OBJECTIVE: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1525-1497.2001.016009606.x

The PHQ-9: validity of a brief depression severity measure.

Background: This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. Methods: The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Results: Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. Conclusions: The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking.

/pdf/lifetime-and-12-month-prevalence-of-dsm-iii-r-psychiatric-1o9w1oagsp.pdf

Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results From the National Comorbidity Survey

Background. A 10-question screening scale of psychological distress and a six-question short-form scale embedded within the 10-question scale were developed for the redesigned US National Health Interview Survey (NHIS). Methods. Initial pilot questions were administered in a US national mail survey (N fl 1401). A reduced set of questions was subsequently administered in a US national telephone survey (N fl 1574). The 10-question and six-question scales, which we refer to as the K10 and K6, were constructed from the reduced set of questions based on Item Response Theory models. The scales were subsequently validated in a two-stage clinical reappraisal survey (N fl 1000 telephone screening interviews in the first stage followed by N fl 153 face-to-face clinical interviews in the second stage that oversampled first-stage respondents who screened positive for emotional problems) in a local convenience sample. The second-stage sample was administered the screening scales along with the Structured Clinical Interview for DSM-IV (SCID). The K6 was subsequently included in the 1997 (N fl 36116) and 1998 (N fl 32440) US National Health Interview Survey, while the K10 was included in the 1997 (N fl 10641) Australian National Survey of Mental Health and Well-Being. Results. Both the K10 and K6 have good precision in the 90th‐99th percentile range of the population distribution (standard errors of standardized scores in the range 0‐20‐0‐25) as well as consistent psychometric properties across major sociodemographic subsamples. The scales strongly discriminate between community cases and non-cases of DSM-IV}SCID disorders, with areas under the Receiver Operating Characteristic (ROC) curve of 0‐87‐0‐88 for disorders having Global Assessment of Functioning (GAF) scores of 0‐70 and 0‐95‐0‐96 for disorders having GAF scores of 0‐50. Conclusions. The brevity, strong psychometric properties, and ability to discriminate DSM-IV cases from non-cases make the K10 and K6 attractive for use in general-purpose health surveys. The scales are already being used in annual government health surveys in the US and Canada as well as in the WHO World Mental Health Surveys. Routine inclusion of either the K10 or K6 in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/F141675CCD0E08C0FB98E01C006B4E0D/S0033291702006074a.pdf/div-class-title-short-screening-scales-to-monitor-population-prevalences-and-trends-in-non-specific-psychological-distress-div.pdf

Short screening scales to monitor population prevalences and trends in non-specific psychological distress.

ContextThe Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed
as a screening instrument but its administration time has limited its clinical
usefulness.ObjectiveTo determine if the self-administered PRIME-MD Patient Health Questionnaire
(PHQ) has validity and utility for diagnosing mental disorders in primary
care comparable to the original clinician-administered PRIME-MD.DesignCriterion standard study undertaken between May 1997 and November 1998.SettingEight primary care clinics in the United States.ParticipantsOf a total of 3000 adult patients (selected by site-specific methods
to avoid sampling bias) assessed by 62 primary care physicians (21 general
internal medicine, 41 family practice), 585 patients had an interview with
a mental health professional within 48 hours of completing the PHQ.Main Outcome MeasuresPatient Health Questionnaire diagnoses compared with independent diagnoses
made by mental health professionals; functional status measures; disability
days; health care use; and treatment/referral decisions.ResultsA total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585
had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those
of independent mental health professionals (for the diagnosis of any 1 or
more PHQ disorder, κ = 0.65; overall accuracy, 85%; sensitivity, 75%;
specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses
had more functional impairment, disability days, and health care use than
did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the
PHQ was far less than to administer the original PRIME-MD (<3 minutes for
85% vs 16% of the cases). Although 80% of the physicians reported that routine
use of the PHQ would be useful, new management actions were initiated or planned
for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously
recognized.ConclusionOur study suggests that the PHQ has diagnostic validity comparable to
the original clinician-administered PRIME-MD, and is more efficient to use.

/pdf/validation-and-utility-of-a-self-report-version-of-prime-md-33rfvg173m.pdf

Validation and utility of a self-report version of PRIME-MD : The PHQ Primary Care Study

Attachment--and loss.

This efficient, user-friendly instrument will help clinicians make standardized, reliable, and accurate diagnoses and avoid the common problem of "premature closure" -- the premature focus on one diagnostic possibility. It will also help clinicians of all levels of experience improve their clinical assessment and interviewing techniques and provides extensive documentation of the diagnostic process, an essential procedure in today's managed care world. Specifically adapted from the research standard for Axis I structured clinical interviewing for use in clinical settings, the SCID-I covers those DSM-IV diagnoses most commonly seen by clinicians and includes the diagnostic criteria for these disorders with corresponding interview questions. The SCID-I is divided into six self-contained modules that can be administered in sequence: mood episodes; psychotic symptoms; psychotic disorders; mood disorders; substance use disorders; and anxiety, adjustment, and other disorders. The Scoresheet, available in sets of five, is a one-time-use scoresheet used to record diagnostic decisions. It also contains abridged DSM-IV diagnostic criteria. This is a package of 5.

Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet

The Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) is an efficient, user-friendly instrument that will help researchers and clinicians make standardized, reliable, and accurate diagnoses of the 10 DSM-IV Axis II personality disorders as well as depressive personality disorder, passive-aggressive personality disorder, and personality disorder not otherwise specified. Now compatible with DSM-IV, the interview questions have been redesigned to reflect the subject's inner experience. This instrument begins with a brief overview that characterizes the subject's typical behavior and relationships and elicits information about the subject's capacity for self-reflection. It then considers each of the personality disorders in detail. The Questionnaire is a single-use personality questionnaire to be completed by the patient that can be used as a screening tool to shorten the interview. Bound separately, it is sold only with the Interview booklet. The Interview is a single-use booklet that is bound separately but used in conjunction with the Questionnaire. It contains the interview questions and provides space to record responses. At the conclusion of the Interview, the clinician completes the Summary Score Sheet and computes a dimensional score for each personality disorder. This is a package of 5.

Structured clinical interview for DSM-IV axis II personality disorders : SCID-II

• The history, rationale, and development of the Structured Clinical Interview for DSM-III-R (SCID) is described. The SCID is a semistuctured interview for making the major Axis I DSM-III-R diagnoses. It is administered by a clinician and includes an introductory overview followed by nine modules, seven of which represent the major axis I diagnostic classes. Because of its modular construction, it can be adapted for use in studies in which particular diagnoses are not of interest. Using a decision tree approach, the SCID guides the clinician in testing diagnostic hypotheses as the interview is conducted. The output of the SCID is a record of the presence or absence of each of the disorders being considered, for current episode (past month) and for lifetime occurrence.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/495830/archpsyc_49_8_005.pdf

The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description.

The reusable Administration Booklet contains interview questions and DSM-IV diagnostic criteria. It is designed to be used with the Scoresheet during a 45- to 90-minute session and is tabbed to help the clinician move from one section to another.

Michael B. First

Papers

Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet

Structured clinical interview for DSM-IV axis II personality disorders : SCID-II

The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description.

Structured Clinical Interview for DSM-IV Axis I Disorders

Structured clinical interview for DSM-IV axis I disorders : SCID-I: clinical version : administration booklet