Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Rd, Rondebosch, Cape Town, 7700, South Africa,
AIDS Behav. 2014 Jun;18(6):1133-41. doi: 10.1007/s10461-014-0698-y.
Given the high prevalence of HIV in South Africa and co-morbid mental disorders in people living with HIV/AIDs (PLWHA) we sought to validate a brief screening tool in primary HIV care.
366 PLWHA were recruited prior to combination anti-retroviral treatment (CART) initiation from two primary health HIV clinics. A mental health nurse administered a socio-demographic questionnaire and the Mini Neuropsychiatric Interview (MINI) and a lay counsellor administered the Substance and Mental Illness Symptom Screener (SAMISS).
Using the MINI, 17 % of participants were identified with either depression, anxiety disorders or adjustment disorder and 18 % with substance or alcohol abuse/dependence. The sensitivity and specificity of the SAMISS was 94 % (95 % CI: 88-98 %) and 58 % (95 % CI: 52-65 %) respectively, with the alcohol component (sensitivity: 94 %; specificity: 85 %) performing better than the mental illness component of the SAMISS (sensitivity: 97 %; specificity: 60 %). The specificity of the tool improved when the cut-off for the mental illness component was increased.
The SAMISS may provide a useful first tier screening tool for common mental disorders in primary care for PLWHA.
未加标签：鉴于南非艾滋病毒感染率较高，且艾滋病毒感染者/艾滋病患者（PLWHA）中并存多种精神障碍，我们试图在初级 HIV 护理中验证一种简短的筛查工具。
方法：从两家初级卫生保健 HIV 诊所招募了 366 名在开始联合抗逆转录病毒治疗（CART）前的 PLWHA。一名心理健康护士管理社会人口统计学问卷和简明精神神经心理评估（MINI），一名非专业顾问管理物质和精神疾病症状筛查器（SAMISS）。
结果：根据 MINI，17%的参与者被诊断为抑郁、焦虑症或适应障碍，18%的参与者患有物质或酒精滥用/依赖。SAMISS 的灵敏度和特异性分别为 94%（95%置信区间：88-98%）和 58%（95%置信区间：52-65%），酒精成分（灵敏度：94%；特异性：85%）的表现优于 SAMISS 的精神疾病成分（灵敏度：97%；特异性：60%）。当增加精神疾病成分的截断值时，该工具的特异性提高。
结论：SAMISS 可能为 PLWHA 的初级保健中常见精神障碍提供有用的一线筛查工具。
