A systematic review and meta-analysis of diagnostic test accuracy studies of self-report screening instruments for common mental disorders in Arabic-speaking adults

Anne de Graaff, Pim Cuijpers, M.M.G. Leeflang, Irene Sferra, Jana Uppendahl, Ralph De Vries, Marit Sijbrandij

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

Background. Self-report screening instruments are frequently used as scalable methods to detect common mental disorders (CMDs), but their validity across cultural and linguistic groups is unclear.We summarized the diagnostic accuracy of brief questionnaires on symptoms of depression, anxiety and posttraumatic stress disorder (PTSD) among Arabic-speaking adults.
Methods. Five databases were searched from inception to 22 January 2021 (PROSPERO:
CRD42018070645). Studies were included when diagnostic accuracy of brief (maximally 25 items) psychological questionnaires was assessed in Arabic-speaking populations and the reference standard was a clinical interview. Data on sensitivity/specificity, area under the curve, and data to generate 2 × 2 tables at various thresholds were extracted. Meta-analysis was performed using the diagmeta package in R. Quality of studies was assessed with QUADAS-2.
Results. Thirty-two studies (Nparticipants = 4042) reporting on 17 questionnaires with 5–25 items targeting depression/anxiety (n = 14), general distress (n = 2), and PTSD (n = 1) were included. Seventeen studies (53%) scored high risk on at least two QUADAS-2 domains. The meta-analysis identified an optimal threshold of 11 (sensitivity 76.9%, specificity 85.1%) for the Edinburgh Postnatal Depression Scale (EPDS) (nstudies = 7, nparticipants = 711), 7 (sensitivity 81.9%, specificity 87.6%) for the Hospital Anxiety and Depression Scale (HADS) anxiety subscale and 6 (sensitivity 73.0%, specificity 88.6%) for the depression subscale (nstudies = 4, nparticipants = 492), and 8 (sensitivity 86.0%, specificity 83.9%) for the Self-Reporting Questionnaire (SRQ-20) (nstudies = 4, nparticipants = 459).
Conclusion. We present optimal thresholds to screen for perinatal depression with the EPDS, anxiety/depression with the HADS, and CMDs with the SRQ-20. More research on Arabiclanguage questionnaires, especially those targeting PTSD, is needed.
Original languageEnglish
Pages (from-to)1-18
Number of pages18
JournalGlobal Mental Health
Volume8
Issue numbere43
DOIs
Publication statusPublished - 23 Nov 2021

Keywords

  • Anxiety disorder
  • Depressive disorder
  • Posttraumatic stress disorder
  • Self-report
  • Sensitivity and Specificity

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