Diagnosing bipolar disorder in trauma exposed primary care patients.
OBJECTIVE
Bipolar disorder (BD) is often under-recognized in non-psychiatric settings, especially in African Americans. The Mood Disorder Questionnaire (MDQ) is a screening instrument proposed to show adequate sensitivity and specificity for bipolar spectrum disorders. The current study is an examination of the usefulness of this instrument in a trauma exposed subgroup of mainly African American patients attending primary care clinics.


METHODS
The sample is a part of a larger study exploring traumatic stress exposure and psychopathology. Consenting patients in 3 academically affiliated primary care clinics were asked to complete the MDQ. Ninety percent of the participants were African American. Diagnostic performance was determined in a trauma exposed subgroup by employing the Structured Clinical Interview for DSM-IV (SCID) as a gold standard.


RESULTS
Of the total group of 579 participants, 178 (30.7%) screened positive for BD along with 77 (33.7%) of the 228 trauma exposed subjects who were SCID interviewed. Only 13 (27%) of the MDQ positives met SCID criteria for BD and were true positives. The sensitivity was 61.9% and the specificity was 69%, with a positive predictive value of 16.8% and a negative predictive value of 94.7%.


CONCLUSIONS
The MDQ was found to have low specificity in a predominately African American group of trauma exposed patients attending primary care.
Graves
Ruth Elaine
RE
Howard University School of Medicine, Washington, DC 20011, USA. revelainegraves@att.net
Alim
Tanya N
TN
Aigbogun
Notalelomwan
N
Chrishon
Kris
K
Mellman
Thomas A
TA
Charney
Dennis S
DS
Lawson
William B
WB
D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D044383:Black People / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data; D011320:Primary Health Care; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D001741:Black or African American