The Brain Overwork Scale: A Population-Based Cross-Sectional Study on the Psychometric Properties of a New 10-Item Scale to Assess Mental Distress in Mongolia.

Identifying mental distress is a complex task, particularly when individuals experience physical symptoms. Traditional self-report questionnaires that detect psychiatric symptoms using emotional words may not work for these individuals. Consequently, there is a need for a screening tool that can identify both the physical and mental symptoms of mental distress in individuals without a clinical diagnosis. Our study aimed to develop and validate a scale that measures mental distress by measuring the extent of brain overwork, which can be extrapolated as the burden of mental distress. In this population-based cross-sectional study, we recruited a total of 739 adults aged 16-65 years from 64 sampling centers of a cohort in Mongolia to validate a 10-item self-report questionnaire. Internal consistency was measured using McDonald's ω coefficient. Test-retest reliability was analyzed using intraclass correlation coefficients. Construct and convergent validities were examined using principal component analysis (PCA) and confirmatory factor analysis (CFA). The Hospital Anxiety and Depression Scale (HADS) and the abbreviated version of World Health Organization Quality of Life (WHOQOL-BREF) were used to evaluate criterion validity. Among the participants, 70.9% were women, 22% held a bachelor's degree or higher, 38.8% were employed, and 66% were married. The overall McDonald's ω coefficient was 0.861, demonstrating evidence of excellent internal consistency. The total intraclass correlation coefficient of the test-retest analysis was 0.75, indicating moderate external reliability. PCA and CFA established a three-domain structure that provided an excellent fit to the data (RMSEA = 0.033, TLI = 0.984, CFI = 0.989, χ