{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:58:12Z","timestamp":1791421092314,"version":"4.3.3"},"reference-count":59,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Much of the research about the validity of depression screening questionnaires is on criterion validity. Evidence is scarce on the concurrent, convergent and construct validity of these measures, particularly from low-income countries. This study aimed to evaluate the psychometric properties of depression screening questionnaires in primary healthcare (PHC) in rural Ethiopia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A facility-based cross-sectional study was conducted with 587 participants recruited from patients attending three PHC facilities and two \u2018Holy water sites\u2019 (places where religious treatment is being provided). The psychometric properties of five mental health screening questionnaires were evaluated: the nine item Patient Health Questionnaire (PHQ-9), the two item version of PHQ-9 (PHQ-2), a version of PHQ-9 with two added items of irritability and noise intolerance (PHQ-11), the Patient Health Questionnaire-15 (PHQ-15), and the World Health Organization-Five Well-being Index (WHO-5). Clinical diagnosis of depression was ascertained by psychiatrists. We analyzed data using exploratory factor analysis, Spearman\u2019s rank order correlation coefficient (Rho), the Mann Whitney test of the equality of medians, univariate logistic regression and Cronbach\u2019s alpha.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>PHQ-9, PHQ-11 and WHO-5 were found to be unidimensional, with items in each scale highly loading onto one factor (factor loadings ranging from 0.64 to 0.87). The items of each instrument were internally consistent, with Cronbach\u2019s alpha ranging from 0.72 (PHQ-2) to 0.89 (PHQ-11). Scores for all screening scales were moderately or highly correlated with each other (Rho\u2009=\u20090.58 to 0.98) and moderately correlated with anxiety and disability scores. Median scores of all screening scales were significantly higher in those diagnosed with depression. The association of items measuring emotional and cognitive symptoms with the diagnosis of depression was stronger than the association with items measuring somatic symptoms. Irritability and noise intolerance had higher association with depression diagnosis than PHQ-9 items.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Emotional and cognitive symptoms are more useful than somatic symptoms to predict the diagnosis of depression in the PHC context in Ethiopia. Future research should focus on testing the unidimensionality of PHQ-9, PHQ-11 and WHO-5 using confirmatory factor analysis; establishing the criterion validity of PHQ-11 and WHO-5; and on assessing test-retest reliability of all the measures.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12875-022-01755-2","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T07:08:57Z","timestamp":1654153737000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Psychometric properties of screening questionnaires to detect depression in primary healthcare setting in rural Ethiopia"],"prefix":"10.1186","volume":"23","author":[{"given":"Kassahun","family":"Habtamu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahel","family":"Birhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girmay","family":"Medhin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Hanlon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebaw","family":"Fekadu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"issue":"11","key":"1755_CR1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001547","volume":"10","author":"AJ Ferrari","year":"2013","unstructured":"Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJ, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med. 2013;10(11):e1001547.","journal-title":"PLoS Med"},{"issue":"11","key":"1755_CR2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030442","volume":"3","author":"CD Mathers","year":"2006","unstructured":"Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.","journal-title":"PLoS Med"},{"issue":"2","key":"1755_CR3","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/S2215-0366(15)00505-2","volume":"3","author":"D Vigo","year":"2016","unstructured":"Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry. 2016;3(2):171\u20138.","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"1755_CR4","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1002\/mpr.139","volume":"12","author":"PS