Valid Screening Instrument Research Articles

Arabic version of Pediatric Sleep Questionnaire (PSQ)

BackgroundLaboratory studies are costly in diagnosing OSA, particularly in research studies.ObjectivesThis study seeks to validate the Arabic version of the Pediatric Sleep Questionnaire (PSQ) in Arabic for an OSA screening test.MethodsThe PSQ was translated into Arabic and culturally adapted to develop the APSQ. The application of the APSQ was made for 66 children with OSA, wherein 33 children were retested after 15 days, and 66 children without OSA.ResultsAPSQ was highly reliable for each subdomain, and the total questionnaire used Cronbach’s alpha. It also shows high reliability for each questionnaire and each subdomain. The area under the curve showed high accuracy for the APSQ with a specificity of 100% and a sensitivity of 96.9%.ConclusionThe Arabic Pediatric Sleep Questionnaire (APSQ) is a reliable and valid instrument for screening for obstructive sleep apnea in children; it is additionally sensitive in identifying manifestations of obstructive sleep apnea in children.

Determining the diagnostic cut-off on the Chinese version of severity of dependence scale for cannabis.

Cannabis use and misuse are surging among the Chinese community in East and Southeast Asia. A quick screening instrument that can effectively identify users with dependence for early intervention is in utmost need. This study examined the psychometric properties of the Chinese version of the Severity of Dependence Scale for cannabis (C-SDS-C) in screening for the DSM-5 defined Cannabis Use Disorder (CUD). A retrospective chart review was conducted on Chinese-speaking individuals reporting cannabis use from three different substance use studies. Their demographic data, frequency of cannabis use within the past 30 days, scorings for the C-SDS-C and the severity of CUD at baseline were analyzed. The C-SDS-C exhibited high reliability (Cronbach's alpha = 0.778). It had a strong correlation with the severity of CUD (r = 0.456, p <.001) and a moderate correlation with the frequency of cannabis use within the past 30 days (r = 0.335, p = .001). All items loaded into a single factor which accounted for 56.64% of the variance. Receiver operating characteristic analysis demonstrated that a C-SDS-C cut-off score of ≥ 3 provided optimal discrimination for moderate to severe CUD among Chinese-speaking individuals using cannabis. The C-SDS-C is a valid and reliable screening instrument to identify cannabis users with moderate-to-severe CUD in the Chinese-speaking population.

Epidemiological Studies on COVID-19 and Mental Health in Mexico: Better Methodology for Better results: a Literature Review

Background. Updated information is required on studies conducted in Mexico on the mental health consequences of COVID-19. Objective. In comparison with previous efforts, we increased the timeframe of the literature search to February 2023 and used a larger list of potential mental health outcomes. Method. We used common international literature databases and more local databases, such as SciELO, and the Biblioteca Virtual en Salud (BVS). We focussed on the methodological issues of these studies, their prevalence estimates and suspected risk factors. Results. We reported on ninety-five studies that included Mexican data on symptoms of alcohol use, anxiety, depression, gaming, sleep problems and suicidal thoughts and behaviours. In most cases, we found a cross-sectional survey with self-reported information on mental health symptoms usually although not always with validated screening instruments and scales. These studies were implemented on websites, and sometimes over the phone, on self-selected volunteers. We found a small subset of fourteen longitudinal datasets (for alcohol use, anxiety, depression, and suicidal thoughts and behaviours) that suggested a more cautious interpretation of the effects of the COVID-19 pandemic on the mental health of Mexicans. Discussion and conclusion. Although the initial rapid studies during the early phases of the pandemic yielded warning signs, they did not necessarily follow standard epidemiological principles. Methodological improvements are required for future studies on the mental health consequences of natural, man-made disasters and epidemic contingencies.

