Screening For Mental Health Problems Research Articles

Association between sociodemographic factors, clinic characteristics and mental health screening rates in primary care.

Screening for mental health problems has been shown to be effective to detect depression and initiate treatment in primary care. Current guidelines recommend periodic screening for depression and anxiety. This study examines the association of patient sociodemographic factors and clinic characteristics on mental health screening in primary care. In this retrospective cohort study, electronic medical record (EMR) data from a 14-month period from 10/15/2021 to 12/14/2022 were analyzed. Data were retrieved from 18 primary care clinics from the Corewell Health healthcare system in West Michigan. The main outcome was documentation of any Patient Health Questionnaire (PHQ-4/PHQ-9/GAD-7) screening in the EMR within the 14-month period at patient level. General linear regression models with logit link function were used to assess adjusted odds ratio (aOR) of having a documented screening. In total, 126,306 unique patients aged 16 years or older with a total of 291,789 encounters were included. The prevalence of 14-month screening was 79.8% (95% CI, 79.6-80.0). Regression analyses revealed higher screening odds for patients of smaller clinics (<5,000 patients, aOR 1.88; 95% CI 1.80-1.98 vs. clinics >10.000 patients), clinics in areas with mental health provider shortages (aOR 1.69; 95% CI 1.62-1.77), frequent visits (aOR 1.80; 95% CI, 1.78-1.83), and having an annual physical / well child visit encounter (aOR 1.52; 95% CI, 1.47-1.57). Smaller positive effect sizes were also found for male sex, Black or African American race, Asian race, Latinx ethnicity (ref. White/Caucasians), and having insurance through Medicaid (ref. other private insurance). The 14-month mental health screening rates have been shown to be significantly lower among patients with infrequent visits seeking care in larger clinics and available mental health resources in the community. Introducing and incentivizing mandatory mental health screening protocols in annual well visits, are viable options to increase screening rates.

The Brief Evaluation of Adolescents and Children Online (BEACON): Psychometric development of a mental health screening measure for school students.

This paper describes the development and psychometric evaluation of a brief self-report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4-11) as well as depression and eating difficulties (grades 6-11), with optional items for suicidality and self-harm (grades 7-11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4-5 and 31 items for grades 6-11 that fulfilled pre-set criteria. Study 2 extended testing with 10,479 students in grades 4-11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6-11) creating a total of 35 items for grades 6-11. All items, for both grade-level versions, met the pre-set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas .87 to .95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help-seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school-based screening for mental health problems.

Prevalence and factors associated with anxiety disorder among married women exposed to violence in rural area, Ismailia, Egypt: A cross-sectional study

BackgroundDomestic abuse is a widespread health issue that negatively impacts both mental health and quality of life. ObjectivesTo determine the prevalence of domestic violence and anxiety among women visiting primary healthcare facilities in the rural Ismailia governorate. MethodsBetween October 2021 and December 2021, a cross-sectional study was conducted. Simple random methods were used to choose the participants from those who attended a clinic. 350 married women were included in the estimated sample size. By using an interview questionnaire, data were gathered including the following parts: The socio-demographic data, designed scale for assessment of violence and anxiety symptoms were assessed by the Hamilton anxiety scale. ResultsThe prevalence of domestic violence was 41% and both physical and sexual abuse was 43%. The most predominant sexual abuse was practice without consent (63%). The prevalence of anxiety was 76%, the predominance was mild degree 46% followed by mild to moderate 18%. The significant predictors for anxiety in the total sample were the increase in age of women, rural residence, and exposure to abuse (OR = 11.2 (4.9–25.4). The use of the husband's stimulant drugs was the most predictor factor for women's abuse (OR = 2.3 (1.4–3.9). Conclusionforty-one of the women exposed to every form of violence, anxiety was present in more than three-quarters of the studied women. It is essential to screen any wife attending primary health care for the manifestation of domestic violence especially in rural areas and increase the awareness of family physicians towards screening of mental health problems.

