PDI-4A: An augmented provisional screening instrument assessing 5 additional common anxiety-related diagnoses in adult primary care patients

John P. Houston, Kurt Kroenke, Jonathan R. Davidson, Lenard A. Adler, Douglas E. Faries, Jonna Ahl, Ralph Swindle, Paula T. Trzepacz

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Patients with nonpsychotic mental health and emotional problems are commonly seen by primary care physicians. The objective of this study was to expand the Provisional Diagnostic Instrument-4 (PDI-4) to include a short self-report screen for 5 common anxiety-related diagnoses: panic attack (PA), social phobia (SP), obsessive-compulsive disorder (OCD), hypochondriasis, and post-traumatic stress disorder (PTSD). Primary care patients (N = 343) were originally evaluated with a self-report screen comprised of 85 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptom-based candidate questions, then interviewed by a trained rater for Structured Clinical Interview Research Version (SCID)/Adult ADHD Clinician Diagnostic Scale version 1.2 (ACDS) assessment and diagnosis. Responses to screening questions were used to calculate sensitivity and specifi city for an SCID diagnosis, and to select the optimal cutoffs in symptom frequency for 1 or 2 questions for each additional anxiety-related diagnosis. The PDI-4 Anxiety (PDI-4A) contains 6 items for provisional differential diagnosis of PA, SP, OCD, hypochondriasis, and PTSD in addition to items for the PDI-4. Sensitivities/specifi cities were: PA, 88%/68%; SP, 57%/70%; OCD, 88%/61%; hypochondriasis, 67%/85%; and PTSD, 71%/72%. Screening for multiple common anxiety diagnoses may be desirable, although limitations may include reduced sensitivity and specifi city for selected diagnoses. The PDI-4A may additionally help primary care physicians identify patients with PA, SP, OCD, hypochondriasis, and PTSD.

Original languageEnglish (US)
Pages (from-to)89-95
Number of pages7
JournalPostgraduate Medicine
Volume123
Issue number5
DOIs
StatePublished - Sep 1 2011

Keywords

  • Anxiety
  • Hypochondriasis
  • Obsessive-compulsive disorder
  • Panic disorder
  • Post-traumatic stress disorder

ASJC Scopus subject areas

  • Medicine(all)

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