Tag: Screening Tool

What is the Seasonal Pattern Assessment Questionnaire?

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Introduction

The Seasonal Pattern Assessment Questionnaire, or SPAQ, is a simple, self-administered screening test for Seasonal Affective Disorder, first developed in 1984. Though some aspects of its accuracy have been questioned since then, it is widely used today, especially by SAD researchers.

Background

The SPAQ is a screening instrument for seasonal affective disorder (SAD), a recurrent major depressive disorder that typically affects its victims during the fall and winter months. It was first developed by American psychiatrist Norman E. Rosenthal and his National Institute of Mental Health colleagues in 1984, and continues to be widely used. It is a self-administered paper-and-pencil test that is freely available in the public domain. The SPAQ can be downloaded.

The questionnaire asks subjects to score the amounts of seasonal changes they have experienced in sleep, socialization, mood, weight, appetite and energy. A global score between 0 and 24 is gotten by adding up the scores on each of these items. Subjects also specify the months during which these changes are greatest and least. Subjects are also asked rate their overall seasonal impairment from “no problem” to “disabling”.

Subjects are often taught how to interpret their scores, and cautioned that a self-assessment can never substitute for a clinical evaluation. If their score on the SPAQ is high, they are advised to consult their physician.

Reliability, Validity, and Specificity

Numerous studies have been done to assess the usefulness of the test. In general, it has been found to be reliable (in that it yields consistent measurements) and valid (in that it measures what it purports to measure). It has also been found to have low specificity (in that people who have other forms of depression can score as if they have SAD). This could give misleadingly high estimates of the prevalence of SAD.

Some studies have questioned the overall validity of the SPAQ, and even the concept of SAD itself.

In spite of its shortcomings, the SPAQ is still a very popular screening tool in SAD research. This is true because of its early development, historically wide dissemination, and the absence of better-validated alternatives.

What is the Centre for Epidemiologic Studies Depression Scale?

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Introduction

The Centre for Epidemiologic Studies Depression Scale (CES-D) is a brief self-report questionnaire developed in 1977 by Laurie Radloff to measure depressive symptoms severity in the general population.

The CES-D consists of 20 questions that asks about various symptoms of depression as they have occurred in the past week, and the majority of the items focus on the affective component of depression. Although initially designed for use in general population surveys, CES-D now serves as a screening instrument in primary care clinics and in research.

A revision, the CESD-R was produced in 2004.

Centre for Epidemiologic Studies Depression Scale for Children

The Centre for Epidemiologic Studies Depression Scale for Children (CES-DC) is a modified version of the Centre for Epidemiologic Studies Depression Scale. This measure assesses both depressive symptoms as well as symptom improvement in a wide range of children and adolescents, ages 6-17. The CES-DC was first developed to measure the incidence and prevalence of depression among children and adolescents in large-scale epidemiological research. Several research studies have found the CES-DC to be a reliable and valid measure of depressive symptoms in children.

Question Breakdown and Scoring

The CES-DC is an inventory of 20 self-report items regarding depressive symptoms, taking about 5 minutes to complete. Each item asks how often a symptom has occurred within the last week. Response choices are assigned point values, which are summed together to determine a total measure score. Response choices for each item and their corresponding point values are as follows:

  • 0 points: “Not at all”.
  • 1 point: “A little”.
  • 2 points: “Some”.
  • 3 points: “A lot”.

Items 4, 8, 12 and 16 are phrased to reflect positive affect and behaviour, and therefore are scored in opposite order as follows:

  • 0 points: “A lot”.
  • 1 point: “Some”.
  • 2 points: “A little”.
  • 3 points: “Not at all”.

Interpretation

Scores on the CES-DC range from 0 to 60, in which higher scores suggest a greater presence of depressive symptoms. A score of 15 or higher is interpreted to indicate a risk for depression. However, screening for depression is a complex process and scoring a 15 or higher on the CES-DC should be followed by further evaluation.

Limitations

A study evaluating the CES-DC found that the scores do not necessarily match up to a DSM diagnosis, and while it is a good psychometric tool for adolescents, reliability and validity is poor when applied to children.

What is the SCOFF Questionnaire?

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Introduction

The SCOFF questionnaire utilises an acronym in a simple five question test devised for use by non-professionals to assess the possible presence of an eating disorder.

