Towards effective screening for paternal perinatal mental illness: a meta-review of instruments and research gaps.

Background: Paternal perinatal mental illness (PPMI), which affects around one in 10 fathers, is under-recognised despite increasing awareness of men's mental health in the perinatal period. Social stigma and men's reluctance to seek help exacerbate this gap. Neglecting the mental health needs of new fathers not only puts them at increased risk for mental illness themselves, but also has a profound and long-lasting impact on their families, children and their own self-esteem as they navigate their new role in the family dynamic. Objective: This meta-review systematically identifies instruments assessing PPMI symptoms, evaluates their psychometric properties and applicability, presents key findings from studies using these tools, and identifies gaps and limitations in the literature on PPMI symptom assessment. Methods: A systematic literature review was conducted using search strategies applied to PubMed, PsycNet APA, Cochrane, and Web of Science, supplemented by hand searches. Relevant information was extracted from each included study. Extracted data were analysed narratively to address the research questions. Results: Findings identified limitations and gaps in current screening practices. While the Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening tool for both fathers and mothers, it inadequately captures atypical depressive symptoms in men. Cutoff scores lack consensus, and instrument sensitivity varies significantly due to cultural and sociodemographic factors. A number of other screening tools have been identified, most of which are more general and not specifically designed for perinatal mental health. Conclusion: This meta-review broadens perspectives on PPMI screening instruments, highlighting key themes, patterns, and differences across the included reviews. While a variety of screening tools are used, the review underscores the necessity for tools specifically tailored to fathers during the perinatal period.

[Outpatient psychosocial screening in a skin cancer center: acceptance, psychosocial distress and utilization of support : A post hoc analysis in a quality management program]. / Ambulantes psychosoziales Screening in einem Hautkrebszentrum: Akzeptanz, psychosoziale Belastung und Inanspruchnahme von Beratungsangeboten : Eine Post-hoc-Analyse im Rahmen der Qualitätssicherung.

BACKGROUND: Psychosocial care of cancer patients is an important aspect throughout the entire course of oncological treatment. Since 2015, psychosocial screening has been implemented in the outpatient clinics of the Skin Cancer Center in Freiburg. We present here a post hoc analysis in the context of a quality management program. QUESTION: Acceptance, psychosocial distress and desire for counseling were evaluated. Exploratively, we investigated which patient and disease characteristics are related to increased subjective distress. MATERIALS AND METHODS: In a full survey from 06/2015 to 12/2015, we evaluated acceptance, psychosocial distress by distress thermometer (DT), and desire for counseling. RESULTS: Of 753 patients, 345 (45.8%) participated in psychosocial screening and data from 310 (174 men, 136 women; 89.7% melanoma patients, mean time since initial diagnosis 4.7 ± 3.9 years) could be analyzed. The mean burden on the DT was 2.97 ± 2.83 (median 2, range 0-10). High distress (DT ≥ 5) was reported by 84 patients (28.8%). Thirty-four patients (11%) indicated a desire for counseling, and 23 patients took up the counseling offer. The patient group with high distress was younger, more often under ongoing or recently completed systemic therapy, and had more often a desire for counseling. CONCLUSION: In addition to assessing psychosocial distress with validated screening instruments, the survey of the subjective desire for care represents an important parameter for the identification of patients in need of care. Young patients and patients with ongoing systemic therapy should be the focus of attention.

The global prevalence of screen-based disordered eating and associated risk factors among high school students: systematic review, meta-analysis, and meta-regression.