Wang","year":"2003","unstructured":"Wang PS, Simon G, Kessler RC. The economic burden of depression and the cost-effectiveness of treatment. Int J Methods Psychiatr Res. 2003;12(1):22\u201333.","journal-title":"Int J Methods Psychiatr Res"},{"issue":"4","key":"1755_CR5","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1007\/s11121-011-0231-8","volume":"12","author":"KA McLaughlin","year":"2011","unstructured":"McLaughlin KA. The public health impact of major depression: a call for interdisciplinary prevention efforts. Prev Sci. 2011;12(4):361\u201371.","journal-title":"Prev Sci"},{"issue":"13","key":"1755_CR6","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.1001\/archinte.160.13.1913","volume":"160","author":"JL Januzzi","year":"2000","unstructured":"Januzzi JL, Stern TA, Pasternak RC, DeSanctis RW. The influence of anxiety and depression on outcomes of patients with coronary artery disease. Arch Intern Med. 2000;160(13):1913\u201321.","journal-title":"Arch Intern Med"},{"issue":"4","key":"1755_CR7","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/0163-8343(92)90094-Q","volume":"14","author":"W Katon","year":"1992","unstructured":"Katon W, Schulberg H. Epidemiology of depression in primary care. Gen Hosp Psychiatry. 1992;14(4):237\u201347.","journal-title":"Gen Hosp Psychiatry"},{"issue":"1","key":"1755_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12875-017-0628-y","volume":"18","author":"A Fekadu","year":"2017","unstructured":"Fekadu A, Medhin G, Selamu M, Giorgis TW, Lund C, Alem A, et al. Recognition of depression by primary care clinicians in rural Ethiopia. BMC Fam Pract. 2017;18(1):1\u20139.","journal-title":"BMC Fam Pract"},{"key":"1755_CR9","volume-title":"National Mental Health Strategy 2012\/13\u20132015\/16","author":"Federal Democratic Repubic of Ethiopia Ministry of Health","year":"2012","unstructured":"Federal Democratic Repubic of Ethiopia Ministry of Health. National Mental Health Strategy 2012\/13\u20132015\/16. Addis Ababa: Federal Ministry of Health; 2012."},{"key":"1755_CR10","unstructured":"World Health Organization. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: mental health Gap Action Programme ( mhGAP): Geneva: WHO; 2016."},{"issue":"8","key":"1755_CR11","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1177\/070674371305800802","volume":"58","author":"MA Craven","year":"2013","unstructured":"Craven MA, Bland R. Depression in primary care: current and future challenges. Can J Psychiatr. 2013;58(8):442\u20138.","journal-title":"Can J Psychiatr"},{"issue":"9690","key":"1755_CR12","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1016\/S0140-6736(09)60879-5","volume":"374","author":"AJ Mitchell","year":"2009","unstructured":"Mitchell AJ, Vaze A, Rao S. Clinical diagnosis of depression in primary care: a meta-analysis. Lancet. 2009;374(9690):609\u201319.","journal-title":"Lancet"},{"issue":"2","key":"1755_CR13","first-page":"34","volume":"26","author":"M Udedi","year":"2014","unstructured":"Udedi M. The prevalence of depression among patients and its detection by primary health care workers at Matawale Health Centre (Zomba). Malawi Med J. 2014;26(2):34\u20137.","journal-title":"Malawi Med J"},{"key":"1755_CR14","doi-asserted-by":"publisher","unstructured":"Ferenchick EK, Ramanuj P, Pincus HA. Depression in primary care: part 1\u2014screening and diagnosis. BMJ. 2019;365:1794. https:\/\/doi.org\/10.1136\/bmj.l794.","DOI":"10.1136\/bmj.l794"},{"issue":"1","key":"1755_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12916-017-0903-8","volume":"15","author":"BD Thombs","year":"2017","unstructured":"Thombs BD, Saadat N, Riehm KE, Karter JM, Vaswani A, Andrews BK, et al. Consistency and sources of divergence in recommendations on screening with questionnaires for presently experienced health problems or symptoms: a comparison of recommendations from the Canadian Task Force on Preventive Health Care, UK National Screening Committee, and US Preventive Services Task Force. BMC Med. 2017;15(1):1\u201317.","journal-title":"BMC Med"},{"issue":"8","key":"1755_CR16","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1503\/cmaj.070281","volume":"178","author":"S Gilbody","year":"2008","unstructured":"Gilbody S, Sheldon T, House A. Screening and case-finding instruments for depression: a meta-analysis. Cmaj. 2008;178(8):997\u20131003.","journal-title":"Cmaj"},{"key":"1755_CR17","doi-asserted-by":"publisher","unstructured":"Romera I, Montejo AL, Aragones E, Angel Arbesu J, Iglesias-Garcia C, Lopez S, et al. Systematic depression screening in high-risk patients attending primary care: a pragmatic cluster-randomized trial. BBC Psychiatry. 