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Accuracy of proactive case finding for mental disorders by community informants in Nepal
Mark J D Jordans1, Brandon A Kohrt2, Nagendra P Luitel2
1Mark J. D. Jordans, PhD, Research and Development Department, HealthNet TPO, Amsterdam, The Netherlands and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London UK; Brandon A. Kohrt, PhD, Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Nagendra P. Luitel, MA, Research Department, Transcultural Psychosocial Organization (TPO), Kathmandu, Nepal; Ivan H. Komproe, PhD, Research and Development Department, HealthNet TPO, Amsterdam, The Netherlands and Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa mark.jordans@hntpo.org.
Background:
Accurate detection of persons in need of mental healthcare is crucial to reduce the treatment gap between psychiatric burden and service use in low- and middle-income (LAMI) countries.
Aims:
To evaluate the accuracy of a community-based proactive case-finding strategy (Community Informant Detection Tool, CIDT), involving pictorial vignettes, designed to initiate pathways for mental health treatment in primary care settings.
Method:
Community informants using the CIDT identified screen positive (n = 110) and negative persons (n = 85). Participants were then administered the Composite International Diagnostic Interview (CIDI).
Results:
The CIDT has a positive predictive value of 0.64 (0.68 for adults only) and a negative predictive value of 0.93 (0.91 for adults only).
Conclusions:
The CIDT has promising detection properties for psychiatric caseness. Further research should investigate its potential to increase demand for, and access to, mental health services.
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