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Should psychological distress screening in the community account for self-perceived health status?
Can J Psychiatry. 2009 Aug; 54(8):526-33.CJ

Abstract

OBJECTIVE

Psychological distress questionnaires are often used as screening instruments for mental disorders in clinical and epidemiologic settings. Poor physical health may affect the screening properties of a questionnaire. We evaluate the effect of self-perceived health status on the screening performance of the Kessler K10 and K6 scales in a community sample.

METHODS

We used data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). Psychological distress was measured by the 6-item (K6) and the 10-item (K10) Kessler instrument. Depression and anxiety disorders were assessed using the World Mental Health Composite International Diagnostic Interview (1-month estimates). Optimal cut-off points regarding health status were determined by finding the K6 and K10 values that allowed for the best balance between sensitivity and specificity. Stratum-specific likelihood ratios (SSLRs) were computed to define strata with discriminating power.

RESULTS

There was a strong association between the screening performance of the K6 and K10 scales and self-perceived health status: for the K10 scale, a cut-off point of 5/6 yielded the best balance between sensitivity and specificity for subjects with excellent or very good health status, while a cut-off point of 14/15 yielded the best balance between sensitivity and specificity for subjects with poor health status.

CONCLUSIONS

The combination of the K6 and K10 scales, with a self-rated health status item, may improve screening properties of the 2 scales.

Authors+Show Affiliations

Department of Psychiatry, McGill University, Douglas Hospital Research Centre, Montreal, Quebec. norbert.schmitz@douglas.mcgill.caNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19726005

Citation

Schmitz, Norbert, et al. "Should Psychological Distress Screening in the Community Account for Self-perceived Health Status?" Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, vol. 54, no. 8, 2009, pp. 526-33.
Schmitz N, Lesage A, Wang J. Should psychological distress screening in the community account for self-perceived health status? Can J Psychiatry. 2009;54(8):526-33.
Schmitz, N., Lesage, A., & Wang, J. (2009). Should psychological distress screening in the community account for self-perceived health status? Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 54(8), 526-33.
Schmitz N, Lesage A, Wang J. Should Psychological Distress Screening in the Community Account for Self-perceived Health Status. Can J Psychiatry. 2009;54(8):526-33. PubMed PMID: 19726005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Should psychological distress screening in the community account for self-perceived health status? AU - Schmitz,Norbert, AU - Lesage,Alain, AU - Wang,Jianli, PY - 2009/9/4/entrez PY - 2009/9/4/pubmed PY - 2009/12/16/medline SP - 526 EP - 33 JF - Canadian journal of psychiatry. Revue canadienne de psychiatrie JO - Can J Psychiatry VL - 54 IS - 8 N2 - OBJECTIVE: Psychological distress questionnaires are often used as screening instruments for mental disorders in clinical and epidemiologic settings. Poor physical health may affect the screening properties of a questionnaire. We evaluate the effect of self-perceived health status on the screening performance of the Kessler K10 and K6 scales in a community sample. METHODS: We used data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). Psychological distress was measured by the 6-item (K6) and the 10-item (K10) Kessler instrument. Depression and anxiety disorders were assessed using the World Mental Health Composite International Diagnostic Interview (1-month estimates). Optimal cut-off points regarding health status were determined by finding the K6 and K10 values that allowed for the best balance between sensitivity and specificity. Stratum-specific likelihood ratios (SSLRs) were computed to define strata with discriminating power. RESULTS: There was a strong association between the screening performance of the K6 and K10 scales and self-perceived health status: for the K10 scale, a cut-off point of 5/6 yielded the best balance between sensitivity and specificity for subjects with excellent or very good health status, while a cut-off point of 14/15 yielded the best balance between sensitivity and specificity for subjects with poor health status. CONCLUSIONS: The combination of the K6 and K10 scales, with a self-rated health status item, may improve screening properties of the 2 scales. SN - 1497-0015 UR - https://www.unboundmedicine.com/medline/citation/19726005/Should_psychological_distress_screening_in_the_community_account_for_self_perceived_health_status L2 - https://journals.sagepub.com/doi/10.1177/070674370905400805?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -