Anxiety and depression

Symptoms of anxiety and depression were assessed with the five-item Hopkins Symptom Checklist (SCL-5). The SCL-5 scale was developed and validated as a short version of the longer SCL-25 scale⁽ 40 ⁾; in a sample of 9380 participants from mid-Norway aged 40–42 and 65–67 years, a correlation of r=0·92 was found between SCL-5 and SCL-25. Another Norwegian sample of 7004 participants aged 16–97 years found a sensitivity of 82% and a specificity of 96% for SCL-5 with a cut-off value of 2·0, with SCL-25>1·75 as criterion⁽ 41 ⁾. Unfortunately, no validation studies have been performed on the Sami population. On a four-point Likert scale ranging from 1 (‘not bothered’) to 4 (‘very much bothered’), participants were asked about the following symptoms during the past 4 weeks: ‘nervousness or shakiness inside’, ‘feeling fearful’, ‘feeling hopeless about the future’, ‘worrying too much about things’ and ‘feeling blue’. An mean score of 2·0 or higher was used to identify anxiety or depression, following suggestions from Strand et al.⁽ 41 ⁾. The mean score was set to missing for participants who answered fewer than four of the questions (missing, n 191).