The Diagnostic Accuracy and Validity of the Teen Screen Questionnaire-Mental Health for Clinical and Epidemiological Studies in Primary-Care Settings

Abstract

Background:To validate a brief, self-reported, Teen Symptom Questionnaire–Mental Health (TSQ-M), for identifying adolescents with mental ill-health, designed for conducting epidemiological studies and clinical work in primary-care settings.Materials and Methods:In this prospective, cross-sectional study of 146 adolescents, re-cruited six rural and urban schools, the newly developed TSQ-M as the measure for validation and General Health Questionnaire-12 item (GHQ-12) as the gold standard measure were administered by independent trained raters. Tests for diagnostic accuracy and validity were conducted.Results:A TSQ-M score of ≥29 (Sn=75.68%, Sp=68.06, +LR=2.37, -LR=0.36, PPV=70.9, NPV=73.1) with the AUC of 0.79, is suggested for screening use in Indian populations. Besides the adequate face and content validity, TSQ-M has moderate internal consistency (Cronbach's α = .64) suggesting that the construct of mental ill-health as conceptualized by TSQ-M has multiple sub-constructs. The presence of sub-constructs was demonstrated by an 8- factor structure, which explained 60% of variance.Conclusion:The TSQ-M is a psychometrically adequate, yet a brief measure, for clinical and research work in identifying mental ill-health among adolescents in primary-care settings in India.

Comparison of the Diagnostic Accuracy and Validity of a Short Version of Teen Screen Questionnaire-Mental Health (TSQ -M-Short) for Use in Community

“…This brief version of the scale (TSQ-M-Short) has an overall diagnostic accuracy (AUC = 0.84) that is statistically significantly better than the original version of the scale (AUC of 0.79) (Nair et al, 2014). [8] This improved diagnostic accuracy will enhance the identification of mental ill-health among adolescents in primary-care settings and in conducting big-data studies.…”

“…This brief version of the scale (TSQ-M-Short) has an overall diagnostic accuracy (AUC = 0.84) that is statistically significantly better than the original version of the scale (AUC of 0.79) (Nair et al ., 2014). [ 8 ] This improved diagnostic accuracy will enhance the identification of mental ill-health among adolescents in primary-care settings and in conducting big-data studies. Like the TSQ-M, Strength and Difficulties Questionnaire, Indian Adolescent Health Questionnaire and Patient Health Questionnaire the construct this brief version measures is mental ill health.…”

“…Teens Symptoms Questionnaire-Mental Health-7 (TSQ-M-7) is a 7-item version of Teens Symptoms Questionnaire-Mental Health (TSQ-M). [ 8 ] The seven items, of TSQ-M-Short, had the highest factor endorsement TSQ-M or clinical relevance and were culled to form this short version of the measure. Like in the original version, the endorsement pattern for the TSQ-M short version was also a 3-point likert scale of ‘Never’, ‘Sometimes’ and ‘Often’ to minimize endorsement related error in big data studies.…”

“…Recently, we had validated the original 21-question version of Teen Screen Questionnaire-Mental Health. [ 8 ] In this study, we have developed and validated a self-administered, brief version (7-question) of the questionnaire named Teen Screen Questionnaire-Mental Health- Short (TSQ-M-Short), which identifies mental ill health over the previous 1-year for big-data epidemiological studies.…”

Indian Academy of Pediatrics Consensus Guidelines for Adolescent Friendly Health Services

“…• Equipment and materials at the center include orchidometer, adult sized stethoscope, blood pressure cuff, examination cot and weighing machine, stadiometer, IAP growth reference data, blood pressure centile, Tanners, immunization and Snellen charts, questionnaires like HEEADSSS, Patient Health Questionnaire-2 (PHQ-2), Screening for Childhood Anxiety Related Emotional Disorders (SCARED), Screening to Behaviour Intervention (S2BI) and Ask Suicide-Screening Questionnaire (ASQ) to screen for psychosocial issues, depression, anxiety, drug use and suicidal behavior respectively (Web Box I) [44][45][46][47]. Teen screening questionnaire-Mental Health (TSQ-M) is a validated Indian tool to screen for mental disorders [48].…”