Scoff is also an alternative/slang word for food.

Background

It was devised by John F. Morgan, Fiona Reid, and J Hubert Lacey in 1999.

The original SCOFF questionnaire was devised for use in the United Kingdom, thus the original acronym needs to be adjusted for users in the United States and Canada.

The letters in the full acronym are taken from key words in the questions:

  • Do you make yourself Sick because you feel uncomfortably full?
  • Do you worry that you have lost Control over how much you eat?
  • Have you recently lost more than One stone (14 lb/6.5 kg) in a 3-month period?
  • Do you believe yourself to be Fat when others say you are too thin?
  • Would you say that Food dominates your life?

Notes

  • The “S” stands for “Sick”:
    • In British English means specifically to “vomit”.
    • In American English and Canadian English it is synonymous with “ill”.
  • The “O” is used in the acronym to denote “one stone”.
    • A “stone” is an Imperial unit of weight which made up of 14 lbs (equivalent to 6.35 kg).

All participants (in Morgan and colleagues research) found the questions and the term “SCOFF” acceptable. Setting the threshold at two or more yes answers to all five questions provided 100% sensitivity for anorexia and bulimia, separately and combined (all patients: 95% confidence interval, 96.9%-100.0%; patients with bulimia: 92.6%-100.0%; and patients with anorexia: 94.7%-100.0%), with a specificity of 87.5% (79.2%-93.4%) for controls.

Scoring

One point is assigned for every “yes”; a score greater than two (≥2) indicates a possible case of anorexia nervosa or bulimia nervosa.

Reference

Morgan, J.F., Reid, F. & Lacy, J.H. (2000) The SCOFF Questionnaire. Western Journal of Medicine. 172(3), pp.164-165.

Can the MHS: A Serve as a Clinically Useful Screening Tool for GAD?

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Research Paper Title

A Brief Online and Offline (Paper-and-Pencil) Screening Tool for Generalized Anxiety Disorder: The Final Phase in the Development and Validation of the Mental Health Screening Tool for Anxiety Disorders (MHS: A).

Background

Generalised anxiety disorder (GAD) can cause significant socioeconomic burden and daily life dysfunction; hence, therapeutic intervention through early detection is important.

Methods

This study was the final stage of a 3-year anxiety screening tool development project that evaluated the psychometric properties and diagnostic screening utility of the Mental Health Screening Tool for Anxiety Disorders (MHS: A), which measures GAD.

Results

A total of 527 Koreans completed online and offline (i.e., paper-and pencil) versions of the MHS: A, Beck Anxiety Inventory (BAI), Generalised Anxiety Disorder-7 (GAD-7), and Penn State Worry Questionnaire (PSWQ). The participants had an average age of 38.6 years and included 340 (64.5%) females. Participants were also administered the Mini-International Neuropsychiatric Interview (MINI).

Internal consistency, convergent/criterion validity, item characteristics, and test information were assessed based on the item response theory (IRT), and a factor analysis and cut-off score analyses were conducted. The MHS: A had good internal consistency and good convergent validity with other anxiety scales.

The two versions (online/offline) of the MHS: A were nearly identical (r = 0.908). It had a one-factor structure and showed better diagnostic accuracy (online/offline: sensitivity = 0.98/0.90, specificity = 0.80/0.83) for GAD detection than the GAD-7 and BAI. The IRT analysis indicated that the MHS: A was most informative as a screening tool for GAD.

Conclusions

The MHS: A can serve as a clinically useful screening tool for GAD in Korea. Furthermore, it can be administered both online and offline and can be flexibly used as a brief mental health screener, especially with the current rise in telehealth.

Reference

Kim, S-H., Park, K., Yoon, S., Choi, Y., Lee, S-H. & Choi, K-H. (2021) A Brief Online and Offline (Paper-and-Pencil) Screening Tool for Generalized Anxiety Disorder: The Final Phase in the Development and Validation of the Mental Health Screening Tool for Anxiety Disorders (MHS: A). Frontiers in Psychology. doi: 10.3389/fpsyg.2021.639366. eCollection 2021.

What is the REM Sleep Behaviour Disorder Screening Questionnaire?

