Study on Standardization of Korean Version of Psychiatric Diagnostic Screening Questionnaire : The Optimal Cutoff Scores

Jae-Hoon Kwak; Jung-Bum Kim; Jeong-Shik Choi; Hee-Cheol Kim; Sung-Won Jung; Eun-Jung Lee; Hyung-Mo Sung; Jung-Kyu Sakong; Im-Hee Shin; Chul-Ho Jung

doi:10.4306/jknpa.2012.51.2.77

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Kwak, Kim, Choi, Kim, Jung, Lee, Sung, Sakong, Shin, and Jung: Study on Standardization of Korean Version of Psychiatric Diagnostic Screening Questionnaire : The Optimal Cutoff Scores

Original Article

Journal of Korean Neuropsychiatric Association

Journal of Korean Neuropsychiatric Association 2012; 51(2): 77-84.

Published online: 31 March 2012

DOI: https://doi.org/10.4306/jknpa.2012.51.2.77

Study on Standardization of Korean Version of Psychiatric Diagnostic Screening Questionnaire : The Optimal Cutoff Scores

Jae-Hoon Kwak, MD¹, Jung-Bum Kim, MD, PhD¹, Jeong-Shik Choi, MD², Hee-Cheol Kim, MD, PhD¹, Sung-Won Jung, MD, PhD¹, Eun-Jung Lee, PhD¹, Hyung-Mo Sung, MD, PhD³, Jung-Kyu Sakong, MD, PhD⁴, Im-Hee Shin, PhD⁵, Chul-Ho Jung, MD, PhD¹

¹Department of Psychiatry, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, Korea.

²Hanmaum Hospital, Daegu, Korea.

³Department of Psychiatry, CHA Gumi Medical Cener, College of Medicine, CHA University, Gumi, Korea.

⁴Department of Psychiatry, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea.

⁵Department of Biostatistics, Catholic University of Daegu School of Medicine, Daegu, Korea.

Address for correspondence: Chul-Ho Jung, MD, PhD. Department of Psychiatry, Dongsan Medical Center, School of Medicine, Keimyung University, 56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea. Tel +82-53-250-7816, Fax +82-53-250-7810, jung5301@dsmc.or.kr

Received 20 December 2011 Revised 23 January 2012 Accepted 31 January 2012

Abstract

Objectives

An exact diagnosis and comorbidity analysis are important in psychiatric disorders. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is both useful as a self-reporting test for screening psychiatric disorders and available for clinical settings due to its simplicity and convenience. This study, as a part of standardization of Korean version of Psychiatric Diagnostic Screening Questionnaire (K-PDSQ), evaluated optimal cutoff scores.

Methods

The samples were 696 patients in total, who were selected from the psychiatric departments of 3 university hospitals from March 2008 to August 2011. Diagnosing by Mini-International Neuropsychiatric Interview-Plus (MINI-Plus), we evaluated sensitivity, specificity, cutoff scores, ROC curve, and area under the curve (AUC) of K-PDSQ. SPSS version 12.0 for Windows and MedCalc version 12.0 were used to analyze the results.

Results

With a cutoff score of 9 for major depressive disorder in K-PDSQ, both the sensitivity and specificity were 80%. The cutoff scores of PTSD, OCD, panic disorder, agoraphobia, psychosis, alcohol related problem, GAD, hypochondriasis, and social phobia of K-PDSQ were 5, 2, 4, 2, 1, 2, 5, 4, and 5, respectively. In most of the subscales, each AUC was above 0.75.

Conclusion

By applying the cutoff scores estimated above, we expect K-PDSQ to help provide diagnostic assessments and to grasp comorbidities before a clinical interview in the setting of busy outpatient clinics.

Keywords: Psychiatric Diagnostic Screening Questionnaire, Screening, Diagnostic instrument, Psychiatric disorder

Figures and Tables

Fig. 1

Receiver operating curves for each of K-PDSQ subscale in 696 psychiatric patients. All curves were significant (p<0.001). MDD : Major depressive disorder, PTSD : Posttraumatic stress disorder, OCD : Obsessive-compulsive disorder, Panic : Panic disorder, Alcohol : Alcohol-related problems, GAD : Generalized anxiety disorder, Social : Social phobia, K-PDSQ : Korean version of Psychiatric Diagnostic Screening Questionnaire.

Table 1

Demographic characteristics of total patients

^* : Others could include private businessmen, farmers, free-lancers, students and so on. M : Mean, SD : Standard deviation, n : Number

Table 2

DSM-IV diagnoses by MINI-Plus

^* : Individuals could be given more than one diagnosis. DSM-IV : Diagnostic and statistical Manual of Mental Disorders-Fourth edition, MINI-Plus : Mini-International Neuropsychiatric Interview-Plus, n : Number

Table 3

Sensitivity and specificity of K-PDSQ subscales at different cutoff scores in 696 psychiatric patients

MDD : Major depressive disorder, PTSD : Posttraumatic stress disorder, OCD : Obsessive-compulsive disorder, Panic : Panic disorder, Agor : Agoraphobia, Psychos : Psychosis, Alcohol : Alcohol-related problems, GAD : Generalized anxiety disorder, Hypocho : Hypochondriasis, Social : Social phobia, K-PDSQ : Korean version of Psychiatric Diagnostic Screening Questionnaire

Table 4

Recommended cutoff scores, AUC, 95% confidence interval, and significance level P of each subscale

AUC : Area under the curve, CI : Confidence interval, MDD : Major depressive disorder, PTSD : Posttraumatic stress disorder, OCD : Obsessive-compulsive disorder, Panic : Panic disorder, Alcohol : Alcohol-related problems, GAD : Generalized anxiety disorder, Hypocho : Hypochondriasis, Social : Social phobia

References

1. Spitzer RL, Fleiss JL, Burdock EI, Hardesty AS. The mental status schedule: rationale, reliability and validity. Compr Psychiatry. 1964. 5:384–395.

