Screening Tools For Mental Disorders Research Articles

Mental disorders in adults from Ribeirão Preto, Brazil: a cross-sectional analysis of two birth cohorts

BackgroundIn Brazil, the prevalence of mental disorders is heterogeneous, with most studies conducted in large cities with high population density. This study aimed to assess the prevalence of mental disorders and psychiatric comorbidities among young adults (22–23 years old) and adults (37–38 years old) from Ribeirão Preto, a city located in the Northeast of the São Paulo state, with approximately 700,000 inhabitants, and to explore associations with sociodemographic variables, suicide risk, and health service usage. Second, we aimed to evaluate the performance of the Self-Report Questionnaire (SRQ-20) as a screening tool for mental disorders to be applied to the local population.MethodsParticipants from the 1978/1979 and 1994 Ribeirão Preto birth cohorts were evaluated using the Mini International Neuropsychiatric Interview (MINI) and the SRQ-20 at mean ages of 22–23, and 37–38 years, respectively.ResultsOur sample comprised 1,769 individuals from the 1978/1979 cohort and 1,037 from the 1994 cohort. The prevalence of mental disorders ranged from 28.6% (1978/79) to 31% (1994), with frequent comorbid diagnoses (42.7% and 43.3%, respectively). Men and women had a similar prevalence of mental disorders in the younger cohort, while women had a higher prevalence in the older cohort. Low educational attainment was associated with higher rates of diagnosis. In both cohorts, alcohol and other psychoactive substance use was higher among those with a psychiatric diagnosis. Although those with a psychiatric diagnosis were less satisfied with their own health, only one-fifth had seen a mental health professional in the previous year. A psychiatric diagnosis increased the suicide risk by 5.6 to 9.1 times. Regarding the SRQ-20, the best cutoff points were 5/6 for men and 7/8 for women, with satisfactory performance.ConclusionsThe prevalence and comorbidity of mental disorders were high in both cohorts and comparable to those in larger Brazilian cities. However, few individuals with a diagnosis had sought specialized care. These data suggest that the mental health gap is still significant in Brazil.

Perceptions of physicians on the use of screening tools for mental disorders in primary health care in Brazil.

This study aimed to analyse perceptions, knowledge and ways of incorporating screening tools for mental disorders (MDs) into the daily practice of physicians working in primary health care (PHC) in the Brazilian public health system. This is a descriptive qualitative study with a sample of 24 physicians. The data collected in the semi-structured interviews were subjected to reflective thematic analysis. The use of screening tools was low, not only due to lack of knowledge, but also due to reasoned criticism of this strategy developed by physicians trained in PHC. Physicians also presented a scenario of chaos, work overload and the fragility of the psychosocial care network as barriers to effective care of patients with MDs and to the incorporation of innovations in this care. Interventions aimed at improving the quality of mental health care should include training on the topic, (re)organizing work processes, strengthening the health care network and producing robust scientific evidence on interventions aimed at qualifying professionals in mental health in PHC.

MMPI-2 Domain and Psychological Distress in Clinical Medical Students

Introduction: The clinical rotation is a stage of medical education that provides a stressful environment for medical students. Psychological distress in medical students affects the learning output and achievement of clinical competencies. MMPI-2 is a screening tool for mental disorders in clinical medical student admission protocols. Nevertheless, the domain for predicting psychological distress during clinical rotation has not been considered before. The aim of the study is to determine the MMPI-2 domain as a predictor of future psychological distress in clinical rotation students.
 Methods: This study used a cross-sectional and retrospective design using the MMPI-2 data derived from admission protocols and the SRQ (self-reporting questionnaire-29) questionnaire measuring the psychological distress in first-year clinical rotation students. 
 Results: 87 data showed that not all MMPI-2 domains were statistically associated with psychological distress in clinical medical students. Domains of psychasthenia (Pt), psychopathic deviated (Pd), neurotic personality (NEGE), introverted personality (Intr), and lower stress resistance (ES) were the best predictors of psychological distress during the clinical process.
 Conclusion: The psychological distress of clinical medical students can be predicted by Pd, Pt, Nege, Intr, and Es scores of MMPI-2 with cut-off points 40T and 50T.

Screening Tools for Mental Disorders Among Female Refugees: a Systematic Review

Female refugees are particularly vulnerable to mental disorders but assessment may be complex and challenging. Various screening tools have been developed for this population, but little is known about their usefulness. The main aim is to examine the literature on the effectiveness of screening tools for mental health problems among female refugees.Systematic review of PubMed, PsycINFO and Embase to locate all published work. Comprehensive search terms were used and inclusion and exclusion criteria were formulated.The initial search yielded 877 articles, of which 757 were removed after titles and abstracts were reviewed. Then, 121 full-text versions of articles were examined and 96 excluded according to the criteria. A total of 25 articles were included in this systematic review in accordance with the PRIMSA guidelines. Twenty screening tools were evaluated.There is a lack of tools used to screen refugee women, and in particular those in emergency settings. Cultural factors may not be accounted for in the development of screening instruments. Further research in this field can help inform public health policies to address social, educational and occupational inclusion for refugee women in different contexts.