Validation of the Dutch Infant Crying and Parent Well-Being Screening Tool in Parents of Infants Less than 12 Months of Age

To evaluate reliability and validity of the Dutch version of the Infant Crying and Parent Well-Being (ICPW) tool in identifying parents struggling with infant crying in the first year of life. The original ICPW tool was translated into Dutch following established guidelines. The internal consistency and criterion validity of the Dutch ICPW tool were evaluated using a cross-sectional design. The translated ICPW tool and validated questionnaires on parental depression, stress, anxiety, and parenting balance were presented to parents of infants under 12months during child health care visits and online. The survey was completed by 488 parents, 400 mothers and 88 fathers. Of these, 172 participated after a child health care visit and 316 via online platforms. The Dutch ICPW showed satisfactory internal consistency (α=0.69) and excellent criterion validity with parental mental health measures (r=0.53-0.85). ICPW scores demonstrated positive correlations with parental depression, stress, and anxiety levels, and a negative correlation with parenting balance. Both mothers and fathers with a positive ICPW screen (≥3) reported significantly higher levels of parental mental health issues compared with those with a negative screen (P<.001). The ICPW was positive in 32% of the parents (n=155), with consistent total scores regardless of the infant's increasing age (r=-0.024, P=.59). The ICPW tool exhibited a strong negative predictive value (93%) for diagnosing postpartum depression. The Dutch ICPW tool is a reliable and valid screening instrument for identifying parents struggling with infant crying.

Evaluating depression in Indonesian adolescents with epilepsy: Comprehensive validation and reliability assessment of the neurological disorders depression inventory-epilepsy for youth Indonesian version (NDDI-E-Y[ID]).

Epilepsy is a common chronic neurological disorder in pediatrics. Depression is an often underdetected comorbidity in childhood epilepsy. This study aimed to adapt the Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y) to the Indonesian language and population, as well as to validate the Indonesian version of NDDI-E-Y (NDDI-E-Y[ID]). This three-stage study comprised instrument translation, cultural verification, and content validity testing (first stage), pilot testing (second stage), followed by concurrent validity and reliability testing (third stage) of the NDDI-E-Y(ID). Validation was done against the Centre for Epidemiologic Studies Depression Scale - Revised (CESD-R). Content validity, assessed by six experts, was quantified using the content validity index for items (I-CVI) and scale (S-CVI). Participants were adolescents aged 12-17 years diagnosed with any type of epilepsy who completed both instruments. Concurrent validity was evaluated using Spearman's correlation and reliability was measured using Cronbach's alpha. The first stage produced a culturally appropriate NDDI-E-Y(ID). Thirty healthy adolescents and 10 adolescents with epilepsy participated in the second stage. In the third stage, another group of 30 adolescents with epilepsy took part. We obtained I-CVI and S-CVI values averaging 1. The NDDI-E-Y(ID) showed a positive and significant correlation with CESD-R (Spearman's rho = 0.671, p < 0.001). A Cronbach's alpha of 0.928 reflected a high internal consistency. Based on the results, the NDDI-E-Y(ID) was found to be a valid and reliable screening instrument for detecting depression in youth with epilepsy. Depression is an under-recognized problem in youth with epilepsy. Currently available depression screening tools are in English, making it less suitable for detection purposes in Indonesia. This study developed and validated the Indonesian version of the NDDI-E-Y, a depression screening tool for youth with epilepsy.

Screening instruments for mental disorders in primary healthcare: a scoping review protocol (SCREENING-MD)

IntroductionWhen mental disorders go undetected until later stages, they can result in poorer health outcomes for patients. Primary healthcare (PHC) stands as a strategic setting for the early identification and...

P8: Comparison between three cognitive impairment screening tools (MMSE, MoCA and MoCA basic) for seniors with low education in primary care in Brazil