2013;13(83). https:\/\/doi.org\/10.1186\/1471-244X-13-83.","DOI":"10.1186\/1471-244X-13-83"},{"issue":"3","key":"1755_CR18","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1176\/ps.2009.60.3.322","volume":"60","author":"KA Yonkers","year":"2009","unstructured":"Yonkers KA, Smith MV, Lin H, Howell HB, Shao L, Rosenheck RA. Depression screening of perinatal women: an evaluation of the healthy start depression initiative. Psychiatr Serv. 2009;60(3):322\u20138.","journal-title":"Psychiatr Serv"},{"issue":"7283","key":"1755_CR19","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1136\/bmj.322.7283.406","volume":"322","author":"SM Gilbody","year":"2001","unstructured":"Gilbody SM, House AO, Sheldon TA. Routinely administered questionnaires for depression and anxiety: systematic review. BMJ. 2001;322(7283):406\u20139.","journal-title":"BMJ"},{"key":"1755_CR20","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.jad.2015.07.015","volume":"186","author":"C Hanlon","year":"2015","unstructured":"Hanlon C, Medhin G, Selamu M, Breuer E, Worku B, Hailemariam M, et al. Validity of brief screening questionnaires to detect depression in primary care in Ethiopia. J Affect Disord. 2015;186:32\u20139.","journal-title":"J Affect Disord"},{"issue":"6","key":"1755_CR21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156939","volume":"11","author":"G-C Ali","year":"2016","unstructured":"Ali G-C, Ryan G, De Silva MJ. Validated screening tools for common mental disorders in low and middle income countries: a systematic review. PLoS One. 2016;11(6):e0156939.","journal-title":"PLoS One"},{"key":"1755_CR22","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1016\/j.jad.2017.08.060","volume":"225","author":"S El-Den","year":"2018","unstructured":"El-Den S, Chen TF, Gan Y-L, Wong E, O\u2019Reilly CL. The psychometric properties of depression screening tools in primary healthcare settings: A systematic review. J Affect Disord. 2018;225:503\u201322.","journal-title":"J Affect Disord"},{"issue":"2","key":"1755_CR23","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/j.psychres.2013.07.015","volume":"210","author":"B Gelaye","year":"2013","unstructured":"Gelaye B, Williams MA, Lemma S, Deyessa N, Bahretibeb Y, Shibre T, et al. Validity of the patient health questionnaire-9 for depression screening and diagnosis in East Africa. Psychiatry Res. 2013;210(2):653\u201361.","journal-title":"Psychiatry Res"},{"issue":"1","key":"1755_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12888-020-02850-3","volume":"20","author":"M Degefa","year":"2020","unstructured":"Degefa M, Dubale B, Bayouh F, Ayele B, Zewde Y. Validation of the PHQ-9 depression scale in Ethiopian cancer patients attending the oncology clinic at Tikur Anbessa specialized hospital. BMC Psychiatry. 2020;20(1):1\u20137.","journal-title":"BMC Psychiatry"},{"issue":"1","key":"1755_CR25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0016049","volume":"6","author":"AA Reda","year":"2011","unstructured":"Reda AA. Reliability and validity of the Ethiopian version of the hospital anxiety and depression scale (HADS) in HIV infected patients. PLoS One. 2011;6(1):e16049.","journal-title":"PLoS One"},{"issue":"1","key":"1755_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-244X-14-194","volume":"14","author":"A Fekadu","year":"2014","unstructured":"Fekadu A, Medhin G, Selamu M, Hailemariam M, Alem A, Giorgis TW, et al. Population level mental distress in rural Ethiopia. BMC Psychiatry. 2014;14(1):1\u201313.","journal-title":"BMC Psychiatry"},{"issue":"1","key":"1755_CR27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13033-018-0259-2","volume":"13","author":"K Habtamu","year":"2019","unstructured":"Habtamu K, Medhin G, Selamu M, Tirfessa K, Hanlon C, Fekadu A. Functional impairment among people diagnosed with depression in primary healthcare in rural Ethiopia: a comparative cross-sectional study. Int J Ment Heal Syst. 2019;13(1):1\u201312.","journal-title":"Int J Ment Heal Syst"},{"issue":"s56","key":"1755_CR28","doi-asserted-by":"publisher","first-page":"s4","DOI":"10.1192\/bjp.bp.114.153676","volume":"208","author":"A Fekadu","year":"2016","unstructured":"Fekadu A, Hanlon C, Medhin G, Alem A, Selamu M, Giorgis TW, et al. Development of a scalable mental healthcare plan for a rural district in Ethiopia. Br J Psychiatry. 