Normal controls are expensive to find: methods to improve cost-effectiveness of the screening evaluation.
A program for the recruitment of control subject is examined by considering the yield of healthy subjects as a function of the initial screening interview. All subjects who passed the screen also completed a diagnostic evaluation for lifetime history of mental disorders. Version 1 of the screen focused on excluding individuals who were currently mentally ill. Approximately 20% met criteria for Never Mentally Ill (NMI); 7% had one episode of a minor mental disorder (MMD); 43% were currently not mentally ill, but had a serious history of mental illness (CNMI); and 30% were currently mentally ill (CMI). Revision of the screen to exclude individuals with any history of treatment for mental illness significantly improved the proportion of NMI subjects (29%), and there was a trend for a decreased proportion of CMI subjects (25%). Additional revision of the screen to exclude individuals with a history of selected untreated mental disorders resulted in a significantly greater proportion of NMI subjects (50%), and a significantly lower proportion of CMI (17%) subjects. The results of this investigation demonstrate that the cost-effectiveness of the initial screen can be greatly improved by expanding the evaluation to include selected untreated as well as treated mental disorders.
Schechter
Dianne
D
Department of Research Assessment and Training, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 123, New York, NY 10032, USA. des3@columbia.edu
Lebovitch
Rochelle
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000175:diagnosis / Q000191:economics* / Q000534:rehabilitation*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D003362:Cost-Benefit Analysis; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods*; D008875:Middle Aged; D018579:Patient Selection