Objectives: Compare the psychometric characteristics of three brief screening instruments - Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and its basic version (MoCA basic), for early detecting mild and major neurocognitive disorder (NCD), discriminating from normal elders and provide MoCA and MoCA basic norms and accuracy data for seniors with a lower education level, including illiterates.Methods: Cross-sectional study, with 60 years or older community dwelling individuals, submitted to diagnostic interviews (according to DSM-5) and screening tests. Of a total of 271 elderly interviewed, 59 had mild and 32 had major NCD. A sum of 266 MMSE; 104 MoCA and 81 MoCA basic were applied. Area under the ROC curve (AUC) was determined for all three tests, and sensitivity (S), specificity (E) and cutoff score (CS) for the last two were determined.Results: The total scores varied significantly according to age and education (p &lt; 0.01). MMSE had a high discriminative validity – AUC for normal vs major NCD = 0,915 (p &lt; 0.001; 95% CI 0,868– 0,963) and regular for normal vs mild NCD = 0,706 (p &lt; 0.001; 95% CI 0,631–0,781). MoCA demonstrated excellent discriminative validity – AUC for normal vs major NCD = 0.932 (p &lt; 0.001; 95% CI 0.842–1.000) and regular for mild NCD – AUC = 0.753 (p &lt; 0.001; 95% CI: 0.654– 0.853). CS was 9 (S = 83% E = 95%) and 16 (S = 83% E = 68%). MoCA basic showed excellent discriminative validity for major NCD vs normal AUC = 0.910 (p &lt; 0.001; 95% CI 0.818–1.002) and good for mild NCD vs normal AUC = 0.834 (p &lt; 0.001; 95% CI: 0.742 –0.927). CS was 21 for both conditions (S = 100% E = 72%; S = 89% E = 72%).Conclusions: The MoCA and MoCA basic are valid screening instruments for cognitive assessment of low-schooled elderly people from the community, but we found different cut-off from the original and other studies. The MMSE still remains a good and useful tool. These results provide information about psychometric characteristics of the instruments for elderly with low schooling in Brazil.

Prevalence of Sexual Dysfunction In Inflammatory Bowel Disease: Systematic Review and Meta-Analysis.

Patients with inflammatory bowel disease (IBD) may experience symptoms of sexual dysfunction (SD). However, the magnitude of this problem remains uncertain. Therefore, we performed a systematic review and meta-analysis to assess the prevalence of SD in adult patients with IBD. MEDLINE EMBASE, EMBASE Classic (from inception to 9th April 2024) were searched to identify observational studies reporting the prevalence of SD in adult patients with IBD based on validated screening instruments. Data were extracted, and pooled prevalence (PP), odds ratios (OR), and 95% confidence intervals (CIs) were calculated. Of 1017 citations evaluated, 18 articles fulfilled eligibility criteria, containing 2,694 patients with IBD recruited from 13 different countries. The PP of SD in IBD patients was 50.6% (95% CI=40.8%-60.5%; I2=96.3%) with an OR=2.94 (95% CI=1.99-4.35, I2=73.4) compared to healthy controls. When we considered UC or CD separately, the PP of SD was 64.8% (95% CI=45.1%-82.1%; I2=88.8%) in patients with UC, and 58.3% (95% CI=36.0%-79.0%; I2=95.3%) in patients with CD. In the subgroup analysis based on sex, the PP of SD was higher in females with IBD than in males (62.7% vs 34.0%; OR=3.99, 95% CI=2.80-5.68; I2=61.7%,). Furthermore, the PP of SD was higher in patients with active disease than patients with inactive disease (75.1% vs 34.2%; OR=9.65, 95% CI=1.02-91.33, I2=95.5%). We demonstrated high prevalence of SD in IBD patients, especially in women. Encouraging gastroenterologists to screen for, and treat, these disorders with a holistic approach might improve quality of life of patients with IBD.

Gambling Habits and Attitudes among Athlete and Non-Athlete High School Students in Skåne Region, Sweden.

Previous literature has reported increased rates of gambling problems in athletes compared to non-athletes. More liberal gambling-related attitudes have been suggested as a reason, although this rarely has been researched. The present study aimed to examine gambling experience, gambling problems, and gambling-related attitudes and parental gambling experience in high school students, comparing student-athletes to students at conventional schools. This is a cross-sectional web survey study in high school students (N = 473, 53% at sports high schools, 57% male) at eleven schools in the Skåne region, Sweden, who answered a web survey addressed gambling experiences, parental gambling and gambling-related attitudes, and included validated screening instruments for gambling problems and psychological distress. A history of any gambling was common and increased with age. Problem gambling was detected in 10% (13% of males and 5% of females, p < .001), and was associated with paternal and maternal gambling but not with psychological distress. Sports high school students were not more likely (9%) than other students (10%) to endorse gambling problems and history of each gambling type. However, paternal (but not maternal) gambling was more commonly reported in athletes, who also had more positive attitudes to gambling's effects on society and gambling availability. In contrast to other studies, this study did not demonstrate higher prevalence of gambling or gambling problems among young athletes than among other students, but liberal attitudes towards gambling, and experience of parental gambling on the father's side, were more common among athletes than among non-athletes. Gambling attitudes in adolescents may need to be targeted in future preventive efforts in young athletes and others.