Firearm-related suicides, homicides, and homicide-suicides involving security officers in two East African Countries: a press media review

BackgroundFirearm violence is a growing public health problem causing death globally. With easy accessibility to firearms, suicides, homicides, and homicide-suicides have increased among security officers, especially in developing countries affected by long-standing civil wars/political insurgencies. No study has explored firearm violence in East African countries. This study describes the press media reporting of suicides, homicides, and homicide-suicides among security officers in two East African countries (Uganda and Kenya).MethodsDue to the absence of suicide databases among East African countries, the present study reviewed press media reports. We utilized content analysis of suicides, homicides, and homicide-suicides reports among security forces. Relevant media reports between January-2020 and May-2023 were searched. Using ANOVA and chi-square tests, we tested for statistical differences in characteristics between victims and perpetrators.ResultsAmong the 56 perpetrated reports, most of them were homicides 44.64% (n = 25/56), 30.36% (n = 17/56) were homicide-suicides, and 25% (n = 14/56) were suicides. Perpetrators’ age ranged from 21 to 47 years, majority being males [53/56 (94.64%)]. Victims were 58, mostly Ugandans [41/58 (73.21%)] with a mean age of 33.5 ± 8.81 years. Among the three main outcomes, statistically significant difference existed by country (χ2 = 23.88, p < 0.001), and perpetrators’ age (F = 8.59, p = 0.005). There was a significant difference between perpetrators and the number of victims lost by age of victims (F = 10.37, p = 0.002). Among victims, type of security of perpetrator and citizenship of victims (χ2 = 24.18, p < 0.001) showed statistical difference with Ugandans having more victims to army officers while Kenyans to police officers. Brief incident descriptions pointed towards relationship dysfunctions, alcohol/substance abuse, intentional harm, and financial disagreements, as the potential causes. Only two perpetrators were reported to have mental health-related conditions.ConclusionThis study shows that media reported firearms-related suicides, homicides, and homicide-suicides among security forces commonly involve males. Perpetrators in Uganda are mainly army officers while in Kenya the perpetrators are mostly police officers. Mental health conditions were not frequently reported among perpetrators. We recommend strengthening and enforcing gun regulation policies among security officers to curb this growing problem in these countries. Routine screening of mental health problems to enable early interventions is recommended among security officers.

Time Management Strategies for Addressing Mental Health Concerns in the Pediatric Visit

Addressing mental health concerns within the time constraints of a busy pediatric practice can be challenging. Increasingly, pediatricians are tasked to cover even more during a routine checkup, including any sleep and dietary concerns as well as screening for mental health problems, social influencers of health, and hand-on-door queries. Since the start of the COVID-19 (coronavirus disease 2019) pandemic, primary care physicians have reported an increase in anxiety and depression in their pediatric patients. We present time management strategies that facilitate the clinician's ability to confront these problems together with the family. These include setting an agenda, acknowledging the limited time, using shared decision-making to prioritize topics, and offering an opportunity for further discussion at a follow-up visit. Using the mnemonic HEL2P3 can provide guidance to balance a visit with competing issues. [ Pediatr Ann . 2023;52(11):e426–e429.]

Screening for mental health problems in childhood cancer survivorship: a systematic review

Abstract Many survivors of childhood cancer suffer from psychological late effects. Therefore, regular psychological screening is strongly advised. Experts recommend screening for mental disorders and symptoms for all survivors at every follow-up visit, regardless of age. However, there is little practical guidance on screening for mental health problems in childhood cancer survivorship care. The aims of this systematic review were to (a) collect comprehensive information on available screening tools, (b) determine which health care professionals performed the screening, and (c) identify practical considerations regarding the timing of screening. The databases PubMed, PsycINFO, and CINAHL were systematically searched for peer-reviewed publications concerning childhood cancer, mental health problems, survivorship, and screening published between January 1990 and January 2023. The search yielded 2268 potentially relevant articles, of which 32 were included in the narrative synthesis. We found that (a) many suitable screening tools are available for the target population, of which the Distress Thermometer, Brief Symptom Inventory-18, Symptom Checklist-90, and Pediatric Quality of Life Inventory were the most commonly used in all studies; (b) professionals of different disciplines were involved in screening, and examples include clinical nurse specialists and psychologists; and (c) early onset, regular, and long-term screening are recommended if resources are available. In conclusion, selecting a screening tool in a clinical setting depends on various factors such as time and cost. However, many brief screening tools can be easily implemented without a large investment of resources. Furthermore, professionals from various disciplines can perform the screening. If they have no background in psychology, training is recommended to give them confidence in dealing with mental health issues. In conclusion, consistent and regular mental health screening is crucial for childhood cancer survivors, and we believe that the benefits outweigh the costs.

Prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of German first and lower leagues.

While several studies on mental health of elite athletes were published in recent years, few compared the prevalence with the general population and none included field hockey players. To analyze the prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of different skill levels and to compare it to the general population. Male and female hockey players from different leagues were asked to answer questions on player characteristics, the Centre of Epidemiologic Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7). One hundred and eighty-seven players (incl. 54 first and 28 second league players) participated in the study (response rate 97.4%). More than a third (n = 64; 35.0%) reported to be affected by an injury/health complaint, but 157 (86.3%) were able to train and play without limitations. The CES-D score indicated depression symptoms in more female (n = 15; 18.3%) than male (n = 5; 4.8%) players (χ2=8.8; p < 0.01). No male and one female player had symptoms of generalized anxiety disorder. Players who played 60 or more matches in the previous 12 months had on average significantly higher depression (t = 2.3; p < 0.05) and generalized anxiety scores (t = 4.2; p < 0.001) than players who played fewer matches. The prevalence of depression and of generalized anxiety symptoms was similar to or lower than in the general population. Although 20 (10.7%) players had depression symptoms, only 4 (2.2%) received psychological counseling or psychotherapy. It is recommended to provide routine screening of mental health problems and low-threshold access to adequate treatment for elite athletes.

Obesity as pleiotropic risk state for metabolic and mental health throughout life

Obesity, a highly prevalent disorder and central diagnosis of the metabolic syndrome, is linked to mental health by clinical observations and biological pathways. Patients with a diagnosis of obesity may show long-lasting increases in risk for receiving psychiatric co-diagnoses. Austrian national registry data of inpatient services from 1997 to 2014 were analyzed to detect associations between a hospital diagnosis of obesity (ICD-10: E66) and disorders grouped by level-3 ICD-10 codes. Data were stratified by age decades and associations between each pair of diagnoses were computed with the Cochran-Mantel-Haenszel method, providing odds ratios (OR) and p values corrected for multiple testing. Further, directions of the associations were assessed by calculating time-order-ratios. Receiving a diagnosis of obesity significantly increased the odds for a large spectrum of psychiatric disorders across all age groups, including depression, psychosis-spectrum, anxiety, eating and personality disorders (all pcorr < 0.01, all OR > 1.5). For all co-diagnoses except for psychosis-spectrum, obesity was significantly more often the diagnosis received first. Further, significant sex differences were found for most disorders, with women showing increased risk for all disorders except schizophrenia and nicotine addiction. In addition to the well-recognized role in promoting disorders related to the metabolic syndrome and severe cardiometabolic sequalae, obesity commonly precedes severe mental health disorders. Risk is most pronounced in young age groups and particularly increased in female patients. Consequently, thorough screening for mental health problems in patients with obesity is urgently called for to allow prevention and facilitate adequate treatment.

Prevalence of mental health problems among children with long COVID: A systematic review and meta-analysis.

The number of children with mental health problems has more than doubled since the COVID-19 pandemic. However, the effect of long Covid on children's mental health is still debatable. Recognising long Covid as a risk factor for mental health problems in children will increase awareness and screening for mental health problems following COVID-19 infection, resulting in earlier intervention and lower morbidity. Therefore, this study aimed to determine the proportion of mental health problems post-COVID-19 infection in children and adolescents, and to compare them with the population with no previous COVID-19 infection. A systematic search was done in seven databases using pre-defined search terms. Cross-sectional, cohort and interventional studies reporting the proportion of mental health problems among children with long COVID in the English language from 2019 to May 2022 were included. Selection of papers, extraction of data and quality assessment were done independently by two reviewers. Studies with satisfactory quality were included in meta-analysis using R and Revman software programmes. The initial search retrieved 1848 studies. After screening, 13 studies were included in the quality assessments. Meta-analysis showed children who had previous COVID-19 infection had more than two times higher odds of having anxiety or depression, and 14% higher odds of having appetite problems, compared to children with no previous infection. The pooled prevalence of mental health problems among the population were as follows; anxiety: 9%(95% CI:1, 23), depression: 15%(95% CI:0.4, 47), concentration problems: 6%(95% CI: 3, 11), sleep problems: 9%(95% CI:5, 13), mood swings: 13% (95%CI:5, 23) and appetite loss: 5%(95% CI:1, 13). However, studies were heterogenous and lack data from low- and middle-income countries. Anxiety, depression and appetite problems were significantly increased among post-COVID-19 infected children, compared to those without a previous infection, which may be attributed to long COVID. The findings underscore the importance of screening and early intervention of children post-COVID-19 infection at one month and between three to four months.

Disease Perception and Mental Health in Pregnancies with Gestational Diabetes-PsychDiab Pilot Study.

(1) Background: The aim of this work is to investigate the extent to which pregnant women's well-being is burdened by the diagnosis of gestational diabetes, as well as their sensitivities and illness perceptions. Since gestational diabetes is associated with mental disorders, we hypothesized that the burden of illness might be related to pre-existing mental distress. (2) Methods: Patients treated for gestational diabetes in our outpatient clinic were retrospectively asked to complete a survey, including the self-designed Psych-Diab-Questionnaire to assess treatment satisfaction, perceived limitations in daily life and the SCL-R-90 questionnaire to assess psychological distress. The association between mental distress and well-being during treatment was analyzed. (3) Results: Of 257 patients invited to participate in the postal survey, 77 (30%) responded. Mental distress was found in 13% (n = 10) without showing other relevant baseline characteristics. Patients with abnormal SCL-R-90 scores showed higher levels of disease burden, were concerned about glucose levels as well as their child's health, and felt less comfortable during pregnancy. (4) Conclusions: Analogous to the postpartum depression screening, screening for mental health problems during pregnancy should be considered to target psychologically distressed patients. Our Psych-Diab-Questionnaire has been shown to be suitable to assess illness perception and well-being.

“If They Don’t Ask, We Don’t Share” – A Qualitative Study on Barriers and Facilitators to Discussing Mental Health with Obstetric Care Providers in Urban Anganwadis among Pregnant Women in India

Abstract Background: Perinatal period is considered a high risk period for developing mental health problems. Screening for mental health problems is not routine in obstetric care settings in low and middle income countries. This qualitative study among low-income urban pregnant women in India aimed to understand the facilitators and barriers for discussing mental health problems with their obstetric health-care providers. Materials and Methods: Two focus group discussions with six pregnant women in each group were conducted using a semi structured interview guide. The transcribed data were translated to English and were analyzed and key themes were identified using a thematic analysis approach. Results: Participants had inadequate knowledge about the impact of maternal mental health problems on pregnancy, fetus and infant. The common barriers to discussing mental health problems were families normalizing mental stress, fear that family conflicts being revealed, stigma about being labeled mentally ill, lack of privacy in clinics and obstetric health-care providers being too busy. Women reported that being specifically asked about mental health problems as part of care and a sensitive attitude of the health-care providers encouraged them to discuss their concerns. Conclusion: This study identified more barriers than facilitators in discussing about mental health among pregnant women and the need for sensitive screening for mental health problems. To enhance screening and support for maternal mental health problems, it is necessary to increase awareness about the importance of mental health in the perinatal period among women and families. In addition, training obstetric health-care providers in sensitive screening for mental health problems, ensuring privacy in clinics and reducing stigma related to perinatal mental health problems.

