Better detection of non-psychotic mental disorders by case description method in China

The tools for detection of mental disorders in China were all translated from their western versions. Descriptions of three common psychiatric syndromes (neurasthenia, anxiety and depression) were applied to psychiatric outpatients and normal controls to test their validity in detection of non-psychotic mental disorders and the psychometric quality was compared with that of Hospital Anxiety and Depression Scale (HADS).

A consecutive sample of psychiatric outpatients were collected as a patient group (N=51) after psychotic patients were ruled out. The research psychiatrist held clinical interviews under the guide of Mini International Neuro-psychiatric Interview and gave a psychiatric diagnosis based on ICD-10. The normal control group (N=29) came from a general hospital and the community nearby. Both groups had read descriptions and ranked the similarity of their situations with the descriptions; they also had completed the HADS.

Of the 51 outpatients, the most common diagnosis was neuroses non-specified (N=14, 27.5%, including neurasthenia); following that, anxiety disorders (N=13, 25.5%) and depressive disorders (N=12, 23.5%). With the case description method, the areas under the Receiver Operating Characteristic (ROC) for the three syndromes and the total score were 0.955, 0.865, 0.910 and 0.998, respectively. To distinguish between the two groups, the cut-off of the total score was 3, the sensitivity was 98%, the specificity was 93%, even better than that of HADS total score (sensitivity 88%, specificity 90%).

This preliminary study suggested better validity of case description method than HADS in detection of non-psychotic disorders, which warrants further confirmative study.