OBJECTIVE: Estimate the prevalence, and associated risk factors, of high school students who are considered at risk for an eating disorder based on screening measures. METHODS: An electronic search of nine databases was completed from their inception until 1st September 2022. A random-effects meta-analysis was conducted, and confounder (moderator) analyses and meta-regressions examined whether the overall prevalence estimate for of screen-based disordered eating (SBDE) was moderated by student age, BMI, or gender, as well as culture and type of SBDE assessment. RESULTS: The mean estimate of the prevalence of SBDE among high school students (K = 42 (66 datapoints), N = 56282] in the sample of 25 countries was 13% ([95% CI] = 10.0-16.8%, I2 = 99.0%, Cochran's Q p = 0.001). This effect was not moderated by features of the samples such as gender, BMI, or age. Among cultures, non-Western countries had a higher prevalence of SBDE prevalence than Western countries, but the difference was not significant. There was considerable variability in the prevalence estimates as a function of the assessment measure, but no meaningful pattern emerged. CONCLUSION: The estimated figure of 1 in 8 high school students with SBDE-unmoderated by gender and BMI-stands out as a problem in need of attention from public health officials, psychologists, psychiatrists, pediatricians, parents, and educators. There is a great need for innovative, integrated policy and program development all along the spectrum of health promotion and universal, selective, and indicated prevention. Further research is also needed to validate and refine this estimate by (a) conducting basic research on the accuracy of eating disorder screening measurements in samples ages 14 through 17; (b) examining representative samples in more countries in general and Latin American countries in particular; (c) clarifying the relationships between SBDE and age throughout the different phases of late childhood, adolescence, and emerging adulthood; and (d) investigating whether there are meaningful forms of disordered eating and whether these are associated with variables such as gender, ethnicity, and BMI.

We searched nine databases to identify studies of high school students that yielded an estimate of disordered eating based on screening measures such as the Eating Attitudes Test. Forty-two 42 studies (N = 56282 students) from 25 countries met the selection criteria. A random effects meta-analysis indicated that across those countries the best estimate of the prevalence of screen-based disordered eating is 13%. This estimate was not significantly moderated by BMI, gender, age, and whether the country was Western or non-Western. There was considerable variability in the prevalence estimates as a function of the assessment measure, but no meaningful pattern emerged. The estimated figure of 1 in 8 high school students with disordered eating is a problem deserving of attention from public health officials, psychologists, psychiatrists, pediatricians, parents, educators, and leaders committed to prevention and early identification of eating disorders and referral for treatment. Further research in many more countries is also needed to validate this estimate and to explore its relationship with development throughout adolescence and with variables that can help us to refine prevention and effective early identification and treatment of eating disorders.

[Update on the diagnosis and treatment of delirium]. / Neues in der Diagnostik und Therapie des Delirs.

Delirium is an acute confusional state with typically fluctuating disturbances of attention, cognition, and qualitative awareness. Its incidence depends on the patient group. In the development of delirium, predisposing factors such as age, frailty, multimorbidity, surgical interventions, and pre-existing dementia are of high clinical relevance. The diagnosis of delirium should be based on symptoms and validated screening methods (e.g., Confusion Assessment Method). As delirium is a direct physiological consequence of a medical condition, the potential underlying cause(s) should be diagnosed. Prevention and therapy are primarily multimodal, non-pharmacological treatments such as reorientation, early mobilization, and sleep improvement. If symptomatic pharmacological treatment is necessary (e.g., due to delirium-related agitation), careful drug selection should be made depending on the patient population and symptoms.

[Which Screening Instruments are used in Kindergarten for Developmental Assessment and Identification of Developmental Needs? Quality and Usefulness Criteria of the Instruments]. / Welche Verfahren zur Entwicklungsbeobachtung und zum Erkennen von Förderbedarf setzen Kitas ein? Güte- und Brauchbarkeitskriterien der Verfahren.

On the basis of the educational plans of the federal states, kindergartens have the duty to observe the development of children.There are various instruments for developmental observations and the identification of developmental needs.However, the quality and content of these instruments vary greatly. To date, there has been little systematic research on the use of screening instruments in kindergarten.Therefore, the aim of this study was to investigate the use and the satisfaction with instruments for developmental observations and the identification of support needs. Additionally, an analysis of the used instruments in regard of their psychometric quality was conducted. N = 190 kindergarten fromThuringia participated in the study. An online questionnaire was completed, which particularly addressed the question of whether and, if so, which screening instruments were used for developmental observations or for the identification of support needs. In addition, specific information on these instruments (e. g. duration, satisfaction) was collected. Nearly 94 % of participating kindergarten used screening instruments for developmental observations, and 69 % used instruments for identifying support needs. For most frequently used instruments the psychometric quality was weak and only few practice criteria were considered.

How symptoms of simple acute infections affect the SSS-8 and SSD-12 as screening instruments for somatic symptom disorder in the primary care setting.

