A comparison of self-reports of distress and affective disorder diagnoses in rheumatoid arthritis: a receiver operator characteristic analysis.
OBJECTIVE
To compare 3 commonly used psychiatric symptom checklists (the Center for Epidemiological Studies Depression Scale [CES-D], the Positive and Negative Affect Schedule, and the Endler Multidimensional Anxiety Scales [EMAS]) to determine their sensitivity, specificity, and ability to discriminate between a disorder (Major Depression [MD], Generalized Anxiety Disorder [GAD]), and no disorder. To compare the checklists for their ability to discriminate between type of disorder (MD and GAD). To evaluate the discriminant ability of the subscales, particularly positive affect; whether the somatic items in the CES-D artificially inflate affective scores; and the optimal cut off score for the CES-D.


METHODS
We compared the 3 scales to diagnostic criterion of MD, GAD, and comorbid disorder using receiver operator characteristic (ROC) and logistic regression analyses. The sample consisted of a national panel of 415 individuals with rheumatoid arthritis (RA).


RESULTS
Each of the scales had high sensitivity and specificity (areas under the curve: CES-D = 0.92, negative affect = 0.88, positive affect and EMAS = 0.82). The CES-D, however, demonstrated better sensitivity and specificity than the positive affect and the EMAS, but not the negative affect scale.


CONCLUSIONS
All 3 self-reports have high combined sensitivity and specificity as measures of affective disorders among RA patients.
McQuillan
Julia
J
University of Nebraska, Lincoln, USA. jmcquillan2@unl.edu
Fifield
Judith
J
Sheehan
T Joseph
TJ
Reisine
Susan
S
Tennen
Howard
H
Hesselbrock
Victor
V
Rothfield
Naomi
N
D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012650:Self Disclosure; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000209:etiology*