Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care

The PRIME-MD 1000 Study

Robert L. Spitzer, Janet B W Williams, Jeffrey G. Johnson, Kurt Kroenke, Mark Linzer, Frank Verloin Degruy, David Brody, Steven R. Hahn

Research output: Contribution to journalArticle

2143 Citations (Scopus)

Abstract

To assess the validity and utility of PRIME-MD (Primary Care Evaluation of Mental Disorders), a new rapid procedure for diagnosing mental disorders by primary care physicians. —Survey; criterion standard. —Four primary care clinics. —A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians. —PRIME-MD diagnoses, independent diagnoses made by mental health professionals, functional status measures (Short-Form General Health Survey), disability days, health care utilization, and treatment/ referral decisions. —Twenty-six percent of the patients had a PRIME-MD diagnosis that met full criteria for a specific disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. The average time required of the primary care physician to complete the PRIME-MD evaluation was 8.4 minutes. There was good agreement between PRIME-MD diagnoses and those of independent mental health professionals (for the diagnosis of any PRIME-MD disorder, κ=0.71; overall accuracy rate=88%). Patients with PRIME-MD diagnoses had lower functioning, more disability days, and higher rates of health care utilization than did patients without PRIME-MD diagnoses (for all measures, P

Original languageEnglish (US)
Pages (from-to)1749-1756
Number of pages8
JournalJournal of the American Medical Association
Volume272
Issue number22
DOIs
StatePublished - 1994
Externally publishedYes

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Mental Disorders
Primary Health Care
Primary Care Physicians
Patient Acceptance of Health Care
Mental Health
Selection Bias
Health Surveys
Diagnostic and Statistical Manual of Mental Disorders
Referral and Consultation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care : The PRIME-MD 1000 Study. / Spitzer, Robert L.; Williams, Janet B W; Johnson, Jeffrey G.; Kroenke, Kurt; Linzer, Mark; Degruy, Frank Verloin; Brody, David; Hahn, Steven R.

In: Journal of the American Medical Association, Vol. 272, No. 22, 1994, p. 1749-1756.

Research output: Contribution to journalArticle

Spitzer, Robert L. ; Williams, Janet B W ; Johnson, Jeffrey G. ; Kroenke, Kurt ; Linzer, Mark ; Degruy, Frank Verloin ; Brody, David ; Hahn, Steven R. / Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care : The PRIME-MD 1000 Study. In: Journal of the American Medical Association. 1994 ; Vol. 272, No. 22. pp. 1749-1756.
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