Objective: Somatic symptom disorder (SSD) is one of the most common reasons for consultations in primary care, in addition to simple acute infections. Questionnaire-based screening instruments to identify patients at high risk of SSD are thus of great clinical relevance. Although screening instruments are frequently used, it is currently unclear to what extent they are influenced by the concurrent presence of simple acute infections. Therefore, this study aimed to investigate how symptoms of simple acute infections affect the two established questionnaires as screening instruments for somatic symptom disorder in the primary care setting. Methods: In our cross-sectional, multicenter design, a total of 1,000 patients in primary care practices were screened using the two most established SSD screening questionnaires, the 8-item Somatic Symptom Scale (SSS-8) and the 12-item Somatic Symptom Disorder-B Criteria Scale (SSD-12), followed by clinical assessment by the primary care physician. Results: A total of 140 patients with a simple acute infection (acute infection group, AIG) and 219 patients with chronic somatic symptoms (somatic symptom group, SSG) were included. The patients in the SSG showed higher total SSS-8 and SSD-12 scores than the patients in the AIG; however, the SSS-8 was more susceptible to changes triggered by symptoms of a simple acute infection than the SSD-12. Conclusion: These results suggest that the SSD-12 is less susceptible to symptoms of a simple acute infection. Its total score and corresponding cutoff value provide a more specific and thus less susceptible screening tool for identifying SSD in primary care.

Intimate Partner Violence Screening Instruments: A Protocol for a COSMIN-Based Systematic Review.

Intimate partner violence (IPV) is a major public health problem resulting in a significant impediment to equal participation, quality of life, and personal, social, and economic development. At present, a variety of screening instruments for IPV have emerged in developed countries, and some of them have been adapted to the language and culture of different countries, such as Hurt, Insult, Threaten, Scream (HITS) and the Abuse Assessment Screen (AAS). The selection of the most appropriate IPV screening instrument for the target population and context from among those instruments has become difficult for researchers when intending to start screening. Therefore, a systemic review of IPV screening instruments is needed. This protocol describes a COSMIN-based systematic review of the measurement properties of these instruments. The aims of the systematic review are to (1) evaluate the methodological quality of studies on the measurement properties including the validity, reliability, and internal consistency of these IPV screening instruments, and (2) provide suggestions for relevant researchers in their local context for using the IPV screening instruments.

White matter hyperintensities in dementia with Lewy bodies are associated with poorer cognitive function and higher dementia stages.

Purpose: White matter hyperintensities (WMHs) are frequently found in elderly individuals with or without dementia. However, the association between WMHs and clinical presentations of dementia with Lewy bodies (DLB) has rarely been studied. Methods: We conducted a retrospective analysis of patients with DLB registered in a dementia database. WMHs were rated visually using the Fazekas scale, and its associated factors including dementia severity, cognitive functions, neuropsychiatric symptoms, and core clinical features were compared among different Fazekas scores. Domains in the Clinical Dementia Rating (CDR), Cognitive abilities Screening Instruments (CASI), and Neuropsychiatric Inventory (NPI) were compared among different Fazekas groups after adjusting for age, sex, education, and disease duration. Results: Among the 449 patients, 76, 207, 110, and 56 had Fazekas score of 0, 1, 2, and 3, respectively. There was a positive association between dementia severity and WMHs severity, and the mean sums of boxes of the Clinical Dementia Rating (CDR-SB) were 5.9, 7.8, 9.5, and 11.2 (f = 16.84, p < 0.001) for the Fazekas scale scores 0, 1, 2, and 3, respectively. There was a negative association between cognitive performance and WMHs severity, and the mean CASI were 57.7, 45.4, 4.06, and 33.4 (f = 14.22, p < 0.001) for the Fazekas scale scores 0, 1, 2, and 3, respectively. However, WMHs were not associated with the core clinical features of DLB. After adjustment, all cognitive domains in CDR increased as the Fazekas score increased. In addition, performance on all cognitive domains in CASI decreased as the Fazekas score increased (all p < 0.001). Among neuropsychiatric symptoms, delusions, euphoria, apathy, aberrant motor behavior, and sleep disorders were significantly worse in the higher Fazekas groups compared to those in the group with Fazekas score of 0 after adjustment. Conclusion: WMHs in DLB might contribute to deterioration of cognitive function, neuropsychiatric symptoms, and dementia stages. However, core clinical features were not significantly influenced by WMHs in DLB.

Think-aloud analysis of commonly used screening instruments for Internet use disorders: The CIUS, the IGDT-10, and the BSMAS.

