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Assessment of physical etiologies for mood and anxiety disorders in structured diagnostic interviews

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Abstract

Background

Structured diagnostic inter- views include items that evaluate physical etiologies for mood and anxiety disorders. The objective of this article was to assess the impact of such items.

Method

A mental health survey in Canada collected data from n = 36,984 household residents. The lifetime prevalence of mood and anxiety disorders was calculated with and without exclusions due to physical causes.

Results

Approximately 10% of subjects with a lifetime depressive disorder reported that all of their episodes were due to one or more physical cause. Many of the reported etiologies were implausible given the DSM-IV requirement that the disturbance be a “direct physiological consequence” of the physical cause. The results were similar for manic episodes and anxiety disorders.

Conclusions

Structured diagnostic interviews assess physical etiologies in ways that are subject to inconsistency and inaccuracy. Physical etiology items may bias estimates by introducing etiological opinions into the assessment of disorder frequency.

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Acknowledgments

This project was funded by a grant from the Institute for Health Economics (http://www.ihe.ab.ca). Dr. Patten is a Health Scholar with the Alberta Heritage Foundation for Medical Research and a Fellow with the Institute of Health Economics.

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Authors and Affiliations

  1. Dept. of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, Canada, T2N 4N1

    Scott B. Patten MD, PhD & Jeanne V.A. Williams MSc

Authors
  1. Scott B. Patten MD, PhD
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  2. Jeanne V.A. Williams MSc
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Corresponding author

Correspondence to Scott B. Patten MD, PhD.

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Patten, S., Williams, J. Assessment of physical etiologies for mood and anxiety disorders in structured diagnostic interviews. Soc Psychiat Epidemiol 42, 462–466 (2007). https://doi.org/10.1007/s00127-007-0195-y

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  • DOI: https://doi.org/10.1007/s00127-007-0195-y

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