Psychometric validity of the distress thermometer and problem check list in ART-naïve HIV infected patients in Northern Nigeria

BACKGROUND: HIV diagnosis comes with a lot of worry and distress. Ability to objectively estimate this distress by non-psychiatrist will enhance early detection of psychological distress for intervention. OBJECTIVES: To investigate the validity of the Distress Thermometer (DT) and its problem checklist in achieving early detection of mental distress among ART-naïve HIV infected patient. MATERIALS AND METHODS: A total of 90 ART-naïve HIV infected patients completed the DT and its problem check list, Hospital Anxiety Depression Scale (HADS), Oslo Social Support Scale and the 14-item Resilience Scale. RESULTS: The DT was positively correlated with all the measures of distress and reversely correlated with all the positive wellness in this study. The correlations were only significant for the negative measures of psychological wellness. The internal consistency of the DT's problem list overall and sub-categories were within acceptable range (i.e. α > 0.50). The Receiver Operating Characteristic (ROC) curves and Area Under the Curves (AUC) analysis were significant and found the DT and Problem List to respectively differentiate between cases of distress, anxiety and depression. The DT's cut-off was >5.0 with AUC range (0.754 – 0.709); sensitivity range (81.0% – 70.4%); specificity range (68.3% – 65.2%) for distress, anxiety and depression as determined by HADS. And the Problem List cut-off was >6.0 with AUC range (0.854 – 0.821); sensitivity range (90.5% – 85.7%); specificity range (68.3% – 65.2%) for distress, anxiety and depression as measured by HADS. CONCLUSION: The DT and Problem List were found to be valid measures of distress in ART-naïve HIV infected patients.