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PONE-D-19-21674

Evaluation of a screening algorithm using the Strengths and Difficulties Questionnaire to identify children with mental health problems: A five-year register-based follow-up on school performance and healthcare use

PLOS ONE

Dear Rasmus Trap Wolf,

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: The paper has an important justification of the study, highlights the convenience of evaluate the potential of a new screening algorithm to identify children with sub-threshold and undiagnosed mental disorders, in a general population. A combination of historical birth cohort data and high-quality data from national registers is used.

Some interesting results and discussion are added to the international scientific literature.

It is a good paper. However, the manuscript has some weakness, which must be improved:

p.1-2. “Today more than 13% of children and adolescents worldwide are affected by mental disorders at any given time (1) with a significantly negative impact on their quality of life (2).” The date of the two previous cited papers are 2015 and 2002. Please add more recent papers. I recommend some recent publications: Self-reported mental health in children ages 6–12 years across eight European countries. Eur. Child Adolesc. Psychiatry 2018, 27, 785–795 (http://dx.doi.org/10.1007/s00787-017-1073-0) or International and Spanish Findings in Scientific Literature about Minors’ Mental Health: Predictive Factors Using the Strengths and Difficulties Questionnaire (2019)( DOI: 10.3390/ijerph16091603).

p.44-45. Please do the same with the 9 cited papers, used to explain the recent situation? Please look for more recent published papers.

p.61 “There exists several studies evaluating different screening programs (15)”. Please add more references than one.

p.77 “i.e. the children’s IQ”. Please define IQ.

p.134. Please clarify the definition of MHP . You do not make differences between borderline and abnormal? (see https://www.sdqinfo.com/) Please clarify it in the manuscript.

p447. Maybe table 9 could be deleted and insert all the information of this table in a paragraph, directly in the text.

p463. Could you think about insert other international results in the discussion, in order to compare you results with other international papers or find a possible explanation? Maybe it would improve the paper. There is no one reference in discussion and conclusions. Please consider it.

Reviewer #2: The work entitled “Evaluation of a screening algorithm using the Strengths and Difficulties Questionnaire to identify children with mental health problems: A five-year register-based follow-up on school performance and healthcare use" is of great interest. The research is very stimulating; it contains new scientific knowledge and provides comprehensive information for further development of this productive line of research. The data are presented in a clear and easy-to-understand fashion, and the paper is, principally, well-argued and clearly worthy of publication. However, I have some comments to make that should be addressed before I recommend this manuscript for publication

From my point of the view, the introduction would benefit from the inclusion of more literature about the SDQ use in mental health screening worldwide. Considering that the study is about the mental health problems and the parents’ report about mental health, some other studies about this would be advisable. For instance: Bach et al., 2019; Navarro et al., 2019; Ortuño-Sierra, Aritio-Solana, and Fonseca-Pedrero, 2018.

In the results section, it is not clear to me why the authors say that: “To investigate whether this subgroup of children with MHP have an unmet need for care, we use the children’s later school performance as an indicator of the consequences of their MHP at the age of 11-12 years”. In my opinion, this should be at least explained in the introduction. Is it there more literature confirming that a decrease in school performance can be used as an indicator of a increase in mental health problems

In the discussion section authors state that: “The 77.3% of children with MHP who do not receive any SMHC during the follow-up period also obtain a statistically significantly worse GPA at their 9th grade exams than children with no MHP.” I do not clearly understand if the comparison should be between those who have MHP and those without MHP. It is not clear if the difference is because the lack of intervention or because of the fact that they have MHP. Authors explain this, but it seems obvious, so do not really see the point of including this.

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Reviewer #1: No

Reviewer #2: No

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Attachment

Submitted filename: Review_SDQ_PlosOne_2019.docx

Evaluation of a screening algorithm using the Strengths and Difficulties Questionnaire to identify children with mental health problems: A five-year register-based follow-up on school performance and healthcare use

PONE-D-19-21674R1

Dear Dr. Rasmus Trap Wolf,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

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With kind regards,

Eduardo Fonseca-Pedrero, PhD

Academic Editor

PLOS ONE

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