Brief Reports

Journal of General Internal Medicine

, Volume 11, Issue 7, pp 426-430

First online:

Brief screens for mental disorders in primary care

  • Andrew C. LeonAffiliated withDepartment of Psychiatry, Box 147, Cornell University Medical College
  • , Mark OlfsonAffiliated withCollege of Physicians and Surgeons of Columbia University and New York State Psychiatric Institute
  • , Myrna M. WeissmanAffiliated withCollege of Physicians and Surgeons of Columbia University and New York State Psychiatric Institute
  • , Laura PorteraAffiliated withDepartment of Psychiatry, Box 147, Cornell University Medical College
  • , Bruce H. FiremanAffiliated withKaiser Permanente
  • , Robert S. BlacklowAffiliated withNortheastern Ohio Universities College of Medicine
  • , Christina HovenAffiliated withDuke University Medical Center
  • , W. Eugene BroadheadAffiliated withDanville (VA) Regional Hospital

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

We evaluated a set of diagnostic screens for mental disorders in primary care. A self-administered screening questionnaire containing 26 items testing for multiple mental disorders was completed by 1,001 patients. Brief diagnostic modules, structured for psychiatric diagnoses, were subsequently administered to each patient by a research nurse. Operating characteristics of the screens were as follows: alcohol dependence (sensitivity [SE] 0.75; positive predictive value [PPV] 0.58; [κ] 0.63), drug dependence (SE 0.50; PPV 0.50; κ 0.50), generalized anxiety disorder (SE 0.74; PPV 0.44; κ 0.44), major depressive disorder (SE 0.71; PPV 0.52; κ 0.50), obsessive compulsive disorder (SE 0.71; PPV 0.15; κ 0.21), and panic disorder (SE 0.71; PPV 0.43; κ 0.48). Other chance-corrected measures of agreement are also reported, and criterion validity of the screens is examined. The results provide evidence that the screens discriminate between patients with symptomatology meeting established diagnostic criteria and those without. They detected previously unrecognized cases in this study and may prove to be valuable tools for psychiatric diagnosis in primary care.

Key words

mental disorders diagnostic screens primary care brief screens operating characteristics