A measurement method for mental health based on dynamic multimodal feature recognition.

The number of college students with mental problems has increased significantly, particularly during COVID-19. However, the clinical features of early-stage psychological problems are subclinical, so the optimal intervention treatment period can easily be missed. Artificial intelligence technology can efficiently assist in assessing mental health problems by mining the deep correlation of multi-dimensional data of patients, providing ideas for solving the screening of normal psychological problems in large-scale college students. Therefore, we propose a mental health assessment method that integrates traditional scales and multimodal intelligent recognition technology to support the large-scale and normalized screening of mental health problems in colleges and universities. Firstly, utilize the psychological assessment scales based on human-computer interaction to conduct health questionnaires based on traditional methods. Secondly, integrate machine learning technology to identify the state of college students and assess the severity of psychological problems. Finally, the experiments showed that the proposed multimodal intelligent recognition method has high accuracy and can better proofread normal scale results. This study recruited 1,500 students for this mental health assessment. The results showed that the incidence of moderate or higher stress, anxiety, and depression was 36.3, 48.1, and 23.0%, which is consistent with the results of our multiple targeted tests. Therefore, the interactive multimodality emotion recognition method proposed provides an effective way for large-scale mental health screening, monitoring, and intervening in college students' mental health problems.

Mental wellbeing among urban young adults in a developing country: A Latent Profile Analysis.

IntroductionThis study aimed to explore the mental wellbeing profiles and their related factors among urban young adults in Vietnam.MethodsA cross-sectional study was conducted in Hanoi, which is the capital of Vietnam. There were 356 Vietnamese who completed the Mental Health Inventory-5 (MHI-5) questionnaire. The Latent Profile Analysis (LPA) was used to identify the subgroups of mental wellbeing through five items of the MHI-5 scale as the continuous variable. Multinomial logistic regression was used to determine factors related to subgroups.ResultsThree classes represented three levels of MHI-5 score, which included “Poor mental health,” “Fair mental health,” and “Good mental health,” were, respectively, 14.3, 46.6, and 39.0%. Compared to a low household economy, participants with an average household economy had 2.11 and 4.79 times higher odds of being in a good mental health class relative to fair and poor mental health classes. Respondents with more than two acute symptoms had 3.85 times higher odds of being in a good mental health class relative to a poor mental health class, as compared to those without acute symptoms. Regarding the measurement of the Perceived Social Support Scale (MSPSS), people having support from their family had 1.80 and 2.23 times higher odds of being in classes of fair and good mental health relative to the poor mental health class; and participants having friend support also had 1.87 times higher odds of being in a good mental health class compared with the fair mental health class, as the MSPSS score increased by 1 unit. People with Rosenberg’s self-esteem scale increased by 1 score, those who had 1.17, 1.26, and 1.47 times higher odds of being in a good compared to fair mental health class, fair compared to poor mental health class, and good compared to poor mental health class, respectively.ConclusionOur findings were given to promote a new classification method for mental health screening among the general population. The current findings could be used as evidence to develop policies and plans that focus on encouraging early screening for mental health problems among the general young population in the future.

Longitudinal investigation of suicidal ideation and associated factors during pediatric acute lymphoblastic leukemia chemotherapy.

