Abstract
BackgroundIn Sub Saharan Africa, there has been limited research on instruments to identify specific mental disorders in children in conflict-affected settings. This study evaluates the psychometric properties of three self-report scales for child mental disorder in order to inform an emerging child mental health programme in post-conflict Burundi.MethodsTrained lay interviewers administered local language versions of three self-report scales, the Depression Self-Rating Scale (DSRS), the Child PSTD Symptom Scale (CPSS) and the Screen for Child Anxiety Related Emotional Disorders (SCARED-41), to a sample of 65 primary school children in Burundi. The test scores were compared with an external ‘gold standard’ criterion: the outcomes of a comprehensive semistructured clinical psychiatric interview for children according the DSM-IV criteria (the Schedule for Affective Disorders and Schizophrenia for School-Age Children – K-SADS-PL).ResultsThe DSRS has an area under the curve (AUC) of 0.85 with a confidence interval (c.i.) of 0.73–0.97. With a cut-off point of 19, the sensitivity was 0.64, and the specificity was 0.88. For the CPSS, with a cut-off point of 26, the AUC was 0.78 (c.i.: 0.62–0.95) with a sensitivity of 0.71 and a specificity of 0.83. The AUC for the SCARED-41, with a cut-off point of 44, was 0.69 (c.i.: 0.54–0.84) with a sensitivity of 0.55 and a specificity of 0.90.ConclusionsThe DSRS and CPSS showed good utility in detecting depressive disorder and posttraumatic stress disorder in Burundian children, but cut-off points had to be put considerably higher than in western norm populations. The psychometric properties of the SCARED-41 to identify anxiety disorders were less strong. The DSRS and CPSS have acceptable properties, and they could be used in clinical practice as part of a two-stage screening procedure in public mental health programmes in Burundi and in similar cultural and linguistic settings in the African Great Lakes region.
Highlights
In Sub Saharan Africa, there has been limited research on instruments to identify specific mental disorders in children in conflict-affected settings
The Depression Self-Rating Scale (DSRS) and Child PSTD Symptom Scale (CPSS) have acceptable properties, and they could be used in clinical practice as part of a two-stage screening procedure in public mental health programmes in Burundi and in similar cultural and linguistic settings in the African Great Lakes region
We have reported earlier on the development of the Child Psychosocial Distress Screener (CPDS), a screening instrument to identify children with high levels of psychosocial distress a[3,4] in order to guide the triage of psychosocially affected children in situations of massive organized violence [5,6]
Summary
In Sub Saharan Africa, there has been limited research on instruments to identify specific mental disorders in children in conflict-affected settings. Global mental health researchers often use brief selfrating questionnaires to screen for DSM-IV disorders [1]. These instruments require minimal time and limited or no clinical expertise and training. They are, often recommended to be used in school, community and research settings to screen for symptoms of mental disorders [2]. In order to identify the children in need of more specialized interventions, instruments are required to screen for specific disorders such as depression, anxiety disorders or posttraumatic stress disorder (PTSD)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