Background: Despite the constant publication of new screening instruments for Internet use disorders (IUD), little is known about their content validity. This study aimed to identify potential mismatches between the items' intention and young adults' interpretation of these items when answering three screening instruments that are commonly used in research and clinical settings: The Compulsive Internet Use Scale (CIUS), the 10 Item-Internet Gaming Disorder Test (IGDT-10), and the Bergen Social Media Addiction Scale (BSMAS). Methods: In total, 30 vocational students (50% female, age = 21.3; SD = 2.1) took part in individual think-aloud interviews. All participants were asked to report their thoughts while completing the CIUS. In addition, participants who reported online games (OG) as their main Internet activity (n = 11) answered the IGDT-10. Participants who reported social networks (SN) as their main Internet activity (n = 18) answered the BSMAS. One participant used OG and SN equally and completed both screening instruments. All interviews were audio-recorded, transcribed, and content-analysed. Results: Overall, four potential sources for errors were identified: (1) High scorings were often not congruent with the underlying diagnostic criteria. In particular, such discrepancies were found in items aimed to assess dysfunctional emotional regulation strategies and cognitive involvement. (2) Some participants were uncertain which time frame or Internet activity should be considered in their answers. (3) Long and complex items led to the building of mean values or the choice of the middle answer category. (4) Some wordings were perceived to be outdated and difficult to understand. Discussion: These findings might help to provide recommendations on how to improve screening instruments for IUD. Most important, items should more clearly distinguish between Internet use as a "normal" leisure activity and Internet use that leads to functional impairments in daily life.

Diseño y aplicación de un cuestionario de detección precoz en salud mental infantil / Design and application of an early detection questionnaire in child mental health

Los problemas en salud mental infantil son frecuentes, complejos y pueden conllevar un riesgo en el desarrollo. La prevención en salud mental es un compromiso colectivo, especialmente por parte de las instituciones que atienden la primera infancia: la escuela y la consulta pediátrica. El objetivo de esta investigación es validar un instrumento diseñado ad hoc de detección precoz en salud mental para la primera infancia. En el diseño del instrumento, denominado Detectar para Prevenir–Salud Mental Infantil–25 (DxP-SMI-25), se tuvo en cuenta la literatura previa y las limitaciones actuales en la detección precoz en salud mental. El contenido del cuestionario se validó mediante un juicio de expertos y se aplicó el cuestionario, junto al Ages & Statges Questionnaires: Social-Emotional-2, con el fin de obtener la validez de criterio. El instrumento diseñado muestra una buena predisposición y permite una evaluación global del desarrollo.

Child mental health problems are frequent, complex and can lead to developmental risk. Prevention in mental health is a collective commitment, especially on the part of the institutions that care for early childhood: the school and the pediatric office. The aim of this paper is to validate an ad hoc instrument designed for early mental health screening in early childhood. The design of the instrument, called Detectar para Prevenir- Salud Mental Infantil-25 (DxP-SMI-25, Detect to Prevent- Children's Mental Health-25), took into account previous literature and current limitations in early mental health screening. The content of the questionnaire was validated by means of expert judgment and the questionnaire was applied, together with the Ages & Statges Questionnaires: Social-Emotional-2, in order to obtain criterion validity. The designed instrument shows a good predisposition and allows a global assessment of development.

Voicing the perspectives of stroke survivors with aphasia: A rapid evidence review of post-stroke mental health, screening practices and lived experiences.

A rapid evidence review (RER) of empirical literature was conducted to explore aphasic stroke survivors' mental health outcomes and lived experiences, as well as the screening instruments for this cohort. The RER was informed by a critical disability theory approach and synthesised qualitative and quantitative evidence within and across 29 studies, published between 2000 and 2021, from a systematic search of three databases. Understanding the relationship between post-stroke aphasia and mental health outcomes is essential for developing comprehensive treatment strategies and designing appropriate long-term care. Available screening instruments currently only detect depression and anxiety, which are then used to detect further mental health issues. The RER revealed that the current screening instruments demonstrate reliability; however, research remains limited regarding their validity. Furthermore, limited studies include aphasic patients as participants and decision-makers in stroke research. Methodological limitations across studies include comparators and small sample sizes. Importantly, across the studies, there is a lack of representation of culturally diverse and minority participants. Overall, the RER results found a high prevalence of aphasic stroke survivors experiencing depression and other mental health outcomes, indicating that implementing mood screening in a timely manner is essential. In addition, the results support that psychological care pathways must be developed and evaluated in consultation with aphasic patients' and carers' lived experiences to identify stepped levels of care and establish appropriate screening instruments. Furthermore, the health system requires consistency, which would ideally be achieved by establishing staff roles and responsibilities regarding mood screening and supportive care in these psychological care pathways. Including mental health specialists such as social workers and establishing specialist training in the multidisciplinary team would support this endeavour. There is a need for further research regarding mood screening instruments, a diversity of aphasic stroke survivors' lived experiences and the clinical expertise of those providing psychological support.

