Validation of the depression anxiety stress scales (DASS) 21 as a screening instrument for depression and anxiety in a rural community-based cohort of northern Vietnamese women

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Background: Depression and anxiety are recognised increasingly as serious public health problems among womenin low- and lower-middle income countries. The aim of this study was to validate the 21-item Depression Anxietyand Stress Scale (DASS21) for use in screening for these common mental disorders among rural women withyoung children in the North of Vietnam.
Methods: The DASS-21 was translated from English to Vietnamese, culturally verified, back-translated andadministered to women who also completed, separately, a psychiatrist-administered Structured Clinical Interview forDSM IV Axis 1 diagnoses of depressive and anxiety disorders. The sample was a community-based representativecohort of adult women with young children living in Ha Nam Province in northern Viet Nam. Cronbach's alpha,Exploratory Factor Analyses (EFA) and Receiver Operating Characteristic (ROC) analyses were performed to identifythe psychometric properties of the Depression, Anxiety, and Stress subscales and the overall scale.
Results: Complete data were available for 221 women. The internal consistency (Cronbach's alpha) of eachsub-scale and the overall scale were high, ranging from 0.70 for the Stress subscale to 0.88 for the overall scale,but EFA indicated that the 21 items all loaded on one factor. Scores on each of the three sub-scales, and thecombinations of two or three of them were able to detect the common mental disorders of depression andanxiety in women with a sensitivity of 79.1 and a specificity of 77.0 at the optimal cut off of >33. However,they did not distinguish between those experiencing only depression or only anxiety.
Conclusions: The total score of the 21 items of the DASS21-Vietnamese validation appears to be comprehensible andsensitive to detecting common mental disorders in women with young children in primary health care in rural northern Vietnam and therefore might also be useful to screen for these conditions in other resource-constrained
Original languageEnglish
Article number24
Pages (from-to)24 - 30
Number of pages7
JournalBMC Psychiatry
Publication statusPublished - 2013

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