Development and validation of a brief three-item form of the perceived social support questionnaire (F-SozU K-3)

ObjectiveThe purpose of the present study was to develop and validate a brief screening instrument (F-SozU K-3) for the measurement of perceived social support in large scale surveys by shortening a well-established German questionnaire (F-SozU K-6). MethodFirst, a brief three-item version of the F-SozU was developed based on a representative sample of N = 2482 respondents using exploratory and confirmatory factor analysis. Second, the newly developed brief three-item questionnaire was evaluated and standardized in an independent second representative population sample (N = 2501). ResultsA suitable three-item solution with a good internal consistency (α = 0.89, ω = 0.89) was identified. Full invariance across sex and partnership was established. Construct validity of the brief three-item form was established. Younger age, female sex, partnership status, and current employment were positively associated with higher social support scores. Norm values for the general sample and separately for sex and partnership status were reported. ConclusionsThe newly developed F-SozU K-3 is a reliable and valid screening instrument. It can be used as an economical alternative to previous longer instruments, especially in large scale surveys.

Prevalence and biopsychosocial indicators of fatigue in cancer patients.

Symptoms of cancer-related fatigue (CRF) can have a significant impact on patients' quality of life and treatment adherence. We aimed to investigate the relationship between CRF and multiple psychosocial and somatic indicators within a large mixed cancer sample. In this cross-sectional study, N = 1787 outpatients with cancer were assessed for CRF, pain, anxiety, and depression using validated screening instruments. We further obtained clinical parameters (Hb, CRP, creatinine, leukocytes, ASAT, and ALAT), sociodemographic data (age, gender, income, education level, marital status, parenthood, and living area), and lifestyle factors. Multivariate linear regression models were applied to estimate the impact of each indicator on CRF. Overall, 90.6% of patients experienced some CRF, with 14.8% experiencing severe CRF. No gender difference was found in the prevalence of CRF. Patients with higher levels of pain, depressive symptoms, and lower Hb levels had significantly higher levels of CRF (ps <0.001). Lower levels of CRF were observed in patients who had children (p = 0.03), had less education (p < 0.001), and were physically active for more than 2 h per week before their oncological diagnosis (p = 0.014). The latter was only a significant indicator in the male subsample. The present results demonstrate a high prevalence of CRF and highlight that not only somatic and psychosocial factors, but also lifestyle factors prior to diagnosis appear to be associated with the etiology and persistence of CRF. To effectively treat CRF, a biopsychosocial, personalized approach is recommended.

Assessing the Factor Structure and Construct Validity of the Beck Depression Inventory (BDI-II) in a Korean Preschool Teacher Sample

Preschool teachers are at high risk of depression. Therefore, emphasis should be placed on evaluating a valid and reliable instrument to measure depressive symptomatology for this population. One such promising instrument is the Beck Depression Inventory (BDI-II), a 21-item self-report measure designed to assess the presence and severity of depression. Although the tool’s psychometric properties have been analyzed in different samples, they have not been validated with a Korean preschool teacher sample. Hence, this study sought to evaluate the psychometric properties of the Korean version of the BDI-II in a sample of Korean preschool teachers. The study participants comprised 252 Korean preschool teachers (243 women and 9 men) with an average age of 33.5 years (SD = 10.3, range = 21-59). The participants completed the Korean version of the BDI-II online. Confirmatory factor analysis was performed to examine the psychometric properties of the BDI-II. Six models based on the literature were tested, including single-factor, correlated two- and three-factor, and bifactor models. The reliability and validity of the BDI-II were also analyzed. The bifactor model demonstrated the best data fit with an overarching vital general depression factor that coexists with comparatively weak specific cognitive, affective, and somatic factors. Internal consistency, measured using McDonald’s omega coefficients, was adequate in all cases. Using a validated screening instrument such as the BDI-II may allow clinicians to better detect depression among preschool teachers because of its conciseness and satisfactory psychometric properties. Since a bifactor model confirmed the unidimensionality of the BDI-II, the scores of specific factors should not be used in isolation. However, clinical assessment may benefit from its subscales if they are used in conjunction with total scores.

