Stockton Melissa Ann, Mazinyo Ernesha Webb, Mlanjeni Lungelwa, Nogemane Kwanda, Ngcelwane Nondumiso, Sweetland Annika C, Basaraba Cale Neil, Bezuidenhout Charl, Sansbury Griffin, Lovero Kathryn L, Olivier David, Grobler Christoffel, Wall Melanie M, Medina-Marino Andrew, Nobatyi Phumza, Wainberg Milton L
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Research Unit, Foundation for Professional Development, Buffalo City Metro, Eastern Cape Province, South Africa.
Glob Ment Health (Camb). 2023 Dec 21;11:e4. doi: 10.1017/gmh.2023.89. eCollection 2024.
In low-resource settings, valid mental health screening tools for non-specialists can be used to identify patients with psychiatric disorders in need of critical mental health care. The Mental Wellness Tool-13 (mwTool-13) is a 13-item screener for identifying adults at risk for common mental disorders (CMDs) alcohol-use disorders (AUDs), substance-use disorders (SUD), severe mental disorders (SMDs), and suicide risk (SR). The mwTool-13 is administered in two steps, specifically, only those who endorse any of the initial three questions receive the remaining ten questions. We evaluated the performance of mwTool-13 in South Africa against a diagnostic gold standard. We recruited a targeted, gender-balanced sample of adults, aged ≥18 years at primary and tertiary healthcare facilities in Eastern Cape Province. Of the 1885 participants, the prevalence of CMD, AUD, SMD, SR, and SUD was 24.4%, 9.5%, 8.1%, 6.0%, and 1.6%, respectively. The mwTool-13 yielded high sensitivities for CMD, SMD, and SR, but sub-optimal sensitivities for AUD and SUD (56.7% and 64.5%, respectively). Including a single AUD question in the initial question set improved the tool's performance in identifying AUD and SUD (sensitivity > 70%), while maintaining brevity, face-validity, and simplicity in the South African setting.
在资源匮乏地区，非专业人员可使用有效的心理健康筛查工具来识别需要关键心理健康护理的精神疾病患者。心理健康工具-13（mwTool-13）是一个包含13个条目的筛查工具，用于识别有常见精神障碍（CMD）、酒精使用障碍（AUD）、物质使用障碍（SUD）、严重精神障碍（SMD）和自杀风险（SR）的成年人。mwTool-13分两步实施，具体而言，只有那些认可最初三个问题中任何一个的人才能收到其余十个问题。我们对照诊断金标准评估了mwTool-13在南非的性能。我们在东开普省的初级和三级医疗机构招募了一个有针对性的、性别均衡的18岁及以上成年人样本。在1885名参与者中，CMD、AUD、SMD、SR和SUD的患病率分别为24.4%、9.5%、8.1%、6.0%和1.6%。mwTool-13对CMD、SMD和SR具有较高的敏感性，但对AUD和SUD的敏感性欠佳（分别为56.7%和64.5%）。在初始问题集中加入一个单一的AUD问题可提高该工具在识别AUD和SUD方面的性能（敏感性>70%），同时在南非环境中保持简洁性、表面效度和简单性。
