Stockton Melissa A, Mazinyo Ernesha Webb, Mlanjeni Lungelwa, Nogemane Kwanda, Ngcelwane Nondumiso, Sweetland Annika C, Basaraba Cale, Bezuidenhout Charl, Sansbury Griffin, Lovero Kathryn L, Gouveia Maria Lídia, Dos Santos Palmira Fortunato, Feliciano Paulino, Fumo Wilza, Suleman Antonio, Oquendo Maria A, Grobler Christoffel, Wall Melanie M, Nobatyi Phumza, Medina-Marino Andrew, Wainberg Milton L
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
University of California Global Health Institute, University of California, San Francisco, USA.
Med Res Arch. 2023 Oct;11(10). doi: 10.18103/mra.v11i10.4381. Epub 2024 Jan 11.
Valid mental and substance use disorders and suicide risk screening tools are needed for community case finding of individuals who may not otherwise seek care. We evaluated the Proxy Mental Wellness Tool-3 (mwTool-3-proxy) a three-item screener that asks about the mental health of another adult, against a diagnostic gold standard in Mozambique and South Africa. The mwTool-3-proxy adapts the three items of the Mental Wellness Tool-3, developed in Mozambique using Mini International Neuropsychiatric Interview diagnoses as the criterion standard, regression modeling and expert consultation to determine the best three items for identifying any mental disorder. The Mental Wellness Tool-3 has been validated in South Africa, Spain and the United States, and is being validated in three countries in the Asia-Pacific and Israel. Pairs of adults in South Africa and Mozambique at primary and tertiary healthcare facilities were separately screened with the mwTool-3-proxy and diagnosed using the Mini International Neuropsychiatric Interview. We calculated the sensitivities and specificities for predicting any mental and/or substance use disorder and suicide risk among the proxy individual. We performed additional analyses restricted to respondents who were relatives of one another and who lived in the same household. The prevalence of any Mini International Neuropsychiatric Interview-diagnosed disorder among the 229 pairs in both countries was 35.6% (38.5% in Mozambique; 32.9% in South Africa). The pooled sensitivity of the mwTool-3-proxy for identifying any disorder among the proxy individual was 73.01 (95%CI: 65.5-79.65) - 70.24 (95%CI: 59.27-79.73) in Mozambique and 80.00 (95%CI 69.17-88.35) in South Africa. The mwTool-3-proxy is a culturally-relevant, ultra-brief valid measure that can improve mental and substance use disorders and suicide risk case detection with strong sensitivity at the community and household level and offer a means to efficiently and feasibly collect clinical and population-level service needs data.
需要有效的精神和物质使用障碍及自杀风险筛查工具，以便在社区中发现那些可能不会主动寻求治疗的个体。我们对照莫桑比克和南非的诊断金标准，评估了代理心理健康工具-3（mwTool-3-proxy），这是一个包含三个条目的筛查工具，用于询问另一位成年人的心理健康状况。mwTool-3-proxy改编自莫桑比克开发的心理健康工具-3的三个条目，该工具以迷你国际神经精神病学访谈诊断为标准，通过回归建模和专家咨询来确定识别任何精神障碍的最佳三个条目。心理健康工具-3已在南非、西班牙和美国得到验证，并且正在亚太地区的三个国家和以色列进行验证。在南非和莫桑比克的初级和三级医疗机构中，成对的成年人分别使用mwTool-3-proxy进行筛查，并使用迷你国际神经精神病学访谈进行诊断。我们计算了预测代理个体中任何精神和/或物质使用障碍及自杀风险的敏感性和特异性。我们还对彼此为亲属且居住在同一家庭的受访者进行了额外分析。两国229对受访者中，经迷你国际神经精神病学访谈诊断出患有任何障碍的患病率为35.6%（莫桑比克为38.5%；南非为32.9%）。mwTool-3-proxy在莫桑比克识别代理个体中任何障碍的合并敏感性为73.01（95%CI：65.5-79.65） - 70.24（95%CI：59.27-79.73），在南非为80.00（95%CI 69.17-88.35）。mwTool-3-proxy是一种与文化相关的超简短有效测量工具，可在社区和家庭层面提高精神和物质使用障碍及自杀风险病例的检测率，具有很强的敏感性，并提供一种有效且可行的方式来收集临床和人群层面的服务需求数据。