Outpatient psychosocial screening in askin cancer center: acceptance, psychosocial distress and utilization of support : Aposthoc analysis in aquality management program

Psychosocial care of cancer patients is an important aspect throughout the entire course of oncological treatment. Since 2015, psychosocial screening has been implemented in the outpatient clinics of the Skin Cancer Center in Freiburg. We present here apost hoc analysis in the context of aquality management program. Acceptance, psychosocial distress and desire for counseling were evaluated. Exploratively, we investigated which patient and disease characteristics are related to increased subjective distress. In afull survey from 06/2015 to 12/2015, we evaluated acceptance, psychosocial distress by distress thermometer (DT), and desire for counseling. Of 753 patients, 345 (45.8%) participated in psychosocial screening and data from 310 (174men, 136women; 89.7% melanoma patients, mean time since initial diagnosis 4.7 ± 3.9years) could be analyzed. The mean burden on the DT was 2.97 ± 2.83 (median2, range 0-10). High distress (DT ≥ 5) was reported by 84patients (28.8%). Thirty-four patients (11%) indicated adesire for counseling, and 23patients took up the counseling offer. The patient group with high distress was younger, more often under ongoing or recently completed systemic therapy, and had more often adesire for counseling. In addition to assessing psychosocial distress with validated screening instruments, the survey of the subjective desire for care represents an important parameter for the identification of patients in need of care. Young patients and patients with ongoing systemic therapy should be the focus of attention.

Mental Health and Traumatic Occupational Exposure in Wildland Fire Dispatchers

Wildland fire dispatchers play a key role in wildland fire management and response organization; however, to date, wildland fire studies have largely focused on the physical hazards and, to a lesser extent, mental health hazards of wildland firefighting operational personnel, and dispatcher studies have primarily focused on 911 and police dispatchers. Studies of other dispatchers have provided some limited insight into potential strains impacting this workforce, including work-related fatigue, burnout, and traumatic exposure. However, the specific job hazards that are faced by wildland fire dispatchers are poorly understood. In 2023, we conducted a cross-sectional survey of 510 wildland fire dispatchers with questions about their occupational health, general health, and well-being. We used validated screening instruments to measure the rates of anxiety, depression, PTSD, and suicidal thoughts and ideation. Here, we also present the results of mental health and trauma exposure questions that were asked as part of a larger survey. We found that demographic factors were significant indicators of anxiety, depression, and binge/restrictive eating. Our data indicate that rates of anxiety, depression, PTSD, and suicidal thoughts and ideation are significantly higher for both the wildland fire dispatching workforce and other emergency responder populations than those of the general United States population.

The “bubbles”-study: validation of ultra-short scales for the assessment of positive mental health, life satisfaction, and perceived social support

Abstract Aim The positive dimension of mental health should be considered to assess the complete state of a person’s mental health and to protect it. Very brief valid screening instruments implemented in general mental health programs and in therapeutic setting are supportive tools hereby. In the present work, we aimed to develop such tools. Subject and methods In two studies (Study 1: N = 1,004; Study 2: N = 1,000) on representative German population samples, we developed and validated three ultra-short scales – the “bubbles” – that consist of only one item per construct based on Positive Mental Health Scale (PMH-Scale; Lukat et al. 2016), Satisfaction with Life Scale (SWLS; Diener et al. 1985), and Social Support Questionnaire (F-SozU K-6; Lin et al. 2019) for the assessment of the positive mental health dimension. The bubbles are designed in a graphical/visual format. Results The results of Study 1 and Study 2 revealed that the bubbles are valid instruments that fit the original instruments on the factor level; the bubbles mostly replicated their association pattern with demographic variables, and with variables that belong to the negative and the positive dimension of mental health. Conclusions The shortness of the bubbles prevents participants’ fatigue and motivation decrease. Thus, due to their time- and cost-efficiency, the bubbles can be used as brief screening tools in research (e.g., large-scale studies, longitudinal studies, experience sampling paradigms) and in praxis (e.g., mental health programs). Future research should validate the bubbles in clinical context and cross-national.