Validation of the WHO self-reporting questionnaire-20 (SRQ-20) item in primary health care settings in Eritrea

BackgroundIn Eritrea, highly centralized mental health care services and lack of trained psychiatric personnel at primary health care units remain a challenge to the mental health care system. These problems can be minimized by introducing screening programs with a simple screening tool for mental disorders in the primary health care settings. Thus, this study aimed to assess the validity of the WHO self-reporting questionnaire 20 (SRQ-20) in Tigrigna version for use in Eritrean primary health care setting.MethodsThe SRQ-20 was translated into a local language (Tigrinya) in a process of forward and backward translation. SRQ-20 data were collected in a primary health care setting on 266 respondents. Internal reliability was tested using Cronbach’s alpha. Factorial validity was done using principal component analysis with varimax rotation to investigate whether SRQ-20 items properly measure the underlying dimensions of mental illness. Criterion validity was analyzed by looking at the relationship between the SRQ-20 and Brief Psychiatric Rating Scale using Pearson’s correlation coefficient. Sensitivity, specificity and the predictive values of the screening instrument were used to assess how well the results of SRQ-20 correspond with the criterion instrument.ResultsThe SRQ-20 had good internal reliability (α = 0.78). Factor analysis yielded two factors, explaining 31.2% of the total variance. The instrument performed well in detecting common mental disorders, with an area under the curve (AUC) of 0.879 (SE = 0.23, 95% CI 0.83–0.92) to the overall sample and with optimal cut-off score at 5/6 with sensitivity 78.6% and specificity 81.5%. Cut-off scores were different for women (5/6) and men (4/5). For male participants, the AUC statistic was 0.877 (SE = 0.04, 95% CI 0.79–0.96) and 0.871 (SE = 0.02 95% CI 0.81–0.92) for female participants.ConclusionThe Tigrinya version of the SRQ-20 can be used for screening probable common mental disorders in Eritrean primary health care setting, but cut-off scores need to be adjusted for men and women separately.

Mental Health Survey of the Iranian Adult Population in 2015.

Mental disorders influence people with a high prevalence and exert remarkable burden on community members. This study was carried out aiming to assess mental health status within the age range category of 15 and above in the Islamic Republic of Iran. The statistical population of this cross-sectional survey consisted of residents of urban and rural areas in Iranian provinces. An estimated sample size of 36000 people was chosen using systematic random sampling and the cluster method. Access was provided by the contribution of the Geographical Post Office for each province. The GHQ-28 was used as a screening tool for mental disorders. Data analysis was carried out using SPSS-18 software. The results were gathered by the traditional scoring method. A total of 23.44% of samples were suspected of having mental disorders. The prevalence of suspicion for mental disorders was higher in urban (24.55%) than rural areas (20.89%). The prevalence of anxiety and somatization symptoms was higher than social dysfunction and depression symptoms. The outcomes also revealed that the prevalence of suspicion for mental disorders increased noticeably with aging. Suspicion for these disorders was more common in women, divorcees and widows, illiterates, less educated, unemployed and disabled individuals compared with other potential groups of the society. Comparison of the outcomes from this study with the research conducted in 1999, demonstrated an increasing prevalence rate of suspicion for mental disorders. Therefore, it is mandatory for Iranian public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.

Validation and comparison of diagnostic accuracy of four screening tools for mental disorders in people seeking treatment for substance use disorders

This study aimed to validate and compare performance of four screening tools for mental disorders in a heterogeneous population seeking substance use treatment. A total of 544 clients were recruited prospectively from three treatment centres and completed the screening instruments followed by a reference standard psychiatric interview for research diagnosis. Performance relative to the reference standard was compared across instruments using receiver operator characteristic (ROC) analysis. Screening tools included the GAIN-SS-IDScr; the K6, the Psychiatric Sub-scale of the Addiction Severity Index, and the Psychiatric Diagnostic Screening Questionnaire. All the screening tools performed reasonably well detecting broad groupings of disorders—any past-month disorder, any depressive disorder, anxiety disorder or psychotic disorder, with the GAIN-SS-IDScr being most efficient due to its shorter length. Results strengthen previous validation data for each of the tools investigated and support their use in detecting mental disorders in the substance use treatment population specifically.

