The primary health care version of ICD-11: the detection of common mental disorders in general medical settings

TY - JOUR

T1 - The primary health care version of ICD-11: the detection of common mental disorders in general medical settings

AU - Goldberg, David P.

AU - Prisciandaro, James J.

AU - Williams, Paul

PY - 2012

Y1 - 2012

N2 - Background: The primary health care version of the ICD-11 is currently being revised.Aim: To test two brief sets of symptoms for depression and anxiety in primary care settings, and validate them against diagnoses of major depression and current generalised anxiety made by the CIDI.Method: The study took place in general medical or primary care clinics in 14 different countries, using the Composite International Diagnostic Interview adapted for primary care (CIDI-PC) in 5,438 patients. The latent structure of common symptoms was explored, and two symptom scales were derived from item response theory (IRT), these were then investigated against research diagnoses.Results: Correlations between dimensions of anxious, depressive and somatic symptoms were found to be high. For major depression the 5 item depression scale has marked superiority over the usual 2 item scales used by both the ICD and DSM systems, and for anxiety there is some superiority. If the questions are used with patients that the clinician suspects may have a psychological disorder, the positive predictive value of the scale is between 78 and 90%.Conclusion: The two scales allow clinicians to make diagnostic assessments of depression and anxiety with a high positive predictive value, provided they use them only when they suspect that a psychological disorder is present. (C) 2012 Elsevier Inc. All rights reserved.

AB - Background: The primary health care version of the ICD-11 is currently being revised.Aim: To test two brief sets of symptoms for depression and anxiety in primary care settings, and validate them against diagnoses of major depression and current generalised anxiety made by the CIDI.Method: The study took place in general medical or primary care clinics in 14 different countries, using the Composite International Diagnostic Interview adapted for primary care (CIDI-PC) in 5,438 patients. The latent structure of common symptoms was explored, and two symptom scales were derived from item response theory (IRT), these were then investigated against research diagnoses.Results: Correlations between dimensions of anxious, depressive and somatic symptoms were found to be high. For major depression the 5 item depression scale has marked superiority over the usual 2 item scales used by both the ICD and DSM systems, and for anxiety there is some superiority. If the questions are used with patients that the clinician suspects may have a psychological disorder, the positive predictive value of the scale is between 78 and 90%.Conclusion: The two scales allow clinicians to make diagnostic assessments of depression and anxiety with a high positive predictive value, provided they use them only when they suspect that a psychological disorder is present. (C) 2012 Elsevier Inc. All rights reserved.

KW - Diagnosing anxiety

KW - Latent structure of symptoms

KW - IMPAIRMENT

KW - Item response analysis

KW - Detection

KW - ANXIETY

KW - DEPRESSION

KW - Diagnosing depression

KW - Primary care

KW - KNOWLEDGE

U2 - 10.1016/j.genhosppsych.2012.06.006

DO - 10.1016/j.genhosppsych.2012.06.006

M3 - Article

SN - 0163-8343

VL - 34

SP - 665

EP - 670

JO - GENERAL HOSPITAL PSYCHIATRY

JF - GENERAL HOSPITAL PSYCHIATRY

IS - 6

ER -