A provisional screening instrument for four common mental disorders in adult primary care patients

John P. Houston, Kurt Kroenke, Douglas E. Faries, Caroline Carney Doebbeling, Lenard A. Adler, Jonna Ahl, Ralph Swindle, Paula T. Trzepacz

Research output: Contribution to journalArticle

20 Scopus citations


Objective: To develop an adult self-report instrument for provisional diagnosis of four common mental disorders in primary care patients. Methods: Primary care patients were evaluated during routine clinic visits with a self-report screening tool comprised of 85 DSM-IV symptom-based candidate questions. Patients with a physician-assessed provisional diagnosis for generalized anxiety disorder (GAD), major depressive episode (MDE), past/present mania, and adult attention-deficit/ hyperactivity disorder (ADHD), or none of these, completed additional self-report clinical questionnaires, and then were interviewed on the telephone by a trained rater for a SCID/ACDS diagnosis. Responses to the symptom-based candidate questions were used to calculate sensitivity and specificity for a SCID/ACDS diagnosis (GAD, N = 24; MDE, N = 89; Mania, N = 24; ADHD, N = 65) and to select the optimal four questions for each diagnosis to be included in the instrument. Results: Analyses resulted in a 17-item instrument for provisional differential diagnosis of GAD, MDE, past/present mania, and ADHD. Comparison of limited symptom-based versus full DSM-IV criteriabased diagnosis showed minimal differences for relative diagnostic accuracy. Sensitivities and specificities, respectively, were 83% and 75% for GAD, 80% and 80% for MDE, 83% and 82% for mania, and 82%and 73% for ADHD. Conclusions: Based on this preliminary work, the Provisional Diagnostic Instrument-4 is a brief, easily scored, self-report instrument that may assist primary care physicians to identify potential cases of GAD, MDE, past/present mania, and ADHD.

Original languageEnglish (US)
Number of pages1
Issue number1
StatePublished - Jan 1 2011


ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Applied Psychology
  • Psychiatry and Mental health

Cite this

Houston, J. P., Kroenke, K., Faries, D. E., Doebbeling, C. C., Adler, L. A., Ahl, J., Swindle, R., & Trzepacz, P. T. (2011). A provisional screening instrument for four common mental disorders in adult primary care patients. Psychosomatics, 52(1).