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Introduction

The REM Sleep Behaviour Disorder Screening Questionnaire (RBDSQ) is a specific questionnaire for rapid eye movement behaviour disorder (RBD) developed by Stiasny-Kolster and team, to assess the most prominent clinical features of RBD.

It is a 10-item, patient self-rating instrument with short questions to be answered by either ‘yes’ or ‘no’.

The validity of the questionnaire was studied by researchers and they have observed it to perform with high sensitivity and reasonable specificity in the diagnosis of RBD.

Refer to Parasomnia.

Use

RBDSQ has the potential to be useful as a screening instrument for neurodegenerative disorder, such as the α-synucleinopathies, Parkinson’s disease or multiple system atrophy which may enable early diagnosis and also recruitment of people with RBD necessary for research studies.

Format

RBDSQ contains a set of 10 items that are to be answered by either ‘yes’ or ‘no’.

  • Items 1 to 4 address the frequency and content of dreams and their relationship to nocturnal movements and behaviour.
  • Item 5 asks about self-injuries and injuries of the bed partner.
  • Item 6 consists of four subitems assessing nocturnal motor behaviour more specifically, e.g. questions about nocturnal vocalisation, sudden limb movements, complex movements, or bedding items that fell down.
  • Items 7 and 8 deal with nocturnal awakenings.
  • Item 9 focuses on disturbed sleep in general.
  • Item 10 focuses on the presence of any neurological disorder.

The maximum total score of the RBDSQ is 13 points.

What is the Goldberg Test?

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Introduction

Goldberg test may refer to any of various psychiatric tests used to assess mental health in general or as screening tools for specific mental disorders e.g. depression or bipolar disorder.

Goldberg, after whom some psychiatric tests are named, might be one of two psychiatrists who share the same last name:

  • Ivan Goldberg, an American psychiatrist; and
  • Sir David Goldberg, a British psychiatrist.

Psychiatric screening tests generally do not substitute getting help from professionals.

Tests Developed by Ivan K. Goldberg

  • Goldberg Depression Test is an 18-question screening tool for depression.
  • Goldberg Mania Scale is an 18-question screening test for mania.

Tests developed by Sir David Goldberg

  • General Health Questionnaire or Goldberg Health Questionnaire (GHQ):
    • Developed in 1972 in its initial format as a 60-question test (GHQ-60) with a four-point scale for each question.
    • It is used to measure the risk of developing psychiatric disorders.
    • Other forms of GHQ are:
      • GHQ-30;
      • GHQ-28; and
      • GHQ-12.
  • Together with Simpson, they developed Personal Health Questionnaire (PHQ) in 1995.
    • It is a 10-question screening instrument for depression.
    • It should not be confused with the 9-question patient health questionnaire (PHQ-9) developed by Spitzer also to quantify the risk for depression.
    • Personal Health Questionnaire is sometimes abbreviated as PHQ-G to differentiate it from PHQ-9.

Are Those With Serious Mental Illness More or Less Likely to Receive Cancer Screening?

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Research Paper Title

Cancer Screening Among Adults With and Without Serious Mental Illness: A Mixed Methods Study.

Background

Persons with serious mental illness (SMI) die 10-20 years earlier than the general population; cancer is the second leading cause of death. Differences in cancer screening between SMI and the general population are not well understood.

Therefore the aim of this study was to describe receipt of cancer screening among individuals with versus without SMI and to explore clinicians’ perceptions around cancer screening for people with SMI.

Methods

Mixed-methods study using 2010-2017 MarketScan commercial insurance administrative claims data and semi-structured clinician interviews. In the quantitative analyses, we used multivariate logistic regression analyses to calculate the likelihood of receiving cervical, breast, colorectal, or prostate cancer screening among people with versus without SMI, defined as schizophrenia or bipolar disorder. We conducted semi-structured interviews with 17 primary care physicians and 15 psychiatrists. Interview transcripts were coded using a hybrid deductive/inductive approach.

Results

Relative to those without SMI, individuals with SMI were less likely to receive screening for cervical cancer [adjusted odds ratio (aOR): 0.80; 95% confidence interval (CI): 0.80-0.81], breast cancer (aOR: 0.79; 95% CI: 0.78-0.80), colorectal cancer (aOR: 0.90; 95% CI: 0.89-0.91), and prostate cancer (aOR: 0.85; 95% CI: 0.84-0.87). Clinicians identified 5 themes that may help explain the lower rates of cancer screening in persons with SMI: access to care, available support, prioritization of other issues, communication, and patient concerns.