Examining brief and ultra-brief anxiety and depression screening methods in a real-world epilepsy clinic sample.

OBJECTIVE: Recent epilepsy quality measure recommendations for depression and anxiety screening endorse ultra-brief screeners, the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2). Thus, it is important to assess how symptom detection may be affected using ultra-brief screeners compared with slightly longer, well-validated instruments: Neurological Disorders Depression Inventory-Epilepsy (NDDI-E) and Generalized Anxiety Disorder-7 (GAD-7). The objective was to compare symptom detection by brief versus ultra-brief depression and anxiety screeners in a large real-world epilepsy clinic sample. METHODS: This was a prospective, cross-sectional assessment of consecutive patients in an adult tertiary epilepsy practice who completed the GAD-7 and NDDI-E with embedded ultra-brief scales (GAD-2; GAD-Single Item: GAD-SI; NDDI-E 2 item: NDDIE-2) on a tablet and had clinic staff administered ultra-brief PHQ-2 (yes/no version) documented in the medical record at the same visit. Prevalences of positive anxiety and depression screens were calculated for each instrument overall, and by epilepsy status. Concordance correlation coefficients (CCC) were calculated comparing the ultra-brief with brief anxiety and depression instruments, and receiver operating curves (ROC) were calculated using the longer instruments as alternative standards. RESULTS: Among N = 422 individuals the prevalence of positive anxiety screen by GAD-7 was 24% and positive depression screen by NDDI-E was 20%. Positive anxiety and depression screens were significantly less prevalent among seizure-free individuals than those with continued seizures. The verbally administered yes/no PHQ-2 had only 1 positive screen (0.2%). Other than poor concordance between the PHQ-2 and NDDI-E, the screener pairs had acceptable concordance (CCC 0.79 to 0.92). Areas under the ROC curves were acceptable for the NDDIE-2, GAD-2 and GAD-SI (0.96, 0.98, and 0.89, respectively). SIGNIFICANCE: In this sample, clinic staff interview-administered yes/no PHQ-2 had exceedingly low sensitivity compared with the NDDI-E self-reported on a tablet. Further investigation is warranted to assess if poor detection is due to characteristics of this PHQ-2 in epilepsy samples, or method of administration in this clinic. The other ultra-brief anxiety and depression instruments demonstrated good concordance with the longer, well-validated instruments and may be useful in clinical practice.

Using the CES-D-7 as a Screening Instrument to Detect Major Depression among the Inmate Population.

Major depression is one of the most prevalent mental health problems in the penitentiary context and has been related to different undesirable outcomes. The aim of the current research was to evaluate the utility of screening tools for major depression brief assessment in the jail context. We interviewed 203 male inmates and complimented the MCMI-III, the SCL-90-R, and the CES-D-7 self-informed scales. Major depression syndrome and disorder were determined based on MCMI-III criteria and the capability of SCL-90-R and CES-D-7 to identify true positives and true negatives when tested. SCL-90-R and CES-D-7 showed good sensitivity for major depression syndrome and disorder. The specificity of SCL-90-R was poor in all cases, but CES-D-7 showed good specificity depending on the cut-off score. Rigorous interviews are needed for better evaluation of major depression in jails, but screening tools like CES-D-7 are useful for rapid assessment considering the work overload of penitentiary psychologists.

Defining 'optimal' test cut-off using global test metrics: evidence from a cognitive screening instrument.

