Khanano Raymond, Barbic Skye, Henderson Joanna, Mathias Steve, Richardson Christopher G
UBC School of Population and Public Health (SPPH), University of British Columbia, Vancouver, British Columbia.
UBC Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia.
J Can Acad Child Adolesc Psychiatry. 2021 May;30(2):82-91. Epub 2021 May 1.
There is increasing interest in the identification of mental disorders among youth through routine screening in integrated health services. One tool currently being used in Canada is the Global Appraisal of Individual Needs Short Screener (GAIN-SS). The aims of this study were to (1) estimate the internal consistency of the GAIN-SS and its internalizing disorder screener (IDScr) (2) examine concurrent validity of the GAIN-SS and IDScr in an integrated youth health service centre, and (3) identify clinical cut-points for youth aged 17-24 years.
Participants [n=201, gender=44% women, median age 21 (min,max: 17,24) years] were recruited from an integrated youth health service in Vancouver, British Columbia. Participants completed the GAIN-SS and three reference measures: Kessler Psychological Distress Scale (K10), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7). Cronbach's alpha, sensitivity, and specificity of the GAIN-SS and IDScr were examined using the K-10, PHQ-9 and GAD-7 as reference measures. Receiver operator characteristic curves were generated to identify optimal cut-points for the GAIN-SS and IDScr.
A cut-point of seven for the GAIN-SS optimized sensitivity (90%) and specificity (42%) with Cronbach's alpha of 0.91. A similar pattern of results was found for the IDScr and the reference measures it was tested against.
The results indicate that the GAIN-SS and IDScr have acceptable sensitivity but poor specificity that could be improved via the optimal cut-points identified in this study. This low specificity may be acceptable within an integrated youth health service that provides follow-up diagnostic assessments by a clinician.
通过综合健康服务中的常规筛查来识别青少年精神障碍的关注度日益增加。加拿大目前正在使用的一种工具是个体需求全球评估简版筛查量表（GAIN-SS）。本研究的目的是：（1）评估GAIN-SS及其内化障碍筛查量表（IDScr）的内部一致性；（2）在青少年综合健康服务中心检验GAIN-SS和IDScr的同时效度；（3）确定17至24岁青少年的临床切点。
参与者[n = 201，44%为女性，年龄中位数21岁（最小、最大年龄：17、24岁）]来自不列颠哥伦比亚省温哥华的一家青少年综合健康服务机构。参与者完成了GAIN-SS和三项参照测量：凯斯勒心理困扰量表（K10）、患者健康问卷（PHQ-9）和广泛性焦虑障碍量表（GAD-7）。以K-10、PHQ-9和GAD-7作为参照测量，检验GAIN-SS和IDScr的克朗巴哈系数、敏感性和特异性。生成受试者工作特征曲线以确定GAIN-SS和IDScr的最佳切点。
GAIN-SS的切点为7时，敏感性最佳（90%），特异性为42%，克朗巴哈系数为0.91。IDScr及其所对照的参照测量也得到了类似的结果模式。
结果表明，GAIN-SS和IDScr具有可接受的敏感性，但特异性较差，可通过本研究确定的最佳切点加以改善。在由临床医生提供后续诊断评估的青少年综合健康服务中，这种低特异性可能是可以接受的。