This study describes the prevalence of suicidal ideation (SI) during acute lymphoblastic leukemia (ALL) therapy and investigates the influence of clinical factors and physical symptoms on SI. The Children's Depressive Inventory (CDI-2) was administered to ALL patients (diagnosed 2012-2017) at start of consolidation, delayed intensification (DI), maintenance cycle 1 (MC1), and maintenance cycle 2 (MC2) in a multi-site study. SI was present if patients endorsed the item "I want to kill myself." Logistic regression models evaluated associations between SI and sociodemographic factors; depressive symptoms; and below average, average, and above average symptom clusters identified using latent class analysis of pain, nausea, fatigue, and sleep. Participants (n=175) were 51% male, 75% high-/very high-risk disease, with a median age of 11.2years at diagnosis (range: 7-18years). Overall, 14.9% of patients (75% under age 12years) endorsed SI during treatment, including 4% at start of consolidation, 9% at DI, 8% at MC1, and 4% at MC2. Non-Hispanic Other patients were 10.9-times (95% CI: 2.30-53.40) more likely than non-Hispanic Whites to endorse SI (p=0.003). The frequency of SI was higher in patients experiencing above average (53.3%) compared to below average (4.1%, p=0.003) symptoms. Depressive symptoms were consistently associated with SI. SI during the initial year of childhood ALL was more prevalent in children under the age of 12years, from ethnic groups not typically associated with increased risk, and who endorsed increased physical and depressive symptoms. Findings highlight the need for improved screening of mental health problems to mitigate symptoms of distress.

Mental Health of Health Care Workers at Imam Khomeini Hospital in Tehran During COVID-19 Pandemic

Background: In this study, screening of mental health problems among Health Care Workers (HCWs) was performed in order to assess the prevalence and severity of depression, anxiety, and perceived stress at Iran’s largest teaching hospital during the COVID-19 pandemic.&#x0D; Methods: In this cross-sectional study, HCWs who were working professionally in specific wards for COVID-19 patients were selected by availability sampling. The patients who met the inclusion criteria and answered the submitted questions were included in the study. Next, two instruments including HADS (Hospital Anxiety and Depression Scale) and PSS-4 (Perceived Stress Scale-4) were used.&#x0D; Results: The study was conducted on 306 HCWs. The mean score and standard deviation of depression, anxiety, and perceived stress were 6.33±4.10, 8.33±4.29, and 6.88±2.90, respectively. Fifty-four percent and 36.6% of the participants showed some degree of anxiety and depression, respectively.&#x0D; Conclusion: It is necessary to use screening methods for psy- chological disorders among HCWs, along with psychosocial support and appropriate psychological interventions in this field.

The Prevalence of Antenatal Depression among Women in Medina, Saudi Arabia

Background: Antenatal depression is a recognized global burden. However, it has remained an ignored part of public health. Most of the maternal depression interventions have been directed towards post-natal depression.&#x0D; Purpose of the Study: The purpose of this study was to understand the third-trimester antenatal depression risk factors and prevalence among Saudi Arabian women.&#x0D; Method: This study employed cross-sectional study design from April 2020 to June 2020 and 201 participants were recruited for this study. The study was conducted at Medina in the Maternity and Children's Hospital (MCH) from April 2020 to June 2020. The inclusion criteria were pregnant women who visited the outpatient clinic of antenatal care in MCH. Pregnant women who had a known familial history or already been diagnosed with depression before pregnancy were excluded from this study. The collection of the data was through researcher administered questionnaire to the pregnant women meeting eligibility criteria who were visiting the clinic of antenatal care at the Maternity and Children's Hospital. Data were collected using a structured and validated Patient Health Questionnaire-9 (PHQ-9). All the collected data were analyzed using descriptive statistics, Anova and t-test statistics. &#x0D; Results: Antenatal depression among participants stands at 35.8% for normal/ minimal depression, 31.3% for mild depression, 3.9% for moderate depression, 5.5% for moderately severe, and 3.5% for severe depression. Antenatal depression was mostly prevalent in the third trimester.&#x0D; Conclusion: The antenatal depression prevalence among pregnant women in Medina is high. Screening for mental health problems and provision of supportive mental health services as a component of antenatal care services is recommended.

Confronting and Coping with Multidrug-Resistant Tuberculosis: Life Experiences in Thailand.

