Psychometric properties and factor structure of the Kessler-10 among Ethiopian adults

Background: Many common mental disorders are underdiagnosed and undertreated in low-resource countries. The ten-item Kessler Psychological Distress Scale (K10) is a brief screening tool widely used to assess psychological distress. We evaluated the K10's performance in an Ethiopian population by assessing internal consistency and construct validity through factor structure.

Methods: K10 survey responses and sociodemographic data were collected from 1928 adults, including patients and caregivers from a general medical setting, who served as controls of a large epidemiological study.

Results: The K10 had good internal consistency, with a Cronbach's alpha of 0.83. Results from exploratory factor analyses showed that the K10 had a two-factor solution that accounted for approximately 66% of the variance. Confirmatory factor analyses demonstrated that a unidimensional model with correlated errors, informed by a theoretical model, was the best fitting model for the setting (comparative fit index of 0.90 and root mean square error of approximation of 0.10).

Limitations: We did not assess the K10's test-retest reliability or its criterion validity (i.e., agreement with a reference measure).

Conclusions: Based on internal consistency and construct validity, the K10 can effectively assess psychological distress among Ethiopian adults for population-based research and potentially clinical screening, consistent with previous findings in this setting. Further studies are needed to test its criterion validity against a reference measure of psychological distress.