The assessment of preschool children with ESSENCE symptoms: concordance between parents, preschool teachers and child psychologists

BackgroundIt is important to detect children with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) in order to implement early intervention and support for the child and family. Standardized instruments for assessment in different contexts of behaviour problems, engagement and psychosocial health obtain an objective picture of the preschool child's mental health.AimTo explore and compare parents', preschool teachers' and child health care psychologists' assessment of behaviour, everyday function, engagement, social interaction and psychosocial health in children with ESSENCE symptoms.MethodParents of 152 children (114 boys and 38 girls, 4.5 ± 1 years) with ESSENCE symptoms, 155 preschool teachers and 8 child psychologists participated. Parents and preschool teachers assessed externalizing and internalizing behavioural problems using the Strengths and Difficulties Questionnaire (SDQ), including the SDQ supplement for assessing the impact of behavioral problems on daily function. Preschool teachers also assessed engagement and social interaction using the Children's Engagement Questionnaire (CEQ), and the child psychologists assessed psychosocial health with the Child Psychosocial Health Assessment (LillaLAPS) and template in conversations with parents of children with neurodevelopmental problems.ResultsParents', preschool teachers' and child psychologists' assessment of the child's ESSENCE symptoms overall agreed. Both parents and preschool teachers see a strength in the child's social abilities. Differences in mean values show that parents assess more conduct, emotional symptoms and problems in daily life and more social skills, compared to the preschool teachers rating more peer problems.ConclusionIt is important to consider different contexts to identify the child's need for support in everyday life. Expanded use of validated screening instruments in clinical practice would promote detection of children not already identified as exhibiting neurodevelopmental problems.

The “Bubbles”-Study: Validation of ultra-short scales for the assessment of addictive so-cial media use and grandiose narcissism

Intensive engagement in social media use (SMU) can result in the development of addictive tendencies and a decrease of mental health. Enhanced levels of the personality trait narcissism foster addictive SMU. An early identification of persons at risk for the addictive tendencies can contribute to the protection of their mental health. Very brief valid screening instruments implemented in general mental health programs and in therapeutic settings are supportive tools in this regard. In two studies on representative German population samples, we developed and validated four ultra-short scales – the “bubbles” – that consist of only one item per construct/subscale based on the Bergen Social Media Addiction Scale (BSMAS; Andreassen, Pallesen, & Griffiths, 2017) and the Narcissistic Personality Inventory (NPI-13; Gentile et al., 2013) for the assessment of addictive SMU (one bubble) and narcissism (one bubble per subscale). The results of Study 1 (N = 700) and Study 2 (N = 770) showed that the bubbles are valid instruments that fit the original instruments on the factor level; the bubbles largely replicated their association pattern with demographic variables, social media-related, personality-related and mental health-related variables. Their shortness prevents fatigue, motivation decrease, and participants’ dropout. Due to their time- and cost-efficiency, the bubbles can be used as brief screening tools in research (e.g., large-scale studies, longitudinal studies) and in praxis (e.g., mental health programs). Future research should validate the bubbles cross-nationally, in children and adolescents, and in clinical contexts.

A contribution to the French validation of the clinical anxiety scale amongst health care workers in Switzerland

