The effectiveness of the Beck Anxiety (BAI-PC) and Depression (BDI-PC) Inventories for Primary Care for discriminating 56 primary care patients with and without revised, third edition Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) diagnosed anxiety and mood disorders was studied. The Anxiety and Mood modules from the Primary Care Evaluation of Mental Disorders (PRIME-MD) were used to establish diagnoses. The coefficient alphas for the BAI-PC and BDI-PC were, respectively, .90 and .88. A BAI-PC cutoff score of 5 and above yielded the highest clinical efficiency (82%) with 85% sensitivity and 81% specificity for identifying patients with and without panic, generalized anxiety, or both disorders, whereas a BDI-PC cutoff score of 6 and above afforded the highest clinical efficiency (92%) with 83% sensitivity and 95% specificity for detecting patients with and without major depressive disorders. The use of these instruments to screen primary care patients before conducting extensive diagnostic evaluations with them was discussed.
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References
1.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.
2.
American Psychiatric Association. (1994) Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
3.
BeckA. T.BeckR. W. (1972). Screening depressed patients in family practice: A rapid technique. Postgraduate Medicine, 52, 81–85.
4.
BeckA. T.SteerR. A. (1993a). Manual for the Beck Anxiety Inventory. San Antonio, TX: The Psychological Corporation.
5.
BeckA. T.SteerR. A. (1993b). Manual for the Beck Depression Inventory. San Antonio, TX: The Psychological Corporation.
6.
BeckA. T.SteerR. A.BrownG. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: The Psychological Corporation.
7.
BorensteinM.CohenJ. (1988). Statistical power analysis [Computer software]. Hillsdale, NJ: Erlbaum.
8.
CavanaughS. V.ClarkD. C.GibbonsR. D. (1983). Diagnosing depression in the hospitalized medically ill. Psychosomatics, 24, 809–815.
9.
CicchettiD. V. (1994). Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6, 284–290.
10.
CoyneJ. C.SchwenkT. L.FechnerbatesS. (1995). Nondetection of depression by primary-care physicians reconsidered. General Hospital Psychiatry, 17, 2–12.
11.
FirstM. B.SpitzerR. L.GibbonM.WilliamsJ. B. W. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders. New York: Biometrics Research Department, New York State Psychiatric Institute.
12.
GoldbergR. J. (1995). Diagnostic dilemmas presented by patients with anxiety and depression. American Journal of Medicine, 98, 278–284.
13.
JuddL. L. (1995). Mood disorders in the general population represent important and worldwide public health problem. International Clinical Psychopharmacology, 10, 5–10.
14.
KairistoV.PoolaA. (1995). Software for illustrative presentation of basic clinical characteristics of laboratory tests-GraphROC for Windows. Scandinavian Journal of Clinical Laboratory Investigation, 66(Suppl. 222), 43–60.
15.
MaserJ. D.CloningerC. R. (Eds.). (1990). Comorbidity of mood and anxiety disorders. Washington, DC: American Psychiatric Press.
16.
MulrowC. D.WilliamsJ. W.GeretyM. B.RamirezG.MontielO. M.KerberC. (1995). Case-finding instruments for depression in primary care settings. Annals of Internal Medicine, 122, 913–921.
17.
PlumbM. M.HollandJ. (1977). Comparative studies of psychological function in patients with advanced cancer, I. Self-reported depressive symptoms. Psychosomatic Medicine, 39, 264–279.
18.
SomozaE.MossmanD. (1992). Comparing diagnostic tests using information theory: The INFO-ROC technique. Journal of Neuropsychiatry and Clinical Neurosciences, 4, 214–219.
19.
SpitzerR. L.WilliamsJ. B. W.GibbonM.FirstM. B. (1990). User's guide for the Structured Clinical Interview for DSM-III-R. Washington, DC: American Psychiatric Press.
20.
SpitzerR. L.WilliamsJ. B. W.KroenkeK.LinzerM.de GruyF. V.IIIHahnS. R.BrodyD. (1995). Prime-MD instruction manual updated for DSM-IV. New York: Biometrics Research Department, New York State Psychiatric Institute.
21.
SpitzerR. L.WilliamsJ. B. W.KroenkeK.LinzerM.de GruyF. V.IIIHahnS. R.BrodyD.JohnsonJ. G. (1994). Utility of a new procedure for diagnosing mental disorders in primary care: The PRIME-MD 1000 study. Journal of the American Medical Association, 14, 1749–1756.
22.
SteerR. A.RissmillerD. J.RanieriW. F.BeckA. T. (1993). Structure of the computer-assisted Beck Anxiety Inventory with psychiatric inpatients. Journal of Personality Assessment, 60, 532–542.
23.
VolkR. J.PaceT. M.ParchmanM. L. (1993). Screening for depression in primary care patients: Dimensionality of the short form of the Beck Depression Inventory. Psychological Assessment, 5, 173–181.
24.
WeissL. (1996). A progress report on the development and validation of the Beck Depression Inventory-Primary Care version prepared for SmithKline Beecham Pharmaceuticals by the staff of the Psychological Corporation, March 1, 1996. Unpublished manuscript
25.
World Health Organization (1992). International classification of diseases and other health related problems (10th ed., rev.). Geneva, Switzerland: Author.
26.
ZigmondA. S.SnaithR. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.
27.
ZungW. W.BroadheadW. E.RothM. E. (1993). Prevalence of depressive symptoms in primary care. Journal of Family Practice, 37, 337–344.
