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Brief screens for mental disorders in primary care
A C Leon1, M Olfson, M M Weissman
1Department of Psychiatry, Cornell University Medical College, New York, NY 10021, USA.
Journal of General Internal Medicine
|July 1, 1996
Summary
This study assessed diagnostic screens for mental disorders in primary care. The screens effectively identified patients with conditions like depression and anxiety, potentially aiding early diagnosis.
Area of Science:
- Psychiatry
- Primary Care Medicine
- Diagnostic Screening
Background:
- Mental health disorders are prevalent in primary care settings.
- Accurate and efficient diagnostic tools are needed for early detection and intervention.
Purpose of the Study:
- To evaluate the operating characteristics and criterion validity of a set of diagnostic screens for mental disorders in primary care.
- To determine the effectiveness of these screens in identifying patients with specific mental health conditions.
Main Methods:
- A 26-item self-administered screening questionnaire was completed by 1,001 primary care patients.
- Brief, structured diagnostic modules were administered by research nurses to assess specific mental disorders.
- Operating characteristics (sensitivity, positive predictive value, kappa) were calculated for each screen.
Main Results:
- Screens demonstrated varying performance: alcohol dependence (SE 0.75, PPV 0.58), generalized anxiety disorder (SE 0.74, PPV 0.44), and major depressive disorder (SE 0.71, PPV 0.52).
- Obsessive compulsive disorder screening showed lower agreement (kappa 0.21).
- The screens successfully discriminated between patients meeting diagnostic criteria and those without, identifying previously unrecognized cases.
Conclusions:
- The evaluated diagnostic screens show promise as valuable tools for psychiatric diagnosis in primary care.
- These tools can aid in the detection of previously unrecognized mental health conditions.
- Further validation and implementation in routine practice are warranted.