Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative
Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six‐item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Menta...
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| Published in | International journal of methods in psychiatric research Vol. 19; no. S1; pp. 4 - 22 |
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| Main Authors | , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Chichester, UK
John Wiley & Sons, Ltd
01.06.2010
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1049-8931 1557-0657 1557-0657 |
| DOI | 10.1002/mpr.310 |
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| Abstract | Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six‐item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM‐IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve‐month prevalence of DSM‐IV SMI was assessed with the fully‐structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76–0.89; inter‐quartile range 0.81–0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Copyright © 2010 John Wiley & Sons, Ltd. |
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| AbstractList | Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six-item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76-0.89; inter-quartile range 0.81-0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six‐item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM‐IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve‐month prevalence of DSM‐IV SMI was assessed with the fully‐structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76–0.89; inter‐quartile range 0.81–0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Copyright © 2010 John Wiley & Sons, Ltd. Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six-item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76-0.89; inter-quartile range 0.81-0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied.Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six-item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76-0.89; inter-quartile range 0.81-0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six‐item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM‐IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve‐month prevalence of DSM‐IV SMI was assessed with the fully‐structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76–0.89; inter‐quartile range 0.81–0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Copyright © 2010 John Wiley & Sons, Ltd. |
| Author | Kessler, Ronald C. Posada-Villa, Jose Oakley-Browne, Mark Mneimneh, Zeina Myer, Landon Sampson, Nancy A. Bromet, Evelyn Sagar, Rajesh Zaslavsky, Alan M. Green, Jennifer Greif Gruber, Michael J. Hu, Chi-Yi Gureje, Oye Lee, Sing Cuitan, Marius Hinkov, Hristo Viana, Maria Carmen Lara, Carmen Furukawa, Toshi A. |
| AuthorAffiliation | 2 Department of Psychiatry, State University of New York, Stony Brook, NY, USA 8 Department of Psychiatry, Autonomous University of Puebla, Puebla, Mexico 11 School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa 12 Discipline of Psychiatry, the University of Tasmania, Australia 3 National School of Public Health & Health Services Management of Bucharest, Romania 1 Department of Health Care Policy, Harvard Medical School, Boston, MA, USA 13 Colegio Mayor de Cundinamarca University, Bogota, Colombia 6 Department of Global Mental Health, National Center for Public Health Protection, Sofia, Bulgaria 15 Section of Psychiatric Epidemiology, Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil 9 Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong, China 5 Department of Psychiatry, University College Hospital, Ibadan, Nigeria 10 Institute for Social Research, University of Michigan, Ann Arbor, MI, USA an |
| AuthorAffiliation_xml | – name: 10 Institute for Social Research, University of Michigan, Ann Arbor, MI, USA and Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), Beirut, Lebanon – name: 6 Department of Global Mental Health, National Center for Public Health Protection, Sofia, Bulgaria – name: 3 National School of Public Health & Health Services Management of Bucharest, Romania – name: 12 Discipline of Psychiatry, the University of Tasmania, Australia – name: 9 Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong, China – name: 2 Department of Psychiatry, State University of New York, Stony Brook, NY, USA – name: 15 Section of Psychiatric Epidemiology, Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil – name: 7 Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China – name: 13 Colegio Mayor de Cundinamarca University, Bogota, Colombia – name: 8 Department of Psychiatry, Autonomous University of Puebla, Puebla, Mexico – name: 1 Department of Health Care Policy, Harvard Medical School, Boston, MA, USA – name: 5 Department of Psychiatry, University College Hospital, Ibadan, Nigeria – name: 4 Department of Psychiatry and Cognitive‐Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan – name: 11 School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa – name: 14 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India |
| Author_xml | – sequence: 1 givenname: Ronald C. surname: Kessler fullname: Kessler, Ronald C. email: Kessler@hcp.med.harvard.edu organization: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA – sequence: 2 givenname: Jennifer Greif surname: Green fullname: Green, Jennifer Greif organization: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA – sequence: 3 givenname: Michael J. surname: Gruber fullname: Gruber, Michael J. organization: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA – sequence: 4 givenname: Nancy A. surname: Sampson fullname: Sampson, Nancy A. organization: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA – sequence: 5 givenname: Evelyn surname: Bromet fullname: Bromet, Evelyn organization: Department of Psychiatry, State University of New York, Stony Brook, NY, USA – sequence: 6 givenname: Marius surname: Cuitan fullname: Cuitan, Marius organization: National School of Public Health & Health Services Management of Bucharest, Romania – sequence: 7 givenname: Toshi A. surname: Furukawa fullname: Furukawa, Toshi A. organization: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan – sequence: 8 givenname: Oye surname: Gureje fullname: Gureje, Oye organization: Department of Psychiatry, University College Hospital, Ibadan, Nigeria – sequence: 9 givenname: Hristo surname: Hinkov fullname: Hinkov, Hristo organization: Department of Global Mental Health, National Center for Public Health Protection, Sofia, Bulgaria – sequence: 10 givenname: Chi-Yi surname: Hu fullname: Hu, Chi-Yi organization: Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China – sequence: 11 givenname: Carmen surname: Lara fullname: Lara, Carmen organization: Department of Psychiatry, Autonomous University of Puebla, Puebla, Mexico – sequence: 12 givenname: Sing surname: Lee fullname: Lee, Sing organization: Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong, China – sequence: 13 givenname: Zeina surname: Mneimneh fullname: Mneimneh, Zeina organization: Institute for Social Research, University of Michigan, Ann Arbor, MI, USA and Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), Beirut, Lebanon – sequence: 14 givenname: Landon surname: Myer fullname: Myer, Landon organization: School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa – sequence: 15 givenname: Mark surname: Oakley-Browne fullname: Oakley-Browne, Mark organization: Discipline of Psychiatry, the University of Tasmania, Australia – sequence: 16 givenname: Jose surname: Posada-Villa fullname: Posada-Villa, Jose organization: Colegio Mayor de Cundinamarca University, Bogota, Colombia – sequence: 17 givenname: Rajesh surname: Sagar fullname: Sagar, Rajesh organization: Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India – sequence: 18 givenname: Maria Carmen surname: Viana fullname: Viana, Maria Carmen organization: Section of Psychiatric Epidemiology, Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil – sequence: 19 givenname: Alan M. surname: Zaslavsky fullname: Zaslavsky, Alan M. organization: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20527002$$D View this record in MEDLINE/PubMed |
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| SubjectTerms | Adolescent Adult Age Aged Community Health Planning Data processing Diagnostic and Statistical Manual of Mental Disorders Female Follow-Up Studies Health Surveys Humans International Cooperation K6 screening scale Male Mental disorders Mental Disorders - diagnosis Mental Disorders - epidemiology Middle Aged psychiatric epidemiology Psychometrics - methods Regression analysis Reproducibility of Results Scaling serious mental illness (SMI) Statistics Surveys and Questionnaires World Health Organization Young Adult |
| Title | Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative |
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