Correspondence between clinical diagnoses of depressive and anxiety disorders and diagnostic screening via the Hopkins Symptom Check List-25 in the Lundby Study.
OBJECTIVE
To compare clinical assessments of mental disorders with the Hopkins Symptom Check List-25 (HSCL-25) in a population-based sample consisting of middle-aged and elderly subjects.


BACKGROUND
The Lundby Study is a prospective cohort study that evaluated mental disorders and personality traits in an unselected Swedish population. The study commenced in 1947, with follow-ups in 1957, 1972 and 1997 (n = 3563).


METHODS
Psychiatrists evaluated participants for mental disorders at several field investigations. In 1997, participants were also asked to complete the HSCL-25. Subjects with diagnoses of schizophrenia, dementia and certain other conditions were excluded leaving 1189 subjects aged 40-96 years. Diagnostic assessments by psychiatrists were compared with the results of the HSCL-25. Sensitivity and specificity were calculated at two cut-off levels of the HSCL-25 (1.55 and 1.75), and receiver operating characteristic (ROC) curves were plotted. The performance of the HSCL-25 was analysed with regard to anxiety and depression subscales.


RESULTS
The concordance of HSCL-25 with clinical best-estimate diagnoses was low. The anxiety subscale discriminated better than the depressive subscale.


CONCLUSIONS
The correspondence between the clinical diagnoses made by psychiatrists and the HSCL-25 was not acceptable at a cut-off level 1.55. The HSCL-25 is limited in its ability to identify clinical syndromes. The HSCL-25 should be applied only as a preliminary screen for emotional distress and anxiety syndromes.
Department of Clinical Sciences, Section of Psychiatry, Lundby Study, Kioskgatan 17, Lund University, SE-221 85 Lund, Sweden. cecilia.mattisson@med.lu.se
Cecilia
C
Mattisson
Mats
M
Bogren
Vibeke
V
Horstmann
D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012647:Self-Assessment; D012680:Sensitivity and Specificity