Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK.
Newcastle University, Translational and Clinical Medicine, Newcastle Upon Tyne, UK.
Int Psychogeriatr. 2022 May;34(5):427-438. doi: 10.1017/S1041610220003804. Epub 2021 Jan 8.
Common mental disorders (CMDs), particularly depression, are major contributors to the global mental health burden. South Asia, while diverse, has cultural, social, and economic challenges, which are common across the region, not least an aging population. This creates an imperative to better understand how CMD affects older people in this context, which relies on valid and culturally appropriate screening and research tools. This review aims to scope the availability of CMD screening tools for older people in South Asia. As a secondary aim, this review will summarize the use of these tools in epidemiology, and the extent to which they have been validated or adapted for this population.
A scoping review was performed, following PRISMA guidelines. The search strategy was developed iteratively in Medline and translated to Embase, PsychInfo, Scopus, and Web of Science. Data were extracted from papers in which a tool was used to identify CMD in a South Asian older population (50+), including validation, adaptation, and use in epidemiology. Validation studies meeting the criteria were critically appraised using the Quality Assessment of Diagnostic Accuracy Studies - version 2 (QUADAS-2) tool.
Of the 4694 papers identified, 176 met the selection criteria at full-text screening as relevant examples of diagnostic or screening tool use. There were 15 tool validation studies, which were critically appraised. Of these, 10 were appropriate to evaluate as diagnostic tests. All of these tools assessed for depression. Geriatric Depression Scale (GDS)-based tools were predominant with variable diagnostic accuracy across different settings. Methodological issues were substantial based on the QUADAS-2 criteria. In the epidemiological studies identified ( = 160), depression alone was assessed for 82% of the studies. Tools lacking cultural validation were commonly used (43%).
This review identifies a number of current research gaps including a need for culturally relevant validation studies, and attention to other CMDs such as anxiety.
常见精神障碍（CMD），尤其是抑郁症，是全球精神卫生负担的主要原因。南亚虽然多样化，但存在文化、社会和经济方面的挑战，这些挑战在该地区普遍存在，尤其是人口老龄化。这就迫切需要更好地了解 CMD 在这种情况下如何影响老年人，这依赖于有效的和文化适宜的筛查和研究工具。本综述旨在评估南亚老年人 CMD 筛查工具的可用性。作为次要目标，本综述将总结这些工具在流行病学中的使用情况，以及它们在多大程度上已经针对该人群进行了验证或改编。
按照 PRISMA 指南进行了范围界定审查。搜索策略在 Medline 中反复制定，并翻译成 Embase、PsychInfo、Scopus 和 Web of Science。从使用工具在南亚老年人群体（50 岁以上）中识别 CMD 的论文中提取数据，包括验证、改编和在流行病学中的使用。使用符合标准的验证研究使用诊断准确性研究的质量评估-版本 2（QUADAS-2）工具进行批判性评估。
在 4694 篇论文中，有 176 篇在全文筛选时符合选择标准，被认为是诊断或筛查工具使用的相关示例。有 15 项工具验证研究进行了批判性评估。其中，有 10 项适合评估为诊断测试。所有这些工具都评估了抑郁症。基于老年抑郁量表（GDS）的工具占主导地位，在不同的环境下具有不同的诊断准确性。根据 QUADAS-2 标准，方法学问题非常严重。在确定的流行病学研究中（n=160），82%的研究仅评估了抑郁症。普遍使用缺乏文化验证的工具（43%）。
本综述确定了一些当前的研究差距，包括需要进行文化相关的验证研究，以及关注其他 CMD，如焦虑症。