2016;208(s56):s4\u2013s12.","journal-title":"Br J Psychiatry"},{"key":"1755_CR29","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112760","volume":"246","author":"R Mayston","year":"2020","unstructured":"Mayston R, Frissa S, Tekola B, Hanlon C, Prince M, Fekadu A. Explanatory models of depression in sub-Saharan Africa: Synthesis of qualitative evidence. Soc Sci Med. 2020;246:112760.","journal-title":"Soc Sci Med"},{"issue":"9","key":"1755_CR30","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606\u201313.","journal-title":"J Gen Intern Med"},{"key":"1755_CR31","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1097\/00006842-200203000-00008","volume":"64","author":"K Kroenke","year":"2002","unstructured":"Kroenke K, Spitzer R, Williams J. The PHQ-15: Validity of a new measure forevaluating somatic symptom severity. Psychosom Med. 2002;64:258\u201366.","journal-title":"Psychosom Med"},{"issue":"2","key":"1755_CR32","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1002\/mpr.145","volume":"12","author":"P Bech","year":"2003","unstructured":"Bech P, Olsen LR, Kjoller M, Rasmussen NK. Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five well-being scale. Int J Methods Psychiatr Res. 2003;12(2):85\u201391.","journal-title":"Int J Methods Psychiatr Res"},{"issue":"3","key":"1755_CR33","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1067\/mob.2000.106580","volume":"183","author":"RL Spitzer","year":"2000","unstructured":"Spitzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J, Group PHQO-GS. Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PRIME-MD patient health questionnaire obstetrics-gynecology study. Am J Obstet Gynecol. 2000;183(3):759\u201369.","journal-title":"Am J Obstet Gynecol"},{"key":"1755_CR34","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychaitric Association","year":"1994","unstructured":"American Psychaitric Association. Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Anociation; 1994."},{"issue":"9","key":"1755_CR35","doi-asserted-by":"publisher","first-page":"509","DOI":"10.3928\/0048-5713-20020901-06","volume":"32","author":"K Kroenke","year":"2002","unstructured":"Kroenke K, Spitzer RL. The PHQ-9: A new depression diagnostic and severity measure. Psychaitr Ann. 2002;32(9):509\u201315.","journal-title":"Psychaitr Ann"},{"key":"1755_CR36","doi-asserted-by":"publisher","unstructured":"Ghazisaeedi M, Mahmoodi H, Arpaci I, Mehrdar S, Barzegari S. Validity, Reliability, and Optimal Cut-off Scores of the WHO-5, PHQ-9, and PHQ-2 to Screen Depression among University Students in Iran. Int J Ment Heal Addict. 2021:1\u201310. https:\/\/doi.org\/10.1007\/s11469-021-00483-5.","DOI":"10.1007\/s11469-021-00483-5"},{"key":"1755_CR37","doi-asserted-by":"publisher","unstructured":"Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003; 41(11):1284\u201392. https:\/\/doi.org\/10.1097\/01.MLR.0000093487.78664.3C.","DOI":"10.1097\/01.MLR.0000093487.78664.3C"},{"issue":"18","key":"1755_CR38","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1001\/jama.282.18.1737","volume":"282","author":"R Spitzer","year":"1999","unstructured":"Spitzer R, Kroenke K, Williams J. Patient Health Questionnaire Primary Care 676 Study G. Validation and utility of a self-report version of PRIME-MD: the PHQ 677 primary care study. Jama. 1999;282(18):1737\u201344.","journal-title":"Jama"},{"key":"1755_CR39","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.jpsychores.2017.08.002","volume":"101","author":"A Toussaint","year":"2017","unstructured":"Toussaint A, Kroenke K, Baye F, Lourens S. Comparing the Patient Health Questionnaire \u2013 15 and the Somatic Symptom Scale \u2013 8 as measures of somatic symptom burden. J Psychosom Res. 2017;101:44\u201350.","journal-title":"J Psychosom Res"},{"key":"1755_CR40","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.jpsychores.2017.10.005","volume":"103","author":"K Sitnikova","year":"2017","unstructured":"Sitnikova K, Dijkstra-Kersten SMA, Mokkink LB, Terluin B, van Marwijk HWJ, Leone SS, et al. Systematic review of measurement properties of questionnaires measuring somatization in primary care patients. J Psychosom Res. 2017;103:42\u201362.","journal-title":"J Psychosom Res"},{"key":"1755_CR41","doi-asserted-by":"publisher","unstructured":"Marsella AJ. Cultural aspects of depressive experience and disorders. Online Read Psychol Culture. 