Psychiatric morbidity in a Nigerian paediatric primary care service: a comparison of two screening instruments

Area of Science:

• Child and Adolescent Psychiatry
• Psychometric Evaluation
• Global Mental Health

Background:

• Screening tools are crucial for identifying child psychiatric disorders in primary care.
• The Children's Behaviour Questionnaire (CBQ) and Reporting Questionnaire for Children (RQC) are widely used but require validation in diverse settings.
• Limited data exists on the performance of these instruments in African primary care contexts.

Purpose of the Study:

• To evaluate the screening properties of the CBQ and RQC in an urban Nigerian primary care setting.
• To compare the diagnostic accuracy of the CBQ and RQC for child psychiatric disorders.
• To determine appropriate cut-off thresholds for these questionnaires in Nigeria.

Main Methods:

• Cross-sectional study involving children in an urban Nigerian primary care setting.
• Utilized validity indices and Receiver Operating Characteristic (ROC) analysis to assess screening performance.
• Compared the ability of CBQ and RQC to differentiate children with and without psychiatric disorders.

Main Results:

• Both the CBQ and RQC demonstrated identical abilities in differentiating children with psychiatric disorders from controls.
• The optimal cut-off threshold for the CBQ in this Nigerian setting differed from previously reported values.
• The CBQ could distinguish between conduct and emotional disorders, while the RQC offered brevity.

Conclusions:

• The CBQ and RQC are valid screening tools for child psychiatric disorders in Nigerian primary care.
• Context-specific cut-off points are necessary for accurate screening with the CBQ.
• The RQC provides a brief alternative for screening, while the CBQ offers more detailed disorder differentiation.