A new tool for psychological screening in primary care

January 01, 0001

A new tool for psychological screening in primary care

Primary care physicians frequently address mood and anxiety disorders. However, screening tests tend to either be diagnosis specific or lengthy. These US authors assessed the use of the My Mood Monitor (M-3) checklist, which is a patient-rated, 27-item tool designed to screen for multiple psychiatric disorders in primary care settings. They enrolled 647 adults at an academic family medicine clinic between July 2007 and February 2008. The main outcomes measured were the sensitivity and specificity of the M-3 for major depression, bipolar disorder, any anxiety disorder, and post-traumatic stress disorder (PTSD. Compared with the Mini International Neuropsychiatric Interview as the diagnostic standard. Feasibility was assessed with exit questionnaires.

The authors report: "The depression module had a sensitivity of 0.84 and a specificity of 0.80. The bipolar module had a sensitivity of 0.88, and a specificity of 0.70. The anxiety module had a sensitivity of 0.82 and a specificity of 0.78, and the PTSD module had a sensitivity of 0.88 and a specificity of 0.76. As a screen for any psychiatric disorder, sensitivity was 0.83 and specificity was 0.76. Patients took less than 5 minutes to complete the M-3 in the waiting room, and less than 1% reported not having time to complete it. Eighty-three percent of clinicians reviewed the checklist in 30 or fewer seconds, and 80% thought it was helpful in reviewing patients’ emotional health."

The authors concluded: "The M-3 demonstrates utility as a valid, efficient, and feasible tool for screening multiple common psychiatric illnesses, including bipolar disorder and PTSD, in primary care. Its diagnostic accuracy equals that of currently used single-disorder screens and has the additional benefit of being combined into a 1-page tool. The M-3 potentially can reduce missed psychiatric diagnoses and facilitate proper treatment of identified cases."

This paper analyzed a convenient and potentially useful new screening tool for a variety of psychological disorders, though the specificities suggest high rates of false positives.

For the full abstract, click here.

Annals of Family Medicine 8:160-169, March 2010
© 2010 Annals of Family Medicine, Inc.
Feasibility and Diagnostic Validity of the M-3 Checklist: A Brief, Self-Rated Screen for Depressive, Bipolar, Anxiety, and Post-Traumatic Stress Disorders in Primary Care. Bradley N. Gaynes, Joanne DeVeaugh-Geiss, Sam Weir, et al.. Correspondence to Bradley N. Gaynes: bgaynes@med.unc.edu

Category: P. Psychological. Keywords: depression, anxiety, PTSD, bipolar, screening, validation study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 4 May 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.