BackgroundAnxiety disorders are frequent but remain often underdiagnosed and undertreated. Hence, valid screening instruments are needed to enhance the diagnostic process. The Clinical Anxiety Scale (CAS) is a 25-item anxiety screening tool derived from the Hamilton Anxiety Scale (HAM-A). However, this scale is not available in French. The General anxiety disorder − 7 (GAD-7) scale, which has been validated in French, is a 7-item instrument with good psychometric properties. This study contributes to the validation of an adapted French version of the CAS, using the GAD-7 as the reference.MethodsA forward-backward English-French-English translation of the CAS was performed according to standard practice. The French versions of the CAS and GAD-7 were completed by 127 French speaking healthcare professionals. CAS internal consistency was assessed using Crohnbach’s alpha, and test-retest reliability was tested after 15 days in a subsample of 30 subjects. Convergent validity with GAD-7 was assessed using Pearson’s correlation coefficient. Test-retest reliability was explored using one-way random effects model to calculate the intra-class correlation coefficient (ICC).ResultsFrench CAS showed excellent internal consistency (Cronbach’s alpha 0.97), high convergent validity with GAD-7 (Pearson’s R 0.81, p < 0.001), and very good test-retest reliability (ICC = 0.97, 95% CI 0.93–0.98).ConclusionThe proposed French version of the CAS showed high reliability and validity that need to be further investigated in different populations.

What is the role of screening instruments in the management of psychiatric comorbidities in epilepsy? Tools and practical tips for the most common comorbidities: Depression and anxiety

Depression and anxiety are the most common psychiatric comorbidities in epilepsy and are known to increase healthcare utilization, the risk of refractory epilepsy, and anti-seizure medication intolerability. Despite this, depression and anxiety continue to be underrecognized and undertreated in people with epilepsy (PWE). Several barriers to the identification of depression and anxiety in PWE exist, including reliance on unstructured interviews rather than standardized, validated instruments. Moreover, there is a dearth of behavioral health providers to manage these comorbidities once identified. The use of validated screening instruments in epilepsy clinics can assist with both the identification of psychiatric symptoms and monitoring of treatment response by the epilepsy clinician for PWE with comorbid depression and/or anxiety. While screening instruments can identify psychiatric symptoms occurring within a specified time, they are not definitively diagnostic. Screeners can be time efficient tools to identify patients requiring further evaluation for diagnostic confirmation.This article reviews recent literature on the utility of depression and anxiety screening instruments in epilepsy care, including commonly used screening instruments, and provides solutions for potential barriers to clinical implementation. Validated depression and anxiety screening instruments can increase identification of depression and anxiety and guide epilepsy clinician management of these comorbidities which has the potential to positively impact patient care.

Diagnostic accuracy of the ‘Dysphagia Screening Tool for Geriatric Patients’ (DSTG) compared to Flexible Endoscopic Evaluation of Swallowing (FEES) for assessing dysphagia in hospitalized geriatric patients – a diagnostic study

BackgroundOropharyngeal dysphagia is highly prevalent among hospitalized geriatric patients. The screening instruments used to date have been evaluated primarily in stroke patients. This diagnostic study aimed to validate a new screening instrument for oropharyngeal dysphagia, the ‘Dysphagia Screening Tool for Geriatric Patients’ (DSTG), as compared to one of the gold standards, flexible endoscopic evaluation of swallowing (FEES).Materials and methodsGeriatric inpatients admitted to five geriatric hospitals in Germany were consecutively evaluated using both DSTG and FEES in random order and by different evaluators blinded to the results of the other evaluation. In the FEES examination, a score of more than 3 on Rosenbek’s Penetration Aspiration Scale was considered evidence of clinically relevant oropharyngeal dysphagia. Sensitivity, specificity and further measures of test performance were calculated for DSTG.ResultsThe 53 volunteers recruited were on average 85 years of age, 56.6% were women. Twenty patients (37.7%) were diagnosed with dysphagia using FEES. Of these, 12 were screened as positive on DSTG. Of the 33 FEES negative patients, 4 tested positive on DSTG. The following test parameters were calculated for DSTG: sensitivity: 0.60, 95% confidence interval [0.39 ; 0.78], specificity 0.88 [0.73 ; 0.95], positive predictive value 0.75 [0.51 ; 0.90], negative predictive value 0.78 [0.63 ; 0.89], positive likelihood ratio 4.95 [1.85 ; 13.27], negative likelihood ratio 0.46 [0.26 ; 0.79]. In a receiver-operator characteristic (ROC) curve analysis, the area under the curve (AUC) was 0.77 [0.62 ; 0.91]. No adverse events occurred.ConclusionThe DSTG appears to be a valid instrument for screening of oropharyngeal dysphagia in geriatric inpatients.