2. Wing JK, Birley JL, Cooper JE, Graham P, Isaacs AD. Reliability of a procedure for measuring and classifying "present psychiatric state". Br J Psychiatry. 1967. 113:499–515.

3. Endicott J, Spitzer RL. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry. 1978. 35:837–844.

4. Robins LN, Helzer JE, Croughan J, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. Arch Gen Psychiatry. 1981. 38:381–389.

5. Spitzer RL, Williams JB, Gibbon M, First MB. The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Arch Gen Psychiatry. 1992. 49:624–629.

6. Robins LN, Wing J, Wittchen HU, Helzer JE, Babor TF, Burke J, et al. The Composite International Diagnostic Interview. An epidemiologic Instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry. 1988. 45:1069–1077.

7. Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R, et al. SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry. 1990. 47:589–593.

8. Lee HY, Song DH. Validity study of Korean version of the schedule for affective disorder and schizophrenia-lifetime. J Korean Neuropsychiatr Assoc. 1987. 26:592–598.

9. Lee MH, Lee HY, Min SK, Kim KH, Kim SY, Song DH, et al. Development of Korean version of the NIMH-diagnostic interview schedule and its validity test. J Korean Neuropsychiatr Assoc. 1986. 25:300–313.

10. Hahn OS, Ahn JH, Song SH, Cho MJ, Kim JK, Bae JN, et al. Develop-ment of Korean version of structured clinical interview schedule for DSM-IV axis I disorder: interrater reliability. J Korean Neuropsychiatr Assoc. 2000. 39:362–372.

11. Cho MJ, Hahm BJ, Suh DW, Hong JP, Bae JN, Kim JK, et al. Development of a Korean version of the composite international diagnostic interview (K-CIDI). J Korean Neuropsychiatr Assoc. 2002. 41:123–137.

12. Coryell W, Endicott J, Andreasen NC, Keller MB, Clayton PJ, Hirschfeld RM, et al. Depression and panic attacks: the significance of overlap as reflected in follow-up and family study data. Am J Psychiatry. 1988. 145:293–300.

13. Coryell W, Noyes R. Placebo response in panic disorder. Am J Psychiatry. 1988. 145:1138–1140.

14. Grunhaus L. Clinical and psychobiological characteristics of simultaneous panic disorder and major depression. Am J Psychiatry. 1988. 145:1214–1221.

15. Keller MB, Klerman GL, Lavori PW, Coryell W, Endicott J, Taylor J. Long-term outcome of episodes of major depression. Clinical and public health significance. JAMA. 1984. 252:788–792.

16. Noyes R Jr, Reich J, Christiansen J, Suelzer M, Pfohl B, Coryell WA. Outcome of panic disorder. Relationship to diagnostic subtypes and comorbidity. Arch Gen Psychiatry. 1990. 47:809–818.

17. Shear MK, Greeno C, Kang J, Ludewig D, Frank E, Swartz HA, et al. Diagnosis of nonpsychotic patients in community clinics. Am J Psychiatry. 2000. 157:581–587.

18. Zimmerman M, Mattia JI. Psychiatric diagnosis in clinical practice: is comorbidity being missed? Compr Psychiatry. 1999. 40:182–191.

19. Spitzer RL, Fleiss JL. A re-analysis of the reliability of psychiatric diagnosis. Br J Psychiatry. 1974. 125:341–347.

20. Cho MJ, Lee DW. Reliability and validity in psychiatric diagnosis. Korean J Psychopathol. 1997. 6:177–182.

21. Zimmerman M, Mattia JI. A self-report scale to help make psychiatric diagnoses: the Psychiatric Diagnostic Screening Questionnaire. Arch Gen Psychiatry. 2001. 58:787–794.

22. Zimmerman M, Chelminski I. A scale to screen for DSM-IV Axis I disorders in psychiatric out-patients: performance of the Psychiatric Diagnostic Screening Questionnaire. Psychol Med. 2006. 36:1601–1611.

23. Choi JS, Kim HC, Jung SW, Lee EJ, Sung HM, Sakong JK, et al. The diagnostic validity of Korean version of psychiatric diagnostic screening questionnaire. Korean J Psychopathol. 2009. 18:57–66.

24. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998. 59:Suppl 20. 22–33. quiz 34-57.

25. Yoo SW, Kim YS, Noh JS, Oh KS, Kim CH, Namkoong K, et al. Validity of Korean version of the Mini-International Neuropsychiatric Interview. Anxiety Mood. 2006. 2:50–55.

26. Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem. 1993. 39:561–577.

27. Chang SM, Sohn JH, Lee JY, Choi JH, Cho SJ, Jeon HJ, et al. Characteristics of diagnostic criteria for depression in Korea. J Korean Neuropsychiatr Assoc. 2007. 46:447–452.

28. Fairburn CG, Beglin SJ. Studies of the epidemiology of bulimia nervosa. Am J Psychiatry. 1990. 147:401–408.

29. Mai F. Somatization disorder: a practical review. Can J Psychiatry. 2004. 49:652–662.

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