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A Novel Screening and Diagnostic Tool for Child and Adolescent Psychiatric Disorders for Telepsychiatry
Savita Malhotra1, Subho Chakrabarti1, Ruchita Shah1
1Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Insights
A new telepsychiatry tool accurately diagnoses child and adolescent psychiatric disorders in India, addressing a shortage of specialists. This diagnostic aid offers a feasible and comprehensive solution for mental healthcare access.
Area of Science:
- Child and Adolescent Psychiatry
- Telepsychiatry
- Digital Health Tools
Background:
- Addressing the scarcity of child psychiatrists and mental health professionals in India.
- Developing a telepsychiatry diagnostic tool for child and adolescent psychiatric disorders.
- Focusing on improving mental healthcare accessibility in underserved regions.
Purpose of the Study:
- To develop and validate a diagnostic tool for child and adolescent psychiatric disorders within a telepsychiatry framework.
- To assess the accuracy and feasibility of the diagnostic tool compared to clinical evaluations.
- To provide a scalable solution for psychiatric diagnoses in resource-limited settings.
Main Methods:
- The tool incorporates screening and International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria-based algorithms for 18 disorders.
- Validation involved comparing the tool's diagnoses with semi-structured clinical evaluations by a psychiatrist in 50 pediatric patients.
- Statistical analyses included descriptive statistics, paired t-tests, sensitivity, specificity, predictive values, and Kappa coefficients.
Main Results:
- The screening sub-module demonstrated high sensitivity, specificity, and negative predictive values across all assessed disorders.
- The diagnostic sub-module showed moderate to substantial agreement (Kappa 0.4-0.6) for most disorders, with high sensitivity and specificity.
- Positive predictive values were acceptable to high, and negative predictive values were consistently high for most conditions.
Conclusions:
- The developed diagnostic tool is comprehensive, efficient, and practical for clinical use.
- The tool achieves an acceptable level of accuracy in diagnosing child and adolescent psychiatric disorders.
- This innovation holds promise for enhancing mental healthcare delivery through telepsychiatry in India.
Background:
A diagnostic tool designed as part of a telepsychiatry application for diagnosis and management of child and adolescent psychiatric disorders in India was developed considering the paucity of trained child psychiatrists and mental health professionals in India.
Materials And Methods:
The diagnostic tool consisted of screening and 10(th) revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria-based diagnostic algorithms for 18 psychiatric disorders seen in childhood and adolescence. Accuracy of diagnoses and feasibility of use of the tool was examined by comparing it with detailed semi-structured clinical evaluations by a qualified psychiatrist with 50 psychiatric patients (children and adolescents).
Statistical Analysis:
Descriptive analyses and paired t-tests were conducted to compare the mean number of diagnosis generated by the two interviews. Sensitivity, specificity, positive and negative predictive values were computed for the screening and the diagnostic sub-modules of the tool, compared to the clinical diagnoses. Kappa coefficients were computed to assess agreement between the diagnoses generated by the diagnostic sub-module and the clinical diagnoses.
Results:
The screening sub-module had high sensitivity, high specificity and negative predictive values for all disorders. For the diagnostic sub-module, there was moderate (kappa-0.4-0.6) to substantial agreement (kappa > 0.6) for all the disorders, (except psychosis) and high sensitivity (barring a few disorders) and specificity for almost all the disorders. Positive predictive values were found to be acceptable to high for most disorders, with consistently high negative predictive values.
Conclusion:
The new tool was found to be comprehensive, reasonably short and feasible. Results showed acceptable level of accuracy in diagnosis generated by the tool.
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