title: Diagnostic Accuracy of the Primary Care Screener for Affective Disorder (PC-SAD) in Primary Care.
abstract: BACKGROUND
  Depression goes often unrecognised and untreated in non-psychiatric medical settings. Screening has recently gained acceptance as a first step towards improving depression recognition and management. The Primary Care Screener for Affective Disorders (PC-SAD) is a self-administered questionnaire to screen for Major Depressive Disorder (MDD) and Dysthymic Disorder (Dys) which has a sophisticated scoring algorithm that confers several advantages. This study tested its performance against a 'gold standard' diagnostic interview in primary care.
  
  
  METHODS
  A total of 416 adults attending 13 urban general internal medicine primary care practices completed the PC-SAD. Of 409 who returned a valid PC-SAD, all those scoring positive (N=151) and a random sample (N=106) of those scoring negative were selected for a 3-month telephone follow-up assessment including the administration of the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) by a psychiatrist who was masked to PC-SAD results.
  
  
  RESULTS
  Most selected patients (N=212) took part in the follow-up assessment. After adjustment for partial verification bias the sensitivity, specificity, positive and negative predictive value for MDD were 90%, 83%, 51%, and 98%. For Dys, the corresponding figures were 78%, 79%, 8%, and 88%.
  
  
  CONCLUSIONS
  While some study limitations suggest caution in interpreting our results, this study corroborated the diagnostic validity of the PC-SAD, although the low PPV may limit its usefulness with regard to Dys. Given its good psychometric properties and the short average administration time, the PC-SAD might be the screening instrument of choice in settings where the technology for computer automated scoring is available.
authors.affiliation: Mental Health Unit, Centre of Epidemiology, Surveillance and Health Promotion, Italian National Institute of Health, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.forename: D A
authors.initials: DA
authors.lastname: Adler
authors.forename: W H
authors.initials: WH
authors.lastname: Rogers
authors.forename: I
authors.initials: I
authors.lastname: Lega
authors.forename: M P
authors.initials: MP
authors.lastname: Zerella
authors.forename: G
authors.initials: G
authors.lastname: Matteucci
authors.forename: L
authors.initials: L
authors.lastname: Tarsitani
authors.forename: M
authors.initials: M
authors.lastname: Caredda
authors.forename: A
authors.initials: A
authors.lastname: Gigantesco
authors.forename: M
authors.initials: M
authors.lastname: Biondi
keywords: Depression; Diagnosis; Primary care; Public health.