Psychiatric disorders among patients admitted to a French medical emergency service
54
Citation
14
Reference
10
Related Paper
Citation Trend
Keywords:
Psychiatric assessment
Depression
Psychiatric interview
Mini-international neuropsychiatric interview
Physicians require a screening instrument to detect psychiatric disorders in patients with chronic fatigue syndrome (CFS). Different threshold scores on the Hospital Anxiety and Depression scale (HAD) and the mental health scale of the Medical Outcome Survey (MOS) were compared with two gold standards for the presence or absence of psychiatric disorder, standard diagnostic criteria (DSM-III-R) and a threshold score for the number of psychiatric symptoms at a standardized psychiatric interview (Revised Clinical Interview Schedule total cut-off score of 11/12). They were compared by use of validating coefficients and receiver operating characteristics in 136 consecutive CFS medical outpatients. The HAD scale at cut-off of 9/10 was a valid and efficient screening instrument for anxiety and depression by comparison with both gold standards. The MOS mental health scale at its recommended cut-off score of 67/68 yielded too many false-positives to be recommended as a psychiatric screening instrument in CFS patients.
Gold standard (test)
Depression
Psychiatric interview
Psychiatric assessment
Mini-international neuropsychiatric interview
Cite
Citations (40)
Objective: To examine rates of psychiatric diagnoses given by patients' primary or regular physicians to persons with chronic fatigue syndrome (CFS), persons with psychiatrically explained fatigue, and a control group. Physicians' psychiatric diagnosis and participants' self-reported psychiatric diagnoses were compared to lifetime psychiatric diagnoses as measured by a structured psychiatric interview. Method: Participants were recruited as part of a community-based epidemiology study of chronic fatigue syndrome. Medical records of 23 persons with chronic fatigue syndrome, 25 persons with psychiatrically explained chronic fatigue, and 19 persons without chronic fatigue (controls) were examined to determine whether their physician had given a diagnosis of mood, anxiety, somatoform, or psychotic disorder. Lifetime psychiatric status was measured using the Structured Clinical Interview for the DSM-IV (SCID). Participants' self reports of specific psychiatric disorders were assessed as part of a detailed medical questionnaire. Results: Physicians' diagnosis of a psychiatric illness when at least one psychiatric disorder was present ranged from 40 percent in the psychiatrically explained group, 50 percent in the control group, and 64.3 percent in the CFS group. Participants in the psychiatrically explained group were more accurate than physicians in reporting the presence of a psychiatric disorder, and in accurately reporting the presence of a mood or anxiety disorder. Conclusions: The present investigation found underrecognition of psychiatric illness by physicians, with relatively little misdiagnosis of psychiatric illness. Physicians had particular difficulty assessing psychiatric disorder in those patients whose chronic fatigue was fully explained by a psychiatric disorder. Results emphasized the importance of using participant self report as a screening for psychiatric disorder.
Psychiatric interview
Psychiatric diagnosis
Psychiatric assessment
Medical record
Chronic Fatigue
Cite
Citations (10)
To determine whether a short computer interview could be used in place of a full diagnostic interview to obtain psychiatric diagnoses, the authors examined the short interview's sensitivity, specificity, and diagnostic agreement with the full interview.Patients recently discharged from a university psychiatric service were interviewed in two back-to-back sessions, one in which a full diagnostic interview was used and the other in which a short computer interview was used. Based on diagnoses derived from both interviews, the sensitivity and specificity of the short interview and kappa values reflecting the diagnostic agreement of the two interviews were calculated.The short interview had high sensitivity and specificity and excellent diagnostic agreement with the full interview for most disorders. It also had a significantly shorter administration time. However, it missed a substantial percentage of cases of generalized anxiety disorder and misclassified as in remission a substantial proportion of patients with active cases of post-traumatic stress disorder.With few exceptions, the short interview may be substituted for the full interview when missing an active case is not important or when a count of individual symptoms and subtyping of disorders are not needed. Such uses include screening subjects for inclusion in a study and obtaining an overview of a patient's lifetime psychiatric status.
