Accuracy of proactive case finding for mental disorders by community informants in Nepal

Jordans MJD, Kohrt BA, Luitel NP, Komproe IH, Lund C.

The British Journal of Psychiatry

Published on: 1 December 2015

Background: Accurate detection of persons in need of mental healthcare is crucial to reduce the treatment gap between psychiatric burden and service use in low- and middle-income (LAMI) countries.

Aims: To evaluate the accuracy of a community-based proactive case-finding strategy (Community Informant Detection Tool, CIDT), involving pictorial vignettes, designed to initiate pathways for mental health treatment in primary care settings.

Method: Community informants using the CIDT identified screen positive (n = 110) and negative persons (n = 85). Participants were then administered the Composite International Diagnostic Interview (CIDI).

Results: The CIDT has a positive predictive value of 0.64 (0.68 for adults only) and a negative predictive value of 0.93 (0.91 for adults only).

Conclusions: The CIDT has promising detection properties for psychiatric caseness. Further research should investigate its potential to increase demand for, and access to, mental health services.

https://doi.org/10.1192/bjp.bp.113.141077