Aim: To examine the variation of several global metrics of test accuracy with test cut-off for the diagnosis of dementia. These metrics included some based on the receiver operating characteristic curve, such as Youden index, and some independent of receiver operating characteristic curve, such as correct classification accuracy. Materials & methods: Data from a test accuracy study of Mini-Addenbrooke's Cognitive Examination were used to calculate and plot each global measure against test cut-off. Results: Different 'optimal' cut-points were identified for the different global measures, with a spread of ten points in observed optimal cut-off in the 30-point Mini-Addenbrooke's Cognitive Examination scale. Using these optima gave a large variation in test sensitivity from very high (diagnostic odds ratio) to very low (likelihood to be diagnosed or misdiagnosed), but all had high negative predictive value. Conclusion: The method used to determine the cut-off of cognitive screening instruments may have significant implications for test performance.

Inter-relação entre duas teses de doutorado que incluíram em suas amostras de pesquisa crianças com transtorno do espectro autista (TEA) / Interrelationship between two doctoral thesis that included in their research samples children with autistic spectrum disorder (ASD)

Este artigo destaca a inter-relação entre duas teses de doutorado. Foram identificados e explorados, a partir da leitura minuciosa e da análise comparativa entre os dois trabalhos, quatro pontos de convergência entre as referidas teses. Além disso, foram apresentados sinteticamente os objetivos, os métodos, os resultados e as conclusões de cada um dos estudos. O objetivo deste relato é discorrer, por meio de quatro pontos convergentes (perfis, definição do quadro, diagnóstico precoce e instrumentos de rastreio), sobre a inter-relação entre duas teses de doutorado que incluíram em suas amostras de pesquisa crianças com o Transtorno do Espectro Autista (TEA). Tais pontos convergentes relacionam-se a questões com as quais os profissionais que atuam junto aos indivíduos com TEA deparam-se frequentemente. Algumas ações como: 1. Conhecer o indivíduo com TEA através do estabelecimento de seu perfil; 2. Manter-se atualizado sobre os critérios diagnósticos e dados de literatura que definem a multifatoriedade do transtorno; e 3. Compreender a importância e a necessidade do diagnóstico precoce e da aplicação de instrumentos de rastreio para a avaliação deste distúrbio do neurodesenvolvimento podem auxiliar os profissionais de diferentes áreas quanto ao trabalho com pessoas diagnosticadas com TEA. O cotejamento realizado entre as duas teses, assim como os dados presentes na exploração de cada ponto convergente entre elas, trazem ao leitor elementos fomentadores de reflexões que confirmam a complexidade do transtorno e a importância das três ações descritas acima.

This article highlights the interrelationship between two doctoral theses. Four points of convergence between these thesis were identified and explored from the detailed reading and comparative analysis between the two works. In addition, the objectives, methods, results, and conclusions of each study were presented briefly. The purpose of this report is to discuss from four converging points (profiles, definition of the condition, early diagnosis, and screening instruments), about the interrelationship between two doctoral theses that included children with ASD in their research samples. Such converging points are related to issues that professionals who work with individuals with ASD often face. Some actions such as: 1. Knowing the individual with ASD through the establishment of their profile; 2. Keeping up to date on the diagnostic criteria and literature data that define the multifactorial nature of the disorder; and 3. Understanding the importance and the need for early diagnosis and the application of screening instruments to assess this neurodevelopmental disorder can assist professionals in different areas, regarding work with people diagnosed with ASD. The comparison made between the two thesis, as well as the data present in the exploration of each converging point between them, bring to the reader elements that encourage reflections that confirm the complexity of the disorder and the importance of the three actions described above.

New trends in instruments for child development screening in Brazil: a systematic review / Novas tendências em instrumentos para triagem do desenvolvimento infantil no Brasil: uma revisão sistemática

INTRODUCTION: Screening instruments are widely used to monitor child development. The accurate use of standardized tools is an indispensable condition for clinical practice and research aimed at detecting developmental risks and other problems in childrenOBJECTIVE: The objective of this systematic review was to analyze the use of standardized tools for child development screening used in studies with Brazilian childrenMETHODS: Two independent researchers selected references in English and Portuguese from five databases through which they searched for studies that used screening tests to assess the development of Brazilian children. All articles were read to determine the main objective, design, target population, the type of screening test, and the purpose of using the test with Brazilian childrenRESULTS: Among the 27 papers analyzed, most of them was observational studies conducted with children up to six years of age, with the main objective to screen development delays and analyze associations between risks and child development. Four instruments were identified: Denver Developmental Screening Test II, Ages and Stages Questionnaire, Bayley Scales of Infant and Toddler Development Screening Test, and Battelle Developmental Inventory Screening Test. Three of these tests have been validated for use in BrazilCONCLUSION: This review suggests that the screening instruments have been used in research for different purposes, such as in the diagnosis of developmental problems, and sometimes inappropriately. Furthermore, studies to validate measures for screening and assessing the development of Brazilian children are still scarce and, therefore, deserve more attention

INTRODUÇÃO: Instrumentos de triagem são usados para monitoramento do desenvolvimento infantil. O uso acurado de ferramentas padronizadas é condição indispensável para a prática clínica e pesquisas que visam detectar risco de desenvolvimento e problemas em criançasOBJETIVO: O objetivo desta revisão sistemática foi analisar o uso de instrumentos padronizados de triagem do desenvolvimento infantil adotados em estudos com crianças brasileirasMÉTODO: Dois pesquisadores independentes selecionaram em cinco bases de dados referencias em Inglês e Português onde buscaram estudos que usaram testes de triagem para avaliação do desenvolvimento de crianças brasileiras. Todos os artigos foram lidos para analisar o objetivo principal, delineamento, população-alvo, o tipo de teste de triagem e o propósito de uso do teste com crianças brasileirasRESULTADOS: Dentre os 27 artigos analisados, a maioria deles eram estudos observacionais conduzidos com crianças até seis anos de idade com objetivo principal de rastrear atrasos e analisar associações entre riscos e desenvolvimento. Quatro instrumentos foram identificados: Teste de Triagem do Desenvolvimento de Denver II; Ages and Stages Questionnaire; Bayley Scales of Infant and Toddler Development, Screening Test; e Battelle Developmental Inventory Screening Test. Três testes estão sendo validados para uso no BrasilCONCLUSÃO: Esta revisão sugere que os instrumentos de triagem têm sido usados nas pesquisas com diferentes finalidades, por vezes de forma apropriada ou incorreta, como por exemplo para diagnosticar problemas de desenvolvimento. Além disso, os estudos de validação de medidas para triagem e avaliação do desenvolvimento de crianças brasileiras ainda são escassos e, por isso, merecem atenção

An overview of screening instruments for cognition and behavior in patients with ALS: selecting the appropriate tool for clinical practice.

Objective: Patients with amyotrophic lateral sclerosis (ALS) not only show motor deficits, but may also have cognitive and/or behavioral impairments. Recognizing these impairments is crucial as they are associated with lower quality of life, shorter survival, and increased caregiver burden. Therefore, ALS-specific neuropsychological screening instruments have been developed that can account for motor and speech difficulties. This study provides an overview and comparison of these screeners. Methods: A systematic review was conducted using Medline and Embase. Articles describing cognitive/behavioral screening instruments assessed in ALS patients were included. Screening instruments were compared on multiple factors, such as domains, adaptability, required time, and validation. Results: We included 99 articles, reporting on nine cognitive screeners (i.e. ACE-R, ALS-BCA, ALS-CBS, ECAS, FAB, MMSE, MoCA, PSSFTS, and UCSF-SB), of which five ALS-specific. Furthermore, eight behavioral screeners (i.e. ALS-FTD-Q, AES, BBI, DAS, FBI, FrSBe, MiND-B, and NPI) were reported on, of which three ALS-specific. Conclusion: Considering the broad range of cognitive domains, adaptability, and satisfying validity, the ALS-CBS and ECAS appear to be the most suitable screeners to detect cognitive and behavioral changes in ALS. The BBI appears to be the best option to screen for behavioral changes in ALS, since all relevant domains are assessed, motor-related problems are considered, and has a satisfactory validity. The MiND-B and ALS-FTD-Q are promising as well. In general, all screening instruments would benefit from additional validation research to gain greater insights into test characteristics and to aid clinicians in selecting screening tools for use in clinical practice.

A systematic review evaluating screening instruments for gambling disorder finds lack of adequate evidence.

