The validity of the Substance Abuse and Mental Illness Symptom Screener (SAMISS) in people living with HIV/AIDS in primary HIV care in Cape Town, South Africa.
Given the high prevalence of HIV in South Africa and co-morbid mental disorders in people living with HIV/AIDs (PLWHA) we sought to validate a brief screening tool in primary HIV care.


METHODS
366 PLWHA were recruited prior to combination anti-retroviral treatment (CART) initiation from two primary health HIV clinics. A mental health nurse administered a socio-demographic questionnaire and the Mini Neuropsychiatric Interview (MINI) and a lay counsellor administered the Substance and Mental Illness Symptom Screener (SAMISS).


RESULTS
Using the MINI, 17 % of participants were identified with either depression, anxiety disorders or adjustment disorder and 18 % with substance or alcohol abuse/dependence. The sensitivity and specificity of the SAMISS was 94 % (95 % CI: 88-98 %) and 58 % (95 % CI: 52-65 %) respectively, with the alcohol component (sensitivity: 94 %; specificity: 85 %) performing better than the mental illness component of the SAMISS (sensitivity: 97 %; specificity: 60 %). The specificity of the tool improved when the cut-off for the mental illness component was increased.


CONCLUSIONS
The SAMISS may provide a useful first tier screening tool for common mental disorders in primary care for PLWHA.
Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Rd, Rondebosch, Cape Town, 7700, South Africa, erica.breuer@uct.ac.za.
Erica
E
Breuer
Kevin
K
Stoloff
Landon
L
Myer
Soraya
S
Seedat
Dan J
DJ
Stein
John A
JA
Joska
D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D010349:Patient Compliance; D015995:Prevalence; D011320:Primary Health Care; D015203:Reproducibility of Results; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires