Ugandan languages, and both translations showed good psychometric properties. The prevalence of likely anxiety disorders was low in this diverse large Ugandan population sample, the largest population study on anxiety in Uganda to date. The low prevalence could partly be due to individuals with more severe anxiety symptoms not participating or GAD-7 not including local idioms of anxiety. Further clinical validation is required.
进行焦虑症状和障碍的有力临床及流行病学评估需要经过本地验证的测量方法。非洲大陆上很少有研究考察广泛性焦虑障碍-7量表（GAD-7）的心理测量特性。我们旨在调查翻译成乌干达的两种语言鲁尼奥罗语和卢干达语的GAD-7的某些心理测量特性，并测量乌干达人群样本中焦虑症状的患病率。
2021年至2022年期间，通过非洲医学与行为科学组织（AMBSO）的人口健康监测（APHS）收集数据，这是一项在乌干达进行的人群队列研究。在个人面对面访谈中发放GAD-7、患者健康问卷-9（PHQ-9）以及关于社会人口学因素的问题。分别使用验证性因子分析（CFA）、两个内部一致性系数（雷维尔的ω总量和克朗巴哈α系数）以及皮尔逊相关系数，来检验翻译成鲁尼奥罗语和卢干达语的GAD-7的结构效度、内部一致性和同时效度。还估计了焦虑症状和可能的焦虑障碍的患病率。
共有4107名年龄在13至80岁之间的个体参与，其中分别有2206人和1901人说鲁尼奥罗语和卢干达语。翻译成鲁尼奥罗语的GAD-7保留了其一因素结构（RMSEA = 0.097，CFI = 0.977，TLI = 0.966），具有良好的内部一致性（ω总量 = 0.85），并且与PHQ-9中度相关（r = 0.67，p < 0.01）。翻译成卢干达语的GAD-7也符合一因素结构（RMSEA = 0.097，CFI = 0.989，TLI = 0.983），表现出出色的内部一致性（ω总量 = 0.90），并且与PHQ-9具有很强的同时效度（r = 0.71，p < 0.01）。总体而言，参与者报告的焦虑症状水平较低。使用GAD-7≥10的二分法临界值，可能的焦虑障碍的总患病率为1.5%（男性为0.5%，女性为2.2%）。
GAD-7被翻译成乌干达的两种语言鲁尼奥罗语和卢干达语，两种翻译版本均显示出良好的心理测量特性。在这个多样化的乌干达大型人群样本中，可能的焦虑障碍患病率较低，这是迄今为止乌干达关于焦虑的最大规模人群研究。患病率较低可能部分归因于焦虑症状较严重的个体未参与，或者GAD-7未包含焦虑的当地习语。需要进一步的临床验证。
