A Screening Tool for Social Anxiety Disorder in Primary Care
There is little research from low- and middle-income countries examining the psychometric properties of a screening tool for social anxiety disorder. The sensitivity and specificity of the Social Anxiety Screening Questionnaire against the Mini-International Neuropsychiatric Interview as a gold standard in social phobia diagnosis were investigated using analyses of receiver operating characteristics. The "best subsets" selection procedure was conducted to determine the best three to five questions. Three questions on the screening questionnaire that best discriminate between a positive and negative diagnosis of social anxiety disorder on the MINI module were identified. Answering yes to all three of these questions gives a false-positive rate of 0.44 and a false negative rate of 0.11. For this combination, the sensitivity was 0.84, and specificity was 0.67. Additional work is needed to develop a more accurate scale that could help increase the percentage of people who receive appropriate treatment of this debilitating disorder.
Available from: Paola Tejada
Revista de la Facultad de Medicina, Universidad Nacional de Colombia 05/2014; 62(1):101-110. DOI:10.15446/revfacmed.v62n1.43759
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ABSTRACT: Evidence suggests that general practitioners (GPs) fail to diagnose up to half of common mental disorder cases. Yet no previous research has systematically summarized the evidence in the case of anxiety disorders. The aim of this review was to systematically assess and meta-analyze the diagnostic accuracy of GPs' assisted (i.e., using severity scales/diagnostic instruments) and unassisted (without such tools) diagnoses of anxiety disorders.
Systematic review (PROSPERO registry CRD42013006736) was conducted. Embase, Ovid Journals - Ovid SP Medline, Pubmed, PsycINFO, Scopus, Web of Science, and Science Direct were searched from January 1980 through June 2014. Seven investigators, working in pairs, evaluated studies for eligibility. The quality of included studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool version 2 (QUADAS-2). The main outcome measures were sensitivity and specificity of clinical diagnoses of any anxiety disorder. We pooled sensitivity and specificity levels from included studies using bivariate meta-analyses.
Twenty-four studies were included in the meta-analysis with a total sample of 34,902 patients. Pooled sensitivity and specificity were estimated at 44.5% (95% CI 33.7-55.9%) and 90.8% (95% CI 87-93.5%). GPs' sensitivity was higher when diagnoses were assisted (63.6%, 95% CI 50.3-75.1%) than when unassisted (30.5%, 95% CI 20.7-42.5%) to the expense of some specificity loss (87.9%, 95% CI 81.3-92.4% vs. 91.4%, 95% CI 86.6-94.6%, respectively). Identification rates remained constant over time (P-value = .998).
The use of diagnostic tools might improve detection of anxiety disorders in "primary care."
© 2015 Wiley Periodicals, Inc.
Depression and Anxiety 03/2015; DOI:10.1002/da.22360 · 4.41 Impact Factor
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