title: Operating characteristics of depression and anxiety disorder phenotype dimensions and trait neuroticism: a theoretical examination of the fear and distress disorders from the Netherlands study of depression and anxiety.
abstract: BACKGROUND
  The receiver operating characteristics (ROC) of anhedonic depression and anxious arousal to detect the distress- (major depression, dysthymia, generalized anxiety disorder) and fear-disorder clusters (i.e. panic disorder, agoraphobia, social phobia) have not been reported in a large sample.
  
  
  METHODS
  A sample of 2981 persons underwent structured psychiatric interview; n=652 were without lifetime depression and anxiety disorder history. Participants also completed a neuroticism scale (Revised NEO Five Factor Inventory [NEO-FFI]), and the 30-item short adaptation of the Mood and Anxiety Symptoms Questionnaire (MASQ-D30) measuring anhedonic depression, anxious arousal and general distress. Maximal sensitivity and specificity was determined by the Youden Index and the area-under-the-curve (AUC) in ROC analysis.
  
  
  RESULTS
  A total of 2624 completed all measures (age M=42.4 years±13.1, 1760 females [67.1%]), including 1060 (40.4%) persons who met criteria for a distress-disorder, and 973 (37.1%) who met criteria for a fear-disorder. The general distress dimension provided the highest ROC values in the detection of the distress-disorders (AUC=.814, sensitivity=71.95%, specificity=76.34%, positive predictive value=67.33, negative predictive value=80.07). None of the measures provided suitable operating characteristics in the detection of the fear-disorders with specificity values <75%.
  
  
  CONCLUSIONS
  Over sampling of depression and anxiety disorders may lead to inflated positive- and negative predictive values.
  
  
  CONCLUSIONS
  The MASQ-D30 general distress dimension showed clinically suitable operating characteristics in the detection of distress-disorders. Neither neuroticism nor the MASQ-D30 dimensions provided suitable operating characteristics in the detection of the fear-disorders.
authors.affiliation: Freemasons Foundation Centre for Men׳s Health, Discipline of Medicine, School of Medicine, The University of Adelaide, Adelaide, South Australia 5005, Australia; Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany. Electronic address: phillip.tully@adelaide.edu.au.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Tully
authors.affiliation: Department of Psychiatry, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Klaas J
authors.initials: KJ
authors.lastname: Wardenaar
authors.affiliation: Department of Psychiatry, Vrije University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D019540:Area Under Curve; D001143:Arousal; D003863:Depression / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D000075384:Neuroticism; D010641:Phenotype; D010698:Phobic Disorders / Q000175:diagnosis* / Q000523:psychology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Anxiety disorders; Depression disorders; Mood and Anxiety Symptoms Questionnaire; Receiver-operating characteristic analysis; Screening