2003;10(2). https:\/\/doi.org\/10.9707\/2307-0919.108.","DOI":"10.9707\/2307-0919.108"},{"issue":"3","key":"1755_CR42","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.comppsych.2013.11.011","volume":"55","author":"YC Lyoo","year":"2014","unstructured":"Lyoo YC, Ju S, Kim E, Kim JE, Lee JH. The patient health questionnaire-15 and its abbreviated version as screening tools for depression in Korean college and graduate students. Compr Psychiatry. 2014;55(3):743\u20138.","journal-title":"Compr Psychiatry"},{"key":"1755_CR43","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.jad.2013.12.015","volume":"156","author":"T Krieger","year":"2014","unstructured":"Krieger T, Zimmermann J, Huffziger S, Ubl B, Diener C, Kuehner C, et al. Measuring depression with a well-being index: further evidence for the validity of the WHO Well-Being Index (WHO-5) as a measure of the severity of depression. J Affect Disord. 2014;156:240\u20134.","journal-title":"J Affect Disord"},{"issue":"3","key":"1755_CR44","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1159\/000376585","volume":"84","author":"CW Topp","year":"2015","unstructured":"Topp CW, \u00d8stergaard SD, S\u00f8ndergaard S, Bech P. The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015;84(3):167\u201376.","journal-title":"Psychother Psychosom"},{"issue":"1","key":"1755_CR45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s41256-018-0081-z","volume":"3","author":"E Chongwo","year":"2018","unstructured":"Chongwo E, Ssewanyana D, Nasambu C, Mwangala PN, Mwangi PM, Nyongesa MK, et al. Validation of a Swahili version of the World Health Organization 5-item well-being index among adults living with HIV and epilepsy in rural coastal Kenya. Global Health Res Policy. 2018;3(1):1\u20137.","journal-title":"Global Health Res Policy"},{"issue":"10","key":"1755_CR46","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","volume":"166","author":"RL Spitzer","year":"2006","unstructured":"Spitzer RL, Kroenke K, Williams JB, L\u00f6we B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092\u20137.","journal-title":"Arch Intern Med"},{"key":"1755_CR47","doi-asserted-by":"publisher","unstructured":"Sapra A, Bhandari P, Sharma S, Chanpura T, Lopp L. Using generalized anxiety disorder-2 (GAD-2) and GAD-7 in a primary care setting. Cureus. 2020;12(5):e8224. https:\/\/doi.org\/10.7759\/cureus.8224.","DOI":"10.7759\/cureus.8224"},{"issue":"8","key":"1755_CR48","doi-asserted-by":"publisher","first-page":"e0182162","DOI":"10.1371\/journal.pone.0182162","volume":"12","author":"P Jordan","year":"2017","unstructured":"Jordan P, Shedden-Mora MC, L\u00f6we B. Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory. PLoS One. 2017;12(8):e0182162.","journal-title":"PLoS One"},{"key":"1755_CR49","volume-title":"Measuring health and disability: Manual for WHO disability assessment schedule WHODAS 2.0","author":"TB \u00dcst\u00fcn","year":"2010","unstructured":"\u00dcst\u00fcn TB, Kostanjsek N, Chatterji S, Rehm J. Measuring health and disability: Manual for WHO disability assessment schedule WHODAS 2.0. Geneva: World Health Organization; 2010."},{"key":"1755_CR50","doi-asserted-by":"publisher","first-page":"815","DOI":"10.2471\/BLT.09.067231","volume":"88","author":"TB \u00dcst\u00fcn","year":"2010","unstructured":"\u00dcst\u00fcn TB, Chatterji S, Kostanjsek N, Rehm J, Kennedy C, Epping-Jordan J, et al. Developing the World Health Organization disability assessment schedule 2.0. Bull World Health Organ. 2010;88:815\u201323.","journal-title":"Bull World Health Organ"},{"issue":"1","key":"1755_CR51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12955-017-0647-3","volume":"15","author":"K Habtamu","year":"2017","unstructured":"Habtamu K, Alem A, Medhin G, Fekadu A, Dewey M, Prince M, et al. Validation of the World Health Organization disability assessment schedule in people with severe mental disorders in rural Ethiopia. Health Qual Life Outcomes. 2017;15(1):1\u201311.","journal-title":"Health Qual Life Outcomes"},{"key":"1755_CR52","doi-asserted-by":"publisher","unstructured":"B\u00f8en H. Characteristics of senior centre users\u2013and the impact of a group programme on social support and late-life depression. Norsk Epidemiol. 2012;22(2):261-269. https:\/\/doi.org\/10.5324\/nje.v22i2.1574.","DOI":"10.5324\/nje.v22i2.1574"},{"issue":"6","key":"1755_CR53","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1007\/s00127-006-0051-5","volume":"41","author":"OS Dalgard","year":"2006","unstructured":"Dalgard OS, Dowrick C, Lehtinen V, Vazquez-Barquero JL, Casey P, Wilkinson G, et al. Negative life events, social support and gender difference in depression. Soc Psychiatry Psychiatr Epidemiol. 