BACKGROUND: Child psychopathology can e understood as normal development gone awry. Attention to psychosocial and behavioural problems has long been recommended as a critical component of well-child care. Likewise, screening for emotional and behavioural problems has been recommended as a routine part of health supervision visits. Different screening instruments have been developed and are widely used. Most of them include a dimensional measurement for internalizing, externalizing, and attention problems, but there is also the need to develop screening algorithms for specific psychiatric syndromes. OBJECTIVE: To present the concurrent validity and efficiency indicators of the Brief Screening and Diagnostic Questionnaire, CBTD, in a primary care health center (PCHC) at Mexico City, as a tool for the surveillance of mental health on children and adolescents. MATERIALS AND METHOD: A sample of 667 consecutive patients (4-16 years old) whose parents responded the CBTD. All patients who obtained a score of five or more symptoms were clinically interviewed using the MINI-KID, together with one of every ten subjects with a lower score. RESULTS: Efficiency showed a sensitivity of 68%, specificity of 82%, positive predictive value (PPV) of 88% and a negative predictive value (NPV) of 57%. When two or more CBTD syndromes are present the PPV is almost 100%. Concurrent validity showed a fair agreement for most of the CBTD syndromes as compared to DSM-IV diagnoses. Syndromes suggesting brain abnormalities, not included in scales of other widely used screening instruments, showed a PPV of 92% and NPV of 96.4%. CONCLUSIONS: The screening results from the CBTD can be used either categorically or dimensionally facilitating the surveillance of mental health on children and adolescents as different syndromatic profiles can be identified and followed for evaluation, along with complementary familial and psychosocial information.
BACKGROUND:Child psychopathology can e understood as normal development gone awry. Attention to psychosocial and behavioural problems has long been recommended as a critical component of well-child care. Likewise, screening for emotional and behavioural problems has been recommended as a routine part of health supervision visits. Different screening instruments have been developed and are widely used. Most of them include a dimensional measurement for internalizing, externalizing, and attention problems, but there is also the need to develop screening algorithms for specific psychiatric syndromes. OBJECTIVE: To present the concurrent validity and efficiency indicators of the Brief Screening and Diagnostic Questionnaire, CBTD, in a primary care health center (PCHC) at Mexico City, as a tool for the surveillance of mental health on children and adolescents. MATERIALS AND METHOD: A sample of 667 consecutive patients (4-16 years old) whose parents responded the CBTD. All patients who obtained a score of five or more symptoms were clinically interviewed using the MINI-KID, together with one of every ten subjects with a lower score. RESULTS: Efficiency showed a sensitivity of 68%, specificity of 82%, positive predictive value (PPV) of 88% and a negative predictive value (NPV) of 57%. When two or more CBTD syndromes are present the PPV is almost 100%. Concurrent validity showed a fair agreement for most of the CBTD syndromes as compared to DSM-IV diagnoses. Syndromes suggesting brain abnormalities, not included in scales of other widely used screening instruments, showed a PPV of 92% and NPV of 96.4%. CONCLUSIONS: The screening results from the CBTD can be used either categorically or dimensionally facilitating the surveillance of mental health on children and adolescents as different syndromatic profiles can be identified and followed for evaluation, along with complementary familial and psychosocial information.