Family psychiatric screening instruments for epidemiologic studies: pilot testing and validation

Area of Science:

• Psychiatry
• Epidemiology
• Medical Informatics

Background:

• Assessing family history of psychiatric disorders in epidemiologic studies is crucial but often limited by time and cost.
• A brief, computer-scorable instrument is needed to facilitate family history collection in large-scale research.

Purpose of the Study:

• To develop and evaluate the accuracy of the Family History Screen for Epidemiologic Studies (FHE) in identifying psychiatric diagnoses.
• To determine the FHE's utility as a screening tool for psychiatric conditions in both self-reports and family history.

Main Methods:

• The Family History Screen for Epidemiologic Studies (FHE) was developed to collect family pedigrees and screen for 15 DSM-III diagnoses.
• The FHE was administered to informants in 77 families, with subsequent best-estimate diagnoses for informants and 239 relatives using established psychiatric interview schedules.
• Accuracy was evaluated by comparing FHE predictions against best-estimate diagnoses.

Main Results:

• The FHE demonstrated high sensitivity and specificity for depression and panic in adult self-reports.
• Screening adult relatives yielded low sensitivity but high specificity for depression, panic, and substance abuse.
• The FHE showed poor sensitivity and specificity when informants reported on children's psychiatric conditions.

Conclusions:

• The FHE is a valuable screening tool for psychiatric disorders in adult informants, particularly in primary care settings.
• The FHE is not recommended for comprehensive family psychiatric history assessment due to limitations in accuracy for relatives and children.
• Further research may refine the FHE for broader application in psychiatric epidemiology and clinical screening.