Academic Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.
Interapy, Amsterdam, The Netherlands.
Int J Methods Psychiatr Res. 2017 Sep;26(3). doi: 10.1002/mpr.1579.
To facilitate easily accessible screening for trauma-related symptoms, a web-based application called Smart Assessment on your Mobile (SAM) was developed. In this study, we examined whether SAM was able to accurately identify posttraumatic stress disorder (PTSD) and depression in adults. Eighty-nine referred police officers completed SAM, containing the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 (PCL-5) and the Depression Anxiety and Stress Scale (DASS-21), on their own device prior to a diagnostic interview where the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and Structured Clinical Interview for DSM-IV (SCID-I/P) were administered. Results showed a substantial agreement between SAM and the diagnostic interview in the assessment of PTSD and depression. An optimal trade-off between sensitivity (89%) and specificity (68%) levels was found at a cut-off score of 31 on the PTSD Checklist for DSM-5 (area under the curve = 0.845, 95% CI [0.765, 0.925], diagnostic odds ratio = 15.97). This is one of the first studies to support the validity and reliability of a mobile screener following trauma. SAM may facilitate screening for trauma-related symptoms on a large scale and could be a first step in a stepped-care model for trauma survivors to help identify individuals who need further diagnostics and care.
为了便于进行创伤相关症状的便捷筛查，开发了一个名为“移动智能评估”（SAM）的基于网络的应用程序。在这项研究中，我们检验了 SAM 是否能够准确识别成年人的创伤后应激障碍（PTSD）和抑郁症。89 名被推荐的警察在接受诊断访谈之前，使用自己的设备完成了 SAM，其中包含用于精神障碍诊断与统计手册（DSM-5）的 PTSD 清单（PCL-5）和抑郁、焦虑和压力量表（DASS-21），在访谈中使用了用于 DSM-5 的临床医生管理 PTSD 量表（CAPS-5）和 DSM-IV 定式临床访谈（SCID-I/P）。结果表明，SAM 在评估 PTSD 和抑郁症方面与诊断访谈具有实质性的一致性。在 PTSD 清单的截断分数为 31 时，发现了敏感性（89%）和特异性（68%）之间的最佳权衡，曲线下面积为 0.845（95%CI[0.765, 0.925]），诊断比值比为 15.97。这是支持创伤后移动筛查器的有效性和可靠性的首批研究之一。SAM 可以促进大规模的创伤相关症状筛查，并且可能是创伤幸存者阶梯式护理模式的第一步，有助于识别需要进一步诊断和护理的个体。