Assessment of mental disorders using the patient health questionnaire as a general screening tool in western Nigeria: A community-based study

Background:Screening at the community level will provide keys to promoting health and preventing diseases at the community level and serve as the fulcrum for timely detection and intervention. This study aims to assess the prevalence and nature of mental disorder among the general population using the patient health questionnaire (PHQ). It also compares the use of PHQ and GHQ as general screening tools for mental disorders.Materials and Methods:This community-based study is cross sectional in design. Multistage sampling technique was used to obtain a representative sample of the communities. The PHQ and GHQ-12 questionnaires were concurrently administered by health care workers that were nondoctors to screen for psychiatric symptoms.Results:A total of 758 participants took part in the study, 496 (65.4%) of the subjects had a form of psychopathology or the other using PHQ and 143 (18.9%) using GHQ questionnaire (χ2 = 20.92, P = 0.000). Three hundred and thirty one subjects (43.7%) met the criteria for Somatoform disorder but 6.0% ever treated at PHC, 269 (35.5%) for depression and 4.8% ever treated, 127 (16.8%) for panic disorder and 5.5% ever treated, while 165 (21.8%) for general anxiety and 4.8% ever treated. Predictors of psychopathology were individuals who were singles (OR = 0.64, CI = 0.49–0.93) concerns about their health (OR = 3.06, CI = 2.06–4.56), worried about finance (OR = 1.84, CI = 1.27–2.67), worried about family life (OR = 2.68, CI = 1.61–4.72), and stressed at work (OR = 1.16, CI = 1.06–1.28).Conclusion:There is a high prevalence of psychopathology at the community level in this African population and few had ever been treated. PHQ as a general screening tool has a higher false-positive value compared to GHQ when used by nondoctors. PHQ should be used as an instrument to screen for specific mental disorders rather than a general screening tool for psychiatric morbidity at the community level.

Validation of Brief Screening Tools for Mental Disorders Among New Zealand Prisoners

Validation of Brief Screening Tools for Mental Disorders Among New Zealand Prisoners

Validation of Brief Screening Tools for Mental Disorders Among New Zealand Prisoners

This study aimed to validate brief intake screens for serious mental illnesses among New Zealand male prisoners. A prospective survey of consecutively admitted male remanded and sentenced prisoners was conducted across two New Zealand sites. Participants completed the Brief Jail Mental Health Screen (BJMHS) and the English Mental Health Screen (EMHS) upon prison admission. The validation standard, the Mini International Neuropsychiatric Interview (MINI), was completed for all positive screens and a random selection of negative screens. A total of 1,292 brief screens and 530 MINI screens were completed. Fifty-one percent of the participants met MINI criteria for one of five targeted major mental disorders. In this study, the BJMHS performed with lower sensitivity, higher specificity, a lower false-positive rate, a significantly higher false-negative rate, and a much higher referral rate than in the validating U.S. study. And in this study the EMHS performed with lower sensitivity, less specificity, higher false-positive and false-negative rates, and a moderately higher overall referral rate than in the validating U.K. study. For the BJMHS and EMHS, the majority of false-negative cases involved a mood disorder and few involved psychosis. Although the BJMHS and EMHS did not perform well in terms of screening for MINI diagnoses, they appeared to be good at identifying a core group of prisoners who are psychotic and most likely to require urgent or semi-urgent intervention by mental health services. The most favorable clinical outcomes were achieved by defining a positive screen as one in which either the EMHS or the BJMHS criteria were fulfilled.

HIV/AIDS and psychiatry: Towards the establishment of a pilot programme for detection and treatment of common mental disorders in people living with HIV/AIDS in Cape Town

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High prevalence of mental disorders in primary care

Objective: To determine the prevalence of common mental disorders in an adult primary care population. Design: Cross-sectional survey in randomly selected subjects, using the PRIME-MD questionnaire. Setting: Eighty-six general practices in Belgium. Subjects: A total of 2316 randomly selected patients, aged 18 years or older and consulting their general practitioner for other than administrative reasons alone, with slightly more women (58.1%) than men (41.3%). Main outcome result: Prevalence rates of mental disorders most commonly seen in primary care practice (mood, anxiety, somatoform, eating and alcohol disorders). Methods: To facilitate data collection and processing, the entire PRIME-MD questionnaire was programmed on a handheld computer. Patient answers and physician assessments were immediately electronically recorded during the interview. All investigators were trained on the use of the PRIME-MD. The recruitment period lasted 6 weeks: from 15 February to 25 March 1999, and patients were randomly selected for the interview based on a computerized procedure. Results: Although only 5.4% of all patients consulted for a psychiatric reason, a threshold/subthreshold psychiatric disorder was detected in 42.5% of all patients. Most commonly detected disorders were mood disorders in 31.0% (major depressive disorder, 13.9% and dysthymia, 12.6%), anxiety disorders in 19.0% (generalized anxiety disorder, 10.3%), somatoform disorders in 18.0% and probable alcohol abuse/dependence in 10.1%. The results also showed the important rate of comorbidity between these disorders. Conclusion: The present study confirms the high prevalence of mental disorders in a general practice setting, and their frequent association. Prevalence rates of our study are even higher than those obtained in previously conducted trials. Our study also demonstrates the utility of the PRIME-MD as a screening tool for mental disorders in primary care. In addition the use of the handheld computer software version of the PRIME-MD allowed us to screen for mental disorders in patients who are unable to attend the GP office and are seen during ‘home’ visits.