In this article, we aimed to understand the life experiences of Thai persons diagnosed with multi-drug-resistant tuberculosis (MDR-TB). A qualitative study using a face-to-face in-depth interview was conducted at a hospital in Thailand which has the highest prevalence of MDR-TB in the country between January and February 2019. Twenty persons living with MDR-TB in Thailand were purposively selected to represent a variety of experiences based on different gender, ages, and treatment phases. Qualitative data were transcribed and thematic analysis was applied to identify common themes and sub-themes. The results indicated that all participants faced emotional difficulties, such as fear of death, fear of stigmatization, confusion, and sadness when first knowing of their diagnosis. Family and social support were the main ways that the patients coped with difficult situations. Suicidal ideas were more prevalent among patients with poor family support. Screening for mental health problems should be routinely performed in MDR-TB patients. Proper health education should be provided to patients and families to reduce emotional difficulties and stigmatization.

Psychometric Properties of the German Version of the Early Childhood Screening Assessment

Fast and accurate screening for mental health problems in early childhood is a prerequisite for effective early intervention. The Early Childhood Screening Assessment (ECSA) is a valid and standardized screening tool for young children. The aims of the current study were to examine the psychometric properties, the factorial structure, and validity evidence for test score interpretation of the German version of the ECSA. Results of a confirmatory factor analysis support a two-factor solution differentiating externalizing and internalizing problems in early childhood. Concurrent validity was demonstrated by positive associations with the Child Behavior Checklist (CBCL). Accuracy of identifying children at risk in comparison to CBCL was good with appropriate sensitivity and specificity. Moreover, ECSA problem scores showed specific associations with low ego-resiliency and field-independence scores and high ego-undercontrol, aggression, and anxiety scores. ECSA caregiver depression scores were associated with children’s ECSA problem scores. The German version of the ECSA is a short and accurate screening tool for mental health problems in early childhood.

Screening for Mental Health Problems in Epidemics: Is It Justifiable?

Given the overwhelming mental health consequences of infectious epidemics, timely identification and treatment of people with mental health problems is essential. In this narrative review, screening instruments and procedures for identification of mental health problems at the time of epidemic crises are reviewed and the results are discussed in the context of our experience in the recent COVID-19 epidemic in Iran. Forty studies were retrieved from searches in several databases which used screening procedures for identification of mental health conditions during infectious epidemics. Studies were performed on three groups of health care workers, at-risk general population, and patients with confirmed/ suspected infection, using a wide range of instruments. Most have used screening instruments for the purpose of prevalence estimation and only 5 have included it as a health intervention while none has investigated its effectiveness. The evidence base for screening at the time of epidemics is weak. If it is used to identify the needs and enhance help seeking, the screening instruments should have adequate psychometric properties; moreover, their integration in the available services is strongly recommended. Original studies are needed to investigate the usefulness of mental health screening programs in crises such as the COVID-19 epidemic.

DEVELOPMENT OF ONLINE MENTAL HEALTH SUPPORTING GROUP TO REDUCE MENTAL BURDEN DURING COVID-19 PANDEMIC

COVID-19 pandemic affects all aspects of human life, not only health, but also economic, education, and daily activity. The sudden changes caused a mental burden for the majority of people. Moreover, the infodemic might increase the burden. Unfortunately, not all people aware of their mental health, and the negative stigma from the community leads the patient to hesitate for sharing and seeking help. Therefore, an anonymous online supporting group (www.laluibersama.com) is developed to increase awareness of mental health and provided the facility to share and to support users. This site consists of several basic information and articles regarding COVID-19, emphasizes on pharmacotherapy and mental health issues, sharing forum, and mental health calculator based on depression, anxiety, and stress scales (DASS 21). From the evaluation, 53.61% of users choose mental health calculators as the most favorite page, followed by article (29.90%), homepage (12.37%), and sharing page (4.12%). Most of the respondents agree that the mental health calculator is unique and useful, therefore can be used as a screening of mental health problems prior to seeking health professional help. Taken together, mental health needs more attention in this pandemic due to the increasing burden, and the screening of mental health problems and sharing to alleviate the users’ burden can be performed at www.lalui bersama.com.