TY  - JOUR
PY  - 2021//
TI  - Brief Screening Tool for Stepped-Care Management of Mental and Substance Use Disorders
JO  - Psychiatric services
A1  - Lovero, Kathryn L.
A1  - Basaraba, Cale
A1  - Khan, Saida
A1  - Suleman, Antonio
A1  - Mabunda, Dirceu
A1  - Feliciano, Paulino
A1  - Dos Santos, Palmira
A1  - Fumo, Wilza
A1  - Mandlate, Flavio
A1  - Greene, M. Claire
A1  - Fiks Salem, Andre
A1  - Mootz, Jennifer J.
A1  - Mocumbi, Ana Olga
A1  - Duarte, Cristiane S.
A1  - Gouveia, Lídia
A1  - Oquendo, Maria A.
A1  - Wall, Melanie M.
A1  - Wainberg, Milton L.
SP  - 891
EP  - 897
VL  - 72
IS  - 8
N2  - OBJECTIVE: Stepped mental health care requires a rapid method for nonspecialists to detect illness. This study aimed to develop and validate a brief instrument, the Mental Wellness Tool (mwTool), for identification and classification.  METHODS: Cross-sectional development and validation samples included adults at six health facilities in Mozambique. Mini International Neuropsychiatric Interview diagnoses were the criterion standard. Candidate items were from nine mental disorder and functioning assessments. Regression modeling and expert consultation determined best items for identifying any mental disorder and classifying positives into disorder categories (severe mental disorder, common mental disorder, substance use disorder, and suicide risk). For validation, sensitivity and specificity were calculated for any mental disorder (index and proxy respondents) and disorder categories (index).  RESULTS: From the development sample (911 participants, mean±SD age=32.0±11 years, 63% female), 13 items were selected-three with 0.83 sensitivity (95% confidence interval [CI]=0.79-0.86) for any mental disorder and 10 additional items classifying participants with a specificity that ranged from 0.72 (severe mental disorder) to 0.90 (suicide risk). For validation (453 participants, age 31±11 years, 65% female), sensitivity for any mental disorder was 0.94 (95% CI=0.89-0.97) with index responses and 0.73 (95% CI=0.58-0.85) with family proxy responses. Specificity for categories ranged from 0.47 (severe mental disorder) to 0.93 (suicide risk). Removing one item increased severe mental disorder specificity to 0.63 (95% CI=0.58-0.68).  CONCLUSIONS: The mwTool performed well for identification of any mental disorder with index and proxy responses to three items and for classification into treatment categories with index responses to nine additional items.<p /> <p>Language: en</p>
LA  - en
SN  - 1075-2730
UR  - http://dx.doi.org/10.1176/appi.ps.202000504
ID  - ref1
ER  -