Mini-international neuropsychiatric interview
Psychiatric interview
Psychiatric diagnosis
Subtyping
Interview
Cite
Citations (74)
Psychiatric assessment
Depression
Psychiatric interview
Mini-international neuropsychiatric interview
Cite
Citations (54)
The author reports the use of a structured psychiatric interview for the routine initial evaluation of all referrals to an inpatient psychiatric consultation service during a 1-year period. Acceptance of this procedure by physician examiners and by patients was high. There was evidence that the structured interview was a useful diagnostic tool and did not interfere with patient rapport. The advantages of structured interviews for routine clinical evaluations are discussed.
Psychiatric interview
Semi-structured interview
Interview
Mini-international neuropsychiatric interview
Psychiatric assessment
Cite
Citations (22)
Psychiatric comorbidity
Psychiatric assessment
Psychiatric history
Psychiatric hospital
Psychiatric diagnosis
Psychiatric interview
Cite
Citations (7)
There is little if any research on the explicit contents delivered by patients in the first minutes of a psychiatric interview.In order to study the impact of the first minutes of a psychiatric interview on final diagnosis, we gathered information from the speech during the first 5 min in 162 new psychiatric patients with a checklist including symptoms extracted from the SCAN interview.The area reported most frequently was life events (51.2%). The average of psychiatric symptoms cited was 2.3. An initial suspected diagnosis was done in 126 patients, and in 73 patients (57.9% of those with a suspected diagnosis, 45.1% of the total sample) the initial diagnosis was coincident with the final diagnosis. The initial clinical impression was more accurate in adjustment and 'neurotic' disorders, and less in mood disorders. Those patients who cited more symptoms received a less accurate initial diagnosis.Psychiatric patients spontaneously report a low number of symptoms. The accuracy of psychiatric diagnosis in the first minutes of an interview is unacceptably low. However, the role of short psychiatric interviewing as a screening method deserves to be further investigated.
Psychiatric interview
Mini-international neuropsychiatric interview
Psychiatric diagnosis
Interview
Psychological evaluation
Psychiatric assessment
Psychiatric history
Cite
Citations (7)
The authors conducted a study to demonstrate the prevalence of psychiatric symptoms among 100 otolaryngology inpatients (50 with non-malignant conditions; 50 with malignancies), and to investigate the efficacy of the Hospital Anxiety and Depression Scale (HADS) as a screening test for psychiatric disorders in otolaryngology. A structured interview was conducted according to the Adjustment Disorders and Major Depressive Episodes section of DSM-N, which demonstrated that 30% of the inpatients with benign diseases met the criteria for some psychiatric disorders (one patient for major depression and 14 for adjustment disorders) and that 46% of the inpatients with malignancies met the criteria (nine patients for major depression and 14 for adjustment disorders). There were highly significant differences between the HADS scores of the patients with psychiatric disorders and those without. Comparing the sensitivity and the specificity using the HADS as a screening test, the optimal cut-off point was 12, which produced 92% sensitivity, 90% specificity and 85% positive predictive value (PPV) among not only non-malignant and malignant cases taken together but also among malignant cases only.
Depression
Mini-international neuropsychiatric interview
Adjustment disorders
Psychiatric interview
Psychiatric assessment
Cite
Citations (38)
The MINI-International Neuropsychiatric Interview (MINI(-Plus)) is a structured diagnostic interview, developed to assess the diagnoses of psychiatric patients according to DSM-IV and ICD-10 criteria in less time than other diagnostic interviews such as the Structured Clinical Interview for DSM-IV disorders (SCID), the Composite International Diagnostic Interview (CIDI) or the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) tend to take. The good psychometric characteristics of the MINI (-Plus) make it a good choice for research purposes. Because of its brevity (20-30 minutes) the interview seems to be especially convenient for diagnosing psychiatric patients in everyday clinical practice. Initial experiences and results with the MINI-Plus in a selected group of Dutch psychiatric patients are described.
Mini-international neuropsychiatric interview
Psychiatric interview
CIDI
Neuropsychiatry
Cite
Citations (314)