A population study comparing screening performance of prototypes for depression and anxiety with standard scales

Abstract

BackgroundScreening instruments for mental disorders need to be short, engaging, and valid. Current screening instruments are usually questionnaire-based and may be opaque to the user. A prototype approach where individuals identify with a description of an individual with typical symptoms of depression, anxiety, social phobia or panic may be a shorter, faster and more acceptable method for screening. The aim of the study was to evaluate the accuracy of four new prototype screeners for predicting depression and anxiety disorders and to compare their performance with existing scales.MethodsShort and ultra-short prototypes were developed for Major Depressive Disorder (MDD), Generalised Anxiety Disorder (GAD), Panic Disorder (PD) and Social Phobia (SP). Prototypes were compared to typical short and ultra-short self-report screening scales, such as the Centre for Epidemiology Scale, CES-D and the GAD-7, and their short forms. The Mini International Neuropsychiatric Interview (MINI) version 6 [1] was used as the gold standard for obtaining clinical criteria through a telephone interview. From a population sample, 225 individuals who endorsed a prototype and 101 who did not were administered the MINI. Receiver operating characteristic (ROC) curves were plotted for the short and ultra short prototypes and for the short and ultra short screening scales.ResultsThe study found that the rates of endorsement of the prototypes were commensurate with prevalence estimates. The short-form and ultra short scales outperformed the short and ultra short prototypes for every disorder except GAD, where the GAD prototype outperformed the GAD 7.ConclusionsThe findings suggest that people may be able to self-identify generalised anxiety more accurately than depression based on a description of a prototypical case. However, levels of identification were lower than expected. Considerable benefits from this method of screening may ensue if our prototypes can be improved for Major Depressive Disorder, Social Phobia and Panic Disorder.

The Mental Component of the Short-Form 12 Health Survey (SF-12) as a Measure of Depressive Disorders in the General Population: Results with Three Alternative Scoring Methods

“…In the same study, results were presented from primary care samples obtained in 15 centers around the world, showing AUCs ranging from 0.83 to 0.95. Similarly, screening performance of the CES-D against depressive disorders has been found to be moderate to high in several studies, with AUC values ranging between 0.74 and 0.94 [39][40][41][42][43][44][45][46][47].…”

Comparative Efficacy of the Generalized Anxiety Disorder 7-Item Scale and the Edinburgh Postnatal Depression Scale as Screening Tools for Generalized Anxiety Disorder in Pregnancy and the Postpartum Period

“…During its initial validation using a cut-off score of 10, the GAD-7 yielded a sensitivity of 89%, specificity of 82%, PPV of 29%, and NPV of 99% in a primary care sample 32. Further studies of the GAD-7 in the general population have yielded a sensitivity of 60.6% and a specificity of 87.6% at a cut-off score of 10 33. Examination of the GAD-7 in psychiatric populations is limited, though a recent study34 observed a sensitivity of 64% and a specificity of 57% at an optimal cut-off score of 13 in psychiatric patients referred to an acute partial hospital program.…”

Effect of depression on mortality and cardiovascular morbidity in type 2 diabetes mellitus after 3 years follow up. The DIADEMA study protocol

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