OBJECTIVES: To date, no research has systematically evaluated screening instruments for gambling disorder to assess their accuracy and the quality of the research. This systematic review evaluated screening instruments for gambling disorder to inform decision makers about choices for population-level screening. STUDY DESIGN AND SETTING: On May 22, 2017 and January 4, 2019, we searched PubMed, PsycInfo, EMBASE, and Cochrane for studies that evaluated screening instruments for gambling disorder. Studies were included if (1) the screening instrument was in English, (2) the screening instrument was compared to a reference standard semistructured interview based on Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases diagnoses of gambling disorder, and (3) data were reported on psychometric properties of the instrument. RESULTS: We identified 31 different screening instruments from 60 studies. Only three instruments from three separate studies were eligible for inclusion in the systematic review. CONCLUSION: Few screening instruments for gambling disorder have been validated with sufficient methodological quality to be recommended for use across a large health system.

Psychometric properties of the Hospital Anxiety and Depression Scale in an inpatient video-monitoring epilepsy cohort.

BACKGROUND: People with epilepsy (PWE) have high rates of comorbid anxiety disorders and depressive disorders, from 25% in general population cohorts to rates of 55% in people with treatment resistant epilepsy. High rates are also seen in patients with psychogenic nonepileptic seizures (PNES). Depressive disorders and anxiety disorders in PWE are associated with decreased quality of life measures and are the strongest risk factors for increased suicidality, rates of which are markedly elevated in PWE, at 12%, compared to the general Australian population (1.8%). The Hospital Anxiety and Depression Scale (HADS) is one of the more commonly used screening tools in medical populations. Past studies of the HADS in general outpatient populations with epilepsy have demonstrated promising validity for detecting depression. OBJECTIVES: The following were the objectives of the study: 1. To examine the validity of HADS in detecting depressive disorders and anxiety disorders in an inpatient population of patients admitted for video monitoring. 2. To investigate the measurement structure of the HADS across the diagnosis groups of epilepsy subtypes and PNES. METHODS: This was a retrospective cohort study of 485 patients admitted to a tertiary epilepsy video electroencephalography (EEG) monitoring unit. All patients received clinical neurological, neuropsychiatric, and neuroimaging assessments to arrive at consensus epilepsy and psychiatric diagnoses. Clinical psychiatric diagnosis of depressive disorders and anxiety disorders, based on the assessment of a neuropsychiatrist, were compared to accepted HADS cutoff scores for these conditions. FINDINGS: Of the 485 patients, 229 patients were with epilepsy, 28 had both epilepsy and PNES, and 121 had PNES. In 107 cases, no definite diagnosis could be made. At a cutoff score of 7 HADS was able to significantly classify patients with depression (area under the curve [AUC] = 0.79, 95% confidence interval [CI] = 0.72-0.82) with a sensitivity of 70% and a specificity of 83%. A similar result was observed for anxiety disorders; a cutoff score of 7 (AUC = 0.75, 95% CI = 0.72-0.81) was able to significantly classify anxiety disorders in patients with a sensitivity of 88% and specificity of 54%. CONCLUSIONS: This study has found that HADS measures two separate, yet correlated, constructs of anxiety disorders and depressive disorders. Our results indicate that while the HADS is sensitive to distress in this population, relatively low cutoff scores would be required to achieve highly sensitive screening. This sample includes patients with a diagnosis of epilepsy and/or PNES, and thus, the findings have clinical applicability to screening in tertiary epilepsy video-EEG monitoring units where both these conditions frequently co-occur.

What is test accuracy? Comparing unitary accuracy metrics for cognitive screening instruments.

Aim: To examine four different accuracy metrics for assessment of commonly used cognitive screening instruments: correct classification accuracy, area under the receiver operating characteristic curve, F measure (F) or F1 score and Matthews correlation coefficient (MCC). Methods: Raw data were extracted from test accuracy studies of Mini-Mental State Examination. Montreal Cognitive Assessment, Mini-Addenbrooke's Cognitive Examination, Six-item Cognitive Impairment Test, informant AD8 and Free-Cog, and used to calculate the accuracy measures. Results: Each metric resulted in similar ordering of the screening instruments for diagnosis of both dementia and mild cognitive impairment. Area under the receiver operating characteristic curve gave the highest (most optimistic) and MCC the lowest (most pessimistic) accuracy value for each test examined, with correct classification accuracy and F falling between. Conclusion: All the accuracy measures examined have potential shortcomings. None can be recommended as the definitive unitary outcome measure for test accuracy studies. However, MCC has theoretical advantages and might be more widely adopted.