Jackson et al developed a brief screening instrument for mental disorders in medical outpatients. This can help identify patients who might benefit from a more extensive evaluation for depressive or anxiety disorders .The authors are from the Uniform Services University of the Health Sciences in Bethesda, Maryland.
Mental disorders identified in medical outpatients:
(1) depressive disorder or major depression
(2) anxiety disorder
(3) panic disorder
(4) somatoform disorder
(5) more than 1 of the above
Predictors:
(1) recent stress, in past week ("During the past week, have you been under stress?")
(2) number of physical symptoms: using the 15 physical symptoms from PRIME-MD (see above)
(3) current health: responses as excellent, very good, good, fair or poor
|
Predictor |
Finding |
Points |
|
stress in past week |
absent |
0 |
|
|
present |
1 |
|
physical symptoms |
<= 5 |
0 |
|
|
>= 6 |
1 |
|
current health |
excellent or very good |
0 |
|
|
good, fair or poor |
1 |
where:
• The abstract mentions 5 or more symptoms as a predictor, while the text refers to 6 or more as the predictor (see Table 2, page 877; text on pages 877 and 878).
number of predictors =
= SUM(points for all 3 predictors)
Interpretation:
• minimum number of predictors: 0
• maximum number of predictors: 3
• The more factors that a patient has, the greater the risk for a mental disorder.
• The number of predictors present may help the primary care provider decide to perform formal mental health screening in a patient.
|
Predictor |
Odds Ratio |
95% Confidence Interval |
|
recent stress |
6.7 |
3.3 – 13.6 |
|
physical symptoms |
4.0 |
2.1 – 7.9 |
|
current health |
2.2 |
1.1 – 4.3 |
|
number or risk factors |
risk for mental disorder |
|
0 |
2% |
|
1 |
19% |
|
2 |
39% |
|
3 |
72% |
Specialty: Psychiatry
