Assessment of physical etiologies for mood and anxiety disorders in structured diagnostic interviews.
BACKGROUND
Structured diagnostic inter- views include items that evaluate physical etiologies for mood and anxiety disorders. The objective of this article was to assess the impact of such items.


METHODS
A mental health survey in Canada collected data from n = 36,984 household residents. The lifetime prevalence of mood and anxiety disorders was calculated with and without exclusions due to physical causes.


RESULTS
Approximately 10% of subjects with a lifetime depressive disorder reported that all of their episodes were due to one or more physical cause. Many of the reported etiologies were implausible given the DSM-IV requirement that the disturbance be a "direct physiological consequence" of the physical cause. The results were similar for manic episodes and anxiety disorders.


CONCLUSIONS
Structured diagnostic interviews assess physical etiologies in ways that are subject to inconsistency and inaccuracy. Physical etiology items may bias estimates by introducing etiological opinions into the assessment of disorder frequency.
Patten
Scott B
SB
Dept. of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary (AB) Canada T2N 4N1. patten@ucalgary.ca
Williams
Jeanne V A
JV
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology*; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D017050:Episode of Care; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D008297:Male; D008487:Medical History Taking / Q000379:methods; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology*; D016584:Panic Disorder / Q000453:epidemiology; D015985:Precipitating Factors; D015995:Prevalence; D015203:Reproducibility of Results; D012647:Self-Assessment; D013577:Syndrome