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Screening for psychiatric disorders with self-administered questionnaires.

Mark Zimmerman1, Carolina Guzman Holst1

  • 1Department of Psychiatry and Human Behavior, Brown Medical School, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.

Psychiatry Research
|June 18, 2018
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Summary
This summary is machine-generated.

Most bipolar disorder screening scales use incorrect cutoff scores, missing patients who need further diagnosis. Prioritizing sensitivity in screening test development is crucial for accurate diagnostic recognition.

Keywords:
Bipolar disorderCase-findingQuestionnairesScreeningUnderdiagnosis

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Diagnostic Test Evaluation

Background:

  • Clinical practice time constraints can lead to missed diagnoses.
  • Self-administered screening scales are recommended to improve diagnostic recognition.
  • Confusion exists between diagnostic testing and screening in research.

Purpose of the Study:

  • To examine the methods used to determine cutoff scores on bipolar disorder screening scales.
  • To assess the frequency of different approaches in deriving recommended cutoff scores.
  • To highlight the importance of appropriate cutoff score determination for screening.

Main Methods:

  • Reviewed 68 reports on the performance of 3 common bipolar disorder screening scales.
  • Analyzed how recommended cutoff scores were derived in the reviewed studies.
  • Compared study approaches to optimizing agreement versus prioritizing sensitivity.

Main Results:

  • Most studies (83.8%) recommended cutoff scores optimizing agreement with the diagnostic gold standard.
  • Only 11 studies (16.2%) recommended cutoff scores prioritizing sensitivity.
  • The majority of studies used an inappropriate method for deriving screening cutoff scores.

Conclusions:

  • Most studies on bipolar disorder screening scales have used the wrong approach for deriving cutoff scores.
  • Clinicians must understand the distinction between screening and diagnostic tests.
  • Prioritizing sensitivity is essential for effective screening to avoid missing potential diagnoses.