THE PRIMARY-CARE ANXIETY AND DEPRESSION (PCAD) SCALE - A CULTURE-ORIENTED SCREENING SCALE

The construction of a screening scale for states of anxiety and depres sion among primary health care (PHC) patients is described. Most of th e scale items were selected from a pool of items chosen from two inter national screening scales which were validated locally, namely the Sel f-Reporting Questionnaire (SRQ-20) and the Hospital Anxiety and Depres sion (HAD) Scale. A validity study of a new sample of PHC patients ind icated that the scale provided a valid measure of anxiety and depressi ve states, and was closely correlated with the psychiatrist's clinical judgement. The scale correlated more strongly with the psychiatrist's clinical judgement than the general practitioners' assessments. Two c ut-off points were established, one of which is more appropriate for c linical use and the other for prevalence estimation. The former thresh old of the scale could be used to alert the busy general practitioner to the possibility that clinically significant anxiety or depression m ay be present.