2006;41(6):444\u201351.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"1","key":"1755_CR54","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1017\/S003329170002105X","volume":"15","author":"T Brugha","year":"1985","unstructured":"Brugha T, Bebbington P, Tennant C, Hurry J. The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychol Med. 1985;15(1):189\u201394.","journal-title":"Psychol Med"},{"issue":"1\u20132","key":"1755_CR55","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.jad.2008.05.009","volume":"113","author":"B Weobong","year":"2009","unstructured":"Weobong B, Akpalu B, Doku V, Owusu-Agyei S, Hurt L, Kirkwood B, et al. The comparative validity of screening scales for postnatal common mental disorder in Kintampo, Ghana. J Affect Disord. 2009;113(1\u20132):109\u201317.","journal-title":"J Affect Disord"},{"key":"1755_CR56","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.jad.2020.06.066","volume":"276","author":"D Lamela","year":"2020","unstructured":"Lamela D, Soreira C, Matos P, Morais A. Systematic review of the factor structure and measurement invariance of the patient health questionnaire-9 (PHQ-9) and validation of the Portuguese version in community settings. J Affect Disord. 2020;276:220\u201333.","journal-title":"J Affect Disord"},{"issue":"2","key":"1755_CR57","doi-asserted-by":"publisher","first-page":"e63","DOI":"10.1111\/dme.12040","volume":"30","author":"TR Hajos","year":"2013","unstructured":"Hajos TR, Pouwer F, Skovlund S, Den Oudsten BL, Geelhoed-Duijvestijn P, Tack C, et al. Psychometric and screening properties of the WHO-5 well-being index in adult outpatients with Type 1 or Type 2 diabetes mellitus. Diabet Med. 2013;30(2):e63\u20139.","journal-title":"Diabet Med"},{"issue":"2","key":"1755_CR58","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1007\/s12529-012-9237-2","volume":"20","author":"M Witth\u00f6ft","year":"2013","unstructured":"Witth\u00f6ft M, Hiller W, Loch N, Jasper F. The latent structure of medically unexplained symptoms and its relation to functional somatic syndromes. Int J Behav Med. 2013;20(2):172\u201383.","journal-title":"Int J Behav Med"},{"key":"1755_CR59","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.jad.2019.09.077","volume":"261","author":"FJ Cano-Garc\u00eda","year":"2020","unstructured":"Cano-Garc\u00eda FJ, Mu\u00f1oz-Navarro R, Abad AS, Moretti LS, Medrano LA, Ruiz-Rodr\u00edguez P, et al. Latent structure and factor invariance of somatic symptoms in the patient health questionnaire (PHQ-15). J Affect Disord. 2020;261:21\u20139.","journal-title":"J Affect Disord"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-022-01755-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-022-01755-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-022-01755-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,13]],"date-time":"2022-11-13T20:23:30Z","timestamp":1668371010000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcfampract.biomedcentral.com\/articles\/10.1186\/s12875-022-01755-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,2]]},"references-count":59,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1755"],"URL":"https:\/\/doi.org\/10.1186\/s12875-022-01755-2","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,2]]},"assertion":[{"value":"12 December 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki. The study protocol was reviewed and ethical approval was obtained from the Institutional Review Board of the College of Health Sciences, Addis Ababa University (Reference Number 007\/18\/Psy). Written informed consent was obtained from all the participants after the nature of the study and the information sought had been fully explained. Non-literate participants gave finger-prints to signify their willingness to participate. The nature and objective of the study were fully explained orally to the group of non-literate participants in understandable form and they gave finger-prints to signify their willingness to participate. Participants who were identified by the psychiatrists as having a mental health condition were provided with the appropriate treatment and follow-up in the out-patient psychiatric clinic in Bui Primary Hospital.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"N\/A.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"138"}}