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Concordance between Hopkins Symptom Checklist (HSCL-10) and Pakistan Anxiety and Depression Questionnaire (PADQ), in a rural self-motivated population in Pakistan

Hammad Raza Syed1*, Henrik Daae Zachrisson2, Odd Steffen Dalgard2, Ingvild Dalen3 and Nora Ahlberg4

Author Affiliations

1 Institute of General Practice and Community Medicine, Oslo, Norway

2 Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway

3 Institute of Basic Medical Sciences, Department of Biostatistics, University of Oslo, Norway

4 National Centre for Minority Health Research, Oslo, Norway

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BMC Psychiatry 2008, 8:59  doi:10.1186/1471-244X-8-59

Published: 22 July 2008



There have been no previous studies conducted in Pakistan comparing the concordance of any well established Western anxiety/depression screening instrument with an indigenous scale, in a community based setting.


Participants (n = 1040) in the present study were recruited from the six villages of our interest from the district Gujarat of Pakistan, using a convenient sampling technique. Interview versions of the Hopkins Symptom Checklist 10-item version (HSCL-10) and the Pakistani Anxiety and Depression Questionnaire (PADQ) were used to observe the pattern of anxiety and depression among the participants.


The internal consistency of HSCL-10 and PADQ were 0.86 and 0.84 respectively. Exploratory factor analysis found evidence for both a one-dimensional (distress) and a two-dimensional (anxiety and depression) solution for the HSCL-10, but only a one-dimensional (distress) solution for the PADQ. The HSCL-10 and PADQ found to be moderately to highly correlated (r = 0.62, p < 0.0001, 0.73 after correction for attenuation).


HSCL-10 has shown good screening abilities in a rural setting in Pakistan, and moderate to good concordance with an indigenous instrument measuring psychological distress. The HSCL-10 can therefore be used as a screening instrument, both in clinical and epidemiological settings in Pakistan, and for Pakistani immigrants living in Western societies.