Conclusions

People with SMI were less likely to receive 4 common types of cancer screening. Improving cancer screening rates in the SMI population will likely require a multidisciplinary approach to overcome barriers to screening.

Reference

Murphy, K.A., Stone, E.M., Presskreischer, R., McGinty, E.E., Daumit, G.L. & Pollack, C.E. (2021) Cancer Screening Among Adults With and Without Serious Mental Illness: A Mixed Methods Study. Medical Care. 59(4), pp.327-333. doi: 10.1097/MLR.0000000000001499.

Is There Value in Targeted Screening & Intervention Programmes of Anxiety in Young Adult Offspring with Parental Mental Health Problems?

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Research Paper Title

Associations of maternal and paternal mental health problems with offspring anxiety at age 20 years: Findings from a population-based prospective cohort study.

Background

Epidemiological studies indicate that children of parents with mental health problems are at an increased risk of developing anxiety disorders.

Few studies have investigated this relationship in young adults.

Methods

Participants were from the Raine Study, which is a multi-generational birth cohort study in Australia. Maternal anxiety and depression in late childhood were assessed using the Depression, Anxiety, and Stress Scale (DASS-42), and paternal lifetime mental health problems were assessed using a self-reported questionnaire.

The short form of DASS-42 (DASS-21) was used to assess anxiety symptoms among offspring at age 20. Negative binomial regression model was used to quantify the association. Data were available for 1,220 mother-offspring and 1,190 father-offspring pairs.

Results

After adjusting for potential confounders, the researchers found an increased risk of anxiety in young adult offspring exposed to maternal anxiety in late childhood and paternal lifetime mental health problems. However, they observed no increased risks of anxiety in offspring exposed to maternal depressive symptoms. Their sensitivity analysis based on the log-binomial model (binary outcome) as well as the linear model (log-transformed data) confirmed the robustness of the main results.

Conclusions

The findings suggest there can be value to consider and apply targeted screening and intervention programmes of anxiety in the young adult offspring with parental mental health problems.

Reference

Ayano, G., Betts, K., Lin, A., Tait, R. & Alati, R. (2021) Associations of maternal and paternal mental health problems with offspring anxiety at age 20 years: Findings from a population-based prospective cohort study. Psychiatry Research. doi: 10.1016/j.psychres.2021.113781. Online ahead of print.

Does the OCI-4 Show Promise as an Ultra-Brief Screening Tool for Identifying likely OCD?

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Research Paper Title

The OCI-4: An ultra-brief screening scale for obsessive-compulsive disorder.

Background

Obsessive-compulsive disorder (OCD) is a prevalent and burdensome condition that is typically assessed using in-depth interviews or lengthy self-report measures. Accordingly, routine screening in busy non-mental health settings is impractical, and OCD is often under- (or mis-) recognised.

Methods

The researchers evaluated an ultra-brief version of a widely used self-report measure, the Obsessive-Compulsive Inventory-Revised (OCI-R), which may be employed as a routine screener for OCD.

A total of 1,087 adults diagnosed with OCD, 1,306 unselected adults from the community, and 423 adults with anxiety related disorders completed the OCI-R along with measures of anxiety and mood.

Analyses were conducted to reduce the number of items and examine evidence for sensitivity and specificity to OCD clinical status, test-retest reliability, sensitivity to treatment, and convergent and discriminant validity.

Results

Four items that optimally assess different dimensions of OCD (washing, checking, ordering, obsessing) were identified. Psychometric evaluation revealed good to excellent test-retest reliability, validity, prediction of clinical OCD status, and sensitivity to treatment.

Conclusions

A 4-item version of the OCI-R, called the OCI-4, shows promise as an ultra-brief screening tool for identifying likely OCD in settings where in-depth assessment is impractical. Patients with a positive screen may be referred for further evaluation and appropriate treatment.

Reference

Abramovitch, A., Abramovitchm J.S. & McKay, D. (2021) The OCI-4: An ultra-brief screening scale for obsessive-compulsive disorder. Journal of Anxiety Disorder. doi: 10.1016/j.janxdis.2021.102354. Online ahead of print.