title: The PHQ-PD as a Screening Tool for Panic Disorder in the Primary Care Setting in Spain.
abstract: BACKGROUND
  Panic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres.
  
  
  METHODS
  We compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entire PHQ test, including the PHQ-PD, to undergo the SCID-I. The sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios of the PHQ-PD were assessed.
  
  
  RESULTS
  The operating characteristics of the PHQ-PD are moderate. The best cut-off score was 5 (sensitivity .77, specificity .72). Modifications to the questionnaire's algorithms improved test characteristics (sensitivity .77, specificity .72) compared to the original algorithm. The screening question alone yielded the highest sensitivity score (.83).
  
  
  CONCLUSIONS
  Although the modified algorithm of the PHQ-PD only yielded moderate results as a diagnostic test for panic disorder, it was better than the original. Using only the first question of the PHQ-PD showed the best psychometric properties (sensitivity). Based on these findings, we suggest the use of the screening questions for screening purposes and the modified algorithm for diagnostic purposes.
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Faculty of Psychology, University of Valencia, Valencia, Spain.
authors.forename: Roger
authors.identifier: http://orcid.org/0000-0002-7064-3699
authors.initials: R
authors.lastname: Muñoz-Navarro
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cano-Vindel
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
authors.forename: Cristina Mae
authors.initials: CM
authors.lastname: Wood
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Castilla La Nueva Primary Care Center, Health Service of Madrid, Madrid, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Ruíz-Rodríguez
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Faculty of Psychology, University Siglo 21, Córdoba, Argentina, Spain.
authors.forename: Leonardo Adrián
authors.initials: LA
authors.lastname: Medrano
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Stress and Health Research Group, Faculty of Psychology, Autonomous University of Barcelona, Barcelona, Bellaterra, Spain.
authors.forename: Joaquín T
authors.initials: JT
authors.lastname: Limonero
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Malva-Rosa Primary Care Center, Health Service of Valencia, Valencia, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Tomás-Tomás
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Gracia-Gracia
authors.affiliation: PsicAP Research Group, Complutense University of Madrid, Madrid, Spain.|Faculty of Psychology, Catholic University of Valencia, Valencia, Spain.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Dongil-Collado
authors.affiliation: Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
authors.forename: M Iciar
authors.initials: MI
authors.lastname: Iruarrizaga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis*; D011320:Primary Health Care; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult