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ID: HR19-719

Presenting author: Laurent Michel

Presenting author biography:

L MICHEL is psychiatrist, specialist in Addiction Medicine and Director of the Pierre Nicole Centre in Paris. He is also a researcher in the CESP/U1018 unit, working on harm reduction and access to care for people who use drugs and psychiatric comorbidities.

Screening for mental health disorders in the community (DRIVE Project): validation of a quick screening tool (QST) among people who inject drugs with Community-Based Organizations (CBO)

Sao Mai Le, Huong Duong Thi, Oanh Khuat Thi Hai, Jonathan Feelemeyer, Minh Khue Pham, Giang Hoang Thi, Thanh Nham Thi Tuyet, Jean-Pierre Moles, Vinh Vu Hai, Roselyne Vallo, catherine Quillet, delphine rapoud, theodore hammett, didier laureillard, don des jarlais, nicolas nagot, Laurent Michel

Introduction
We present the results of the validation phase of a QST for CBO members to screen for depression, psychotic symptoms and suicidality among PWID enrolled in the ANRS-NIDA DRIVE cohort in Haiphong, Vietnam.
Method:
A combination of tools (PHQ-4, simplified questions on psychotic symptoms and suicide from the MINI international neuropsychiatric interview) was use during a validation phase in order to identify the most pertinent items (acceptability, sensitivity) and threshold scores to be selected to reach an acceptable sensitivity level. QST was matched to the original MINI test and confirmed by a clinical diagnosis of a psychiatrist during a follow-up visit of the DRIVE cohort. All CBO members involved in the survey received a training on mental health and on the tools selected. Five psychiatrists from the Haiphong’s University mental health department were involved in the psychiatric assessment (MINI and clinical confirmation).
Result:
447 randomly selected PWID from the DRIVE cohort got a mental health assessment (QST + MINI + Clinical assessment): 14.5%, 9.8% and 11.8% were respectively diagnosed with a major current depressive disorder, a psychotic syndrome and/or a suicidal risk according to the MINI. The sensitivity level of the QST (9 items) to detect any of these disorders was estimated to 71.3% after adjustment for the acceptability and sensitivity of the items and score threshold calculation, but further analyses are needed. Nearly half of the diagnoses of psychotic syndrome were clinically attributed to methamphetamines use.
Conclusion
Our survey confirms the feasibility and acceptability of a QST for mental health disorder in the community and also an acceptable level of sensitivity, considering the complexity of the diagnosis of mental health disorders. In countries with limited mental health access to care implementation, CBO members involvement is crucial and needs to include adapted tools for routine screening and specialist referral.