title: Results of the search for personality disorder screening tools: clinical implications.
abstract: OBJECTIVE
  To examine the characteristics, validity, posttest probabilities, and screening capabilities of 8 different instruments used to predict personality disorders.
  
  
  METHODS
  Screening instruments were examined in 3 prospective, observational, test-development studies in 3 random samples of Dutch psychiatric outpatients, using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) as the "gold standard." The studies were performed from March 2004 to March 2005 (study 1: N = 195, mean age = 32.7 years), October 2006 to January 2007 (study 2: N = 79, mean age = 34.3 years), and January 2008 to October 2009 (study 3: N = 102, mean age = 33.7 years). The following 8 assessment instruments were examined: 3 short questionnaires (a self-report form of the Standardized Assessment of Personality-Abbreviated Scale [SAPAS-SR], the self-report Iowa Personality Disorder Screen [IPDS], and a short self-report version of the SCID-II [S-SCID-II]); 2 longer questionnaires (the self-report SCID-II Personality Questionnaire [SCID-II-PQ] and the NEO Five-Factor Inventory [NEO-FFI]); 1 short semistructured interview (the Quick Personality Assessment Schedule [PAS-Q]); and 2 informant-based interviews (the Standardized Assessment of Personality [SAP] and the Standardized Assessment of Personality-Abbreviated Scale for Informants [SAPAS-INF]).
  
  
  RESULTS
  The SCID-II rate of identification of personality disorders in the 3 studies was between 48.1% and 64.1%. The SAPAS-SR, the IPDS, and the PAS-Q had the best sensitivity (83%, 77%, and 80%, respectively) and specificity (80%, 85%, and 82%, respectively). Moreover, these 3 instruments correctly classified the largest number of patients. Using the SAPAS-SR, the IPDS, or the PAS-Q raises the odds from 50% to between 80% and 84% that a patient in a psychiatric outpatient population will receive a personality disorder diagnosis.
  
  
  CONCLUSIONS
  The results provide evidence for the usefulness of the SAPAS-SR, IPDS, and PAS-Q instruments for personality disorder screening. Because the PAS-Q takes a longer time and requires qualified personnel to administer it, we recommend use of the SAPAS-SR or the self-report version of the IPDS.
authors.affiliation: Department of Psychiatry, Namsos Hospital, Helse Nord-Trøndelag, Namsos, Norway. sara.germans@hnt.no
authors.forename: Sara
authors.initials: S
authors.lastname: Germans
authors.forename: Guus L
authors.initials: GL
authors.lastname: Van Heck
authors.forename: Paul P G
authors.initials: PP
authors.lastname: Hodiamont
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D057566:Self Report