ArticleBMC psychiatry2022
Validation of brief screening instruments for internalizing and externalizing disorders in Mozambican adolescents.
Article in BMC psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review and meta-analysis of diagnostic test accuracy of mental health screening tools applicable to adolescents in sub-Saharan Africa.Frontiers in psychiatry · 2026Pooled it
- Parental Differential Treatment of Siblings and Child Psychopathology: A Network Meta-analysis.Clinical child and family psychology review · 2025Pooled it
- The validity and reliability of the Patient Health Questionnaire - Adolescent version (PHQ - A) in Vietnam.BMC psychology · 2026Article
- Prevalence and factors associated with depressive symptoms among adolescents in Saudi Arabia after the COVID-19 pandemic: a cross-sectional study.Frontiers in psychiatry · 2026Article
- The migration experience and mental health in the context of insecurity: evidence from Burkina Faso.Population health metrics · 2025Review
- Cognitive interviewing of the PHQ-A for depression screening among adolescents living with and without HIV in Malawi.Journal of affective disorders · 2025Article
- Cutoffs of the Instrumental Activities of Daily Living-Compensation (IADL-C) Scale for Identification of Functional Limitations Consistent With Mild Cognitive Impairment and Dementia.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2025Article
- Mental health and help-seeking behaviors among Mozambican youth: insights from a post-pandemic National Survey Amidst Internal Conflict.Social psychiatry and psychiatric epidemiology · 2025Article
- Supporting the mental health of adolescent mothers in Kenya and Mozambique: pilot protocol for the Thriving Mamas programme.Pilot and feasibility studies · 2025Article
- Article
- Associations between the Strengths and Difficulties Questionnaire (SDQ) and Tests of Variables of Attention (TOVA) in rural school-aged children in Benin Africa.Global mental health (Cambridge, England) · 2025Article
- Mental health care cascade performance and associated factors: longitudinal analyses of routine Ministry of Health services in Mozambique.BMJ public health · 2025Article
- Optometry Students' Mental Health at a University in South Africa: Investigating the Links Between Anxiety, Depression, and Key Variables.Clinical optometry · 2025Article
- Suicidal behaviour, depression and generalized anxiety and associated factors among female and male adolescents in Mozambique in 2022-23.Child and adolescent psychiatry and mental health · 2024Article
- Validation of screening instruments for common mental disorders and suicide risk in south African primary care settings.Journal of affective disorders · 2024Article
- Translation, cultural adaptation and validation of Patient Health Questionnaire and generalized anxiety disorder among adolescents in Nepal.Child and adolescent psychiatry and mental health · 2024Article
- A Chinese adaptation of the Patient Health Questionnaire for Adolescents (PHQ-A): factor structure and psychometric properties.BMC psychiatry · 2024Article
- Prevalence and associated factors of common mental disorders among internally displaced people by armed conflict in Cabo Delgado, Mozambique: a cross-sectional community-based study.Frontiers in public health · 2024Article
- COVID-19 school closures and mental health of adolescent students: Evidence from rural Mozambique.SSM. Mental health · 2023Article
- Mental health and psychological well-being of Kenyan adolescents from Nairobi and the Coast regions in the context of COVID-19.Child and adolescent psychiatry and mental health · 2023Article
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Funding
Abstract
backgroundMental disorders are the leading cause of disability for youth worldwide. However, there is a dearth of validated, brief instruments to assess mental health in low- and middle-income countries (LMIC). We aimed to facilitate identification of mental disorders in LMIC contexts by adapting and validating measures of internalizing and externalizing disorders for adolescents in Mozambique, an LMIC in southeastern Africa.
methodsWe selected instruments with good support for validity in high-income and other LMIC settings: the Patient Health Questionnaire Adolescent (PHQ-A), Generalized Anxiety Disorders 7 (GAD-7), and Strengths and Difficulties Questionnaire (SDQ). Instruments were adapted by local and international mental health specialists followed by cognitive interviews (n = 48) with Mozambican adolescents. We administered the instruments along with the Miniature International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)to 485 adolescents aged 12-19 years attending two secondary schools in Maputo City, Mozambique. One week later, we re-administered instruments to a randomly selected sample of 49 adolescents.
resultsParticipants were 66.2% (n = 321) female and the average age was 15.9 (S.D = 1.7).Internal consistency (alpha = 0.80, PHQ-A; 0.84, GAD-7; 0.80, SDQ) and test-retest reliabilty (ICC = 0.74, PHQ-A; 0.70, GAD-7; 0.77, SDQ) were acceptabe for the PHQ-A, GAD-7, and the full SDQ. The SDQ internalizing subscale showed poor test-retest reliability (ICC = 0.63) and the SDQ externalizing subscale showed poor internal consistency (alpha = 0.65). All instruments demonstrated good sensitivity and specificity (> 0.70). Youden's index identified optimal cutoff scores of 8 for the PHQ-A, 5 for the GAD-7, 10 for the SDQ internalizing and 9 for the SDQ externalizing subscales, though a range of scores provided acceptable sensitivity and specificity.
conclusionsOur data supports reliability and validity of the PHQ-A, GAD-7, and SDQ instruments for rapidly assessing mental health problems in Mozambican adolescents. Use of these tools in other contexts with limited specialists may asist with expanding mental health assessment. Specific instrument and cutoff selection should be based on screening goals, treatment resources, and program objectives.
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