title: A provisional screening instrument for four common mental disorders in adult primary care patients.
abstract: OBJECTIVE
  To develop an adult self-report instrument for provisional diagnosis of four common mental disorders in primary care patients.
  
  
  METHODS
  Primary care patients were evaluated during routine clinic visits with a self-report screening tool comprised of 85 DSM-IV symptom-based candidate questions. Patients with a physician-assessed provisional diagnosis for generalized anxiety disorder (GAD), major depressive episode (MDE), past/present mania, and adult attention-deficit/hyperactivity disorder (ADHD), or none of these, completed additional self-report clinical questionnaires, and then were interviewed on the telephone by a trained rater for a SCID/ACDS diagnosis. Responses to the symptom-based candidate questions were used to calculate sensitivity and specificity for a SCID/ACDS diagnosis (GAD, N = 24; MDE, N = 89; Mania, N = 24; ADHD, N = 65) and to select the optimal four questions for each diagnosis to be included in the instrument.
  
  
  RESULTS
  Analyses resulted in a 17-item instrument for provisional differential diagnosis of GAD, MDE, past/present mania, and ADHD. Comparison of limited symptom-based versus full DSM-IV criteria-based diagnosis showed minimal differences for relative diagnostic accuracy. Sensitivities and specificities, respectively, were 83% and 75% for GAD, 80% and 80% for MDE, 83% and 82% for mania, and 82%and 73% for ADHD.
  
  
  CONCLUSIONS
  Based on this preliminary work, the Provisional Diagnostic Instrument-4 is a brief, easily scored, self-report instrument that may assist primary care physicians to identify potential cases of GAD, MDE, past/present mania, and ADHD.
authors.affiliation: Lilly USA, LLC, Indianapolis, IN 46285, USA. hourstonjp@lilly.com
authors.forename: John P
authors.initials: JP
authors.lastname: Houston
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Faries
authors.forename: Caroline Carney
authors.initials: CC
authors.lastname: Doebbeling
authors.forename: Lenard A
authors.initials: LA
authors.lastname: Adler
authors.forename: Jonna
authors.initials: J
authors.lastname: Ahl
authors.forename: Ralph
authors.initials: R
authors.lastname: Swindle
authors.forename: Paula T
authors.initials: PT
authors.lastname: Trzepacz
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000295:instrumentation* / Q000379:methods; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States