Brief screening for family psychiatric history: the family history screen.
BACKGROUND
Brief screens to collect lifetime family psychiatric history are useful in clinical practice and for identifying potential families for genetic studies.


METHODS
The Family History Screen (FHS) collects information on 15 psychiatric disorders and suicidal behavior in informants and their first-degree relatives. Since each question is posed only once about all family members as a group, the administrative time is 5 to 20 minutes, depending on family size and illness. Data on the validity against best-estimate (BE) diagnosis based on independent and blind direct interviews on 289 probands and 305 relatives and test-retest reliability across 15 months in 417 subjects are presented.


RESULTS
Agreement between FHS and BE diagnosis for proband and relative self-report had median sensitivity (SEN) of 67.6 and 71.1 respectively; median specificity (SPC) was 87.6 and 89.4, respectively. Marked decrease in SEN occurred when a single informant (the proband) reported on a relative (median, 37.5); however, median SPC was 95.8. Use of more than 1 informant substantially improved SEN (median, 68.2), with a modest reduction in SPC (median, 86.8). Test-retest reliability across 15 months resulted in a median kappa of 0.56.


CONCLUSIONS
The FHS is a promising brief screen for collecting lifetime psychiatric history on an informant and/or first-degree relatives. Its validity is best demonstrated for major depression, anxiety disorders, substance dependence (alcohol and drug dependence), and suicide attempts. It is not a substitute for more lengthy family history if more detail on diagnosis is required.
Weissman
M M
MM
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, New York 10032, USA. weissman@child.cpmc.columbia.edu
Wickramaratne
P
P
Adams
P
P
Wolk
S
S
Verdeli
H
H
Olfson
M
M
D000293:Adolescent; D000328:Adult; D003625:Data Collection / Q000379:methods / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005190:Family; D005192:Family Health; D006306:Health Surveys; D006801:Humans; D008487:Medical History Taking / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D008875:Middle Aged; D010375:Pedigree; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires