Accuracy of online survey assessment of mental disorders and suicidal thoughts and behaviors in Spanish university students. Results of the WHO World Mental Health- International College Student initiative

Abstract

Objective To assess the accuracy of WMH-ICS online screening scales for evaluating four common mental disorders (Major Depressive Episode[MDE], Mania/Hypomania[M/H], Panic Disorder[PD], Generalized Anxiety Disorder[GAD]) and suicidal thoughts and behaviors[STB] used in the UNIVERSAL project. Methods Clinical diagnostic reappraisal was carried out on a subsample of the UNIVERSAL project, a longitudinal online survey of first year Spanish students (18–24 years old), part of the WHO World Mental Health-International College Student (WMH-ICS) initiative. Lifetime and 12-month prevalence of MDE, M/H, PD, GAD and STB were assessed with the Composite International Diagnostic Interview-Screening Scales [CIDI-SC], the Self-Injurious Thoughts and Behaviors Interview [SITBI] and the Columbia-Suicide Severity Rating Scale [C-SSRS]. Trained clinical psychologists, blinded to responses in the initial survey, administered via telephone the Mini-International Neuropsychiatric Interview [MINI]. Measures of diagnostic accuracy and McNemar χ 2 test were calculated. Sensitivity analyses were conducted to maximize diagnostic capacity. Results A total of 287 students were included in the clinical reappraisal study. For 12-month and lifetime mood disorders, sensitivity/specificity were 67%/88.6% and 65%/73.3%, respectively. For 12-month and lifetime anxiety disorders, these were 76.8%/86.5% and 59.6%/71.1%, and for 12-month and lifetime STB, 75.9%/94.8% and 87.2%/86.3%. For 12-month and lifetime mood disorders, anxiety disorders and STB, positive predictive values were in the range of 18.1–55.1% and negative predictive values 90.2–99.0%; likelihood ratios positive were in the range of 2.1–14.6 and likelihood ratios negative 0.1–0.6. All outcomes showed adequate areas under the curve [AUCs] (AUC>0.7), except M/H and PD (AUC = 0.6). Post hoc analyses to select optimal diagnostic thresholds led to improved concordance for all diagnoses (AUCs>0.8). Conclusion The WMS-ICS survey showed reasonable concordance with the MINI telephone interviews performed by mental health professionals, when utilizing optimized cut-off scores. The current study provides initial evidence that the WMS-ICS survey might be useful for screening purposes.

Gender commonalities and differences in risk and protective factors of suicidal thoughts and behaviors: A cross‐sectional study of Spanish university students

“…Fourth, results are based on self‐reported data, without a clinical interview. It is unknown to what extent these two sources coincide but we addressed this limitation by undergoing a clinical reappraisal study to control the validity of the research, which indicates a good concordance with these results (Ballester et al, ). Fifth, analyses according to sexual orientation were not performed and transsexual individuals were excluded.…”

Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis

“…These would have been necessary during the COVID-19 pandemic, with many countries practicing self-isolation and social distancing measures, making face-to-face assessment challenging and dangerous. Evidence suggests that remote, online screening results in comparable estimates to face-to-face delivery, and these methods, in and of themselves, are not a concern [ 96 , 97 ]. That being said, their use is associated with non-random sampling methodologies, and consequently increases the chance of selection bias.…”

PTSD symptoms related to COVID-19 as a high risk factor for suicide - Key to prevention

“…Because residence location did not affect PTSD severity within the Kansai region, these results suggest that our online data accurately represent the Japanese population in terms of PTSD severity pattern, according to age and sex. It should be noted that mental illness scores based on online surveys can be higher than those obtained from other types of surveys 19,20 , which may also explain the prevalence of COVID-19-related PTSD diagnosis in our online populations (21·3%), as well as in previous online research (7-35·6%) 21–24 . Consequently, simulated numbers of suicides based on mental illness scores are higher than actual numbers.…”