Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam.
CESP Inserm UMRS 1018, Paris Saclay University, Pierre Nicole Center, French Red Cross, Paris, France.
Drug Alcohol Rev. 2022 Mar;41(3):697-705. doi: 10.1111/dar.13402. Epub 2021 Nov 16.
The prevalence of mental health disorders among people who use drugs is high and well documented. This hard-to-reach population faces a very low awareness and access to mental health care, especially in developing countries. The objectives of this study were to design and assess a quick screening tool (QST) that community-based organisations (CBO) could routinely apply to a Vietnamese population of people who inject drugs (PWID), in order to refer them appropriately to mental health specialists.
We devised a tool that included nine questions covering anxiety, depression, suicide risk and psychotic symptomatology. Its use required no specific background and 2 h training. Specificity and sensitivity of the QST were assessed in a population of 418 PWID recruited via respondent driven sampling, using the Mini International Neuropsychiatric Interview questionnaire plus clinical evaluation as a reference standard. Acceptability was assessed using a self-administered anonymous questionnaire submitted to all CBO members who used the QST.
CBO members considered the QST easy to use, relevant and helpful to deal with mental health issues. Area under the curve for detection of any symptom using the QST was 0.770. The maximum sensitivity and specificity were reached with a cut-off of 2 [sensitivity was 71.1% (95% confidence interval 62.4, 78.8), specificity was 75.9% (70.5, 80.7)].
The QST appeared to be both efficient and well accepted. Given the burden of mental health problems among hard-to-reach PWID in developing countries, community-based screenings such as this one could be a particularly appropriate response.
使用毒品的人群中心理健康障碍的患病率很高，这一点已得到充分证实。这个难以接触的群体对心理健康护理的认识度和可及性非常低，尤其是在发展中国家。本研究的目的是设计和评估一种快速筛查工具（QST），社区组织（CBO）可以常规应用于越南注射毒品者（PWID）人群，以便将他们适当地转介给心理健康专家。
我们设计了一个包含九个问题的工具，涵盖焦虑、抑郁、自杀风险和精神病症状。使用该工具不需要特定的背景知识，只需 2 小时的培训。通过应答驱动抽样招募的 418 名 PWID 人群，使用 Mini 国际神经精神访谈问卷加临床评估作为参考标准，评估了 QST 的特异性和敏感性。通过向所有使用 QST 的 CBO 成员提交匿名自我管理问卷，评估了可接受性。
CBO 成员认为 QST 使用方便、相关且有助于处理心理健康问题。使用 QST 检测任何症状的曲线下面积为 0.770。使用 2 作为截断值可达到最大敏感性和特异性[敏感性为 71.1%（95%置信区间 62.4，78.8），特异性为 75.9%（70.5，80.7）]。
QST 似乎既有效又被广泛接受。鉴于发展中国家难以接触的 PWID 中心理健康问题的负担很重，像这样的基于社区的筛查可能是一种特别合适的应对措施。
