title: PRIME-MD: its utility in detecting mental disorders in American Indians.
abstract: OBJECTIVE
  To examine the utility of using PRIME-MD (Primary Care Evaluation of Mental Disorders) for diagnosing mental disorders in American Indians.
  
  
  METHODS
  One hundred randomly selected, adult, American-Indian patients who receive health care services at an urban Indian Health Service primary care clinic were evaluated for mental disorder by three primary care physicians using the PRIME-MD diagnostic assessment procedure. The main outcome measures were PRIME-MD diagnoses, diagnoses by an independent mental health professional, and treatment/referral decisions.
  
  
  RESULTS
  Eighteen percent of the patients had a threshold (met full DSM-IV criteria ) PRIME-MD diagnosis, and an additional 17 percent had a subthreshold PRIME-MD diagnosis. The most frequently occurring PRIME-MD diagnoses were: probable alcohol abuse/dependence, major depressive disorder, and generalized anxiety disorder. Over 60 percent of the patients with a PRIME-MD diagnosis who were known "somewhat" or "fairly well" to their physician had not been recognized as having that psychiatric disorder prior to the PRIME-MD assessment. Therapy and/or referral was initiated for nineteen of the twenty-seven patients with a PRIME-MD diagnosis who were not previously receiving treatment. The primary care physicians were able to complete the PRIME-MD evaluations within an average of 7.8 minutes. There was a fair agreement between the PRIME-MD diagnoses and the diagnoses of the mental health professional (kappa = 0.56; overall accuracy rate = 79%).
  
  
  CONCLUSIONS
  The present study represents the first formal examination of the use of PRIME-MD with American Indians. The results are encouraging. Further studies using PRIME-MD with other urban groups and reservation populations are recommended.
authors.affiliation: Case Western Reserve University, USA.
authors.forename: T
authors.initials: T
authors.lastname: Parker
authors.forename: P A
authors.initials: PA
authors.lastname: May
authors.forename: M A
authors.initials: MA
authors.lastname: Maviglia
authors.forename: S
authors.initials: S
authors.lastname: Petrakis
authors.forename: S
authors.initials: S
authors.lastname: Sunde
authors.forename: S V
authors.initials: SV
authors.lastname: Gloyd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D008875:Middle Aged; D009516:New Mexico; D010348:Patient Care Team; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D012017:Referral and Consultation; D015203:Reproducibility of Results