The validity of applying questionnaires for screening mental disorder in the army / 解放军医学杂志

ABSTRACT

Objective To explore the most convenient and valid tool for screening mental disorders among servicemen. Methods Soldiers and officers stationed at Guilin were enrolled for the study. They were first examined with the Symptom Check-list 90 (SCL-90), Cornell Medicine Index (M-R)[CMI(M-R)], University Student Personality Inventory (UPI) and WHO neurosis screening schedule respectively. Then they were subjected clinical interview and examination individually, and clinical diagnosis of mental disorder was made according to CCMD-3 standard. The validity of each questionnaire was evaluated by using Criterion-related Validity. Results The sensitivity of WHO neurosis screening schedule was found to be 100%, and the specificity was 92.1%. SCL-90 and CMI (M-R) yielded similar results, their sensitivity was found to be 46.9% and 43.4%, and the specificity to be 86.1% and 78.9%, respectively. The sensitivity of UPI was found to be 83.1% and the specificity 46.1%. Conclusion The WHO neurosis screening schedule is the best in both sensitivity and specificity of validity, but its practice is time-consuming and laborious, which limits its application. SCL-90 and CMI (M-R) are imperfect in sensitivity of validity, and they cannot screen out the mental disorder in more than a half of the subjects. In a group test, they can hardly serve as a screening tool. UPI can screen out most of the mental disorder, and its sensitivity of validity reaches 83.1%. Additionally, the UPI questionnaire contains fake-test items, which could retest those who were missed due to untruly or not conscientiously answer the questionnaires. An acceptable way to obtain a true screening test is to give the individuals a propaganda of mental health and explain the questionnaires for 30 minutes before the test, which helps the examinee to understand the procedure and accept the questionnaires, so that the results of the test could be more reliable. In conclusion, UPI is a valuable screening tool to be recommended.