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01.04.2015

Validation of clinical symptom IRT scores for diagnosis and severity assessment of common mental disorders

verfasst von: Elena Olariu, José-Ignacio Castro-Rodriguez, Pilar Álvarez, Carolina Garnier, Marta Reinoso, Luis Miguel Martín-López, Jordi Alonso, Carlos G. Forero

Erschienen in: Quality of Life Research | Ausgabe 4/2015

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Abstract

Purpose

We studied the validity and responsiveness of an item response theory (IRT) scoring method for assessing major depressive episode (MDE) and generalized anxiety disorder (GAD) severity based on direct assessment of DSM-IV-TR symptoms.

Methods

Prospective cohort study (baseline, 1-month, 3-months assessments) of patients seeking help for incident or aggravated mood or anxiety symptoms from primary, outpatient and inpatient mental health centers (N = 244; 67.81 % active cases − 100 % under psychiatric treatment). The drop-out rate at 3 months was 24.89 %. Patients were assessed at each follow-up for presence/absence of DSM-IV symptoms of MDE (nine symptoms) and GAD (eight symptoms). IRT scores for depression (INS-D) and anxiety (INS-G), based on response patterns, were obtained by means of a 2-parameter model. Diagnostic accuracy was assessed with receiver operating characteristic analysis, using a blinded MINI interview as gold standard. Scores’ construct validity was compared with external clinician-administered (Hamilton Depression Rating Scale, HRSD; Hamilton Anxiety Rating Scale, HAM-A) and self-reported severity measures (PHQ-9; Beck Anxiety Inventory—Subjective Aspects, BAI-Sub). Responsiveness was analyzed based on the evolution of HRSD and HAM-A scores.

Results

Both severity scores showed excellent reliability (INS-D: 0.92; INS-G: 0.93) and yielded high diagnostic accuracy (INS-D: AUC = 0.96; INS-G: AUC = 0.91) with respect to MINI diagnoses. INS-D and INS-G had higher correlations with clinician-administered measures of the same disorder (INS-D-HRSD: 0.73; INS-G-HAM-A: 0.53) than with self-reported measures (INS-D-PHQ-9: 0.69; INS-G-BAI-Sub: 0.49). Patients who recovered during follow-up showed important decreases in severity (Cohen’s d INS-D:−1.38; INS-G: −1.75). About 90 % variance of INS-D and INS-G score changes over time was associated with changes in clinical status.

Conclusions

INS-D and INS-G are short reliable, valid, and responsive measures that can be used for diagnostic and severity assessment of mood and anxiety disorders in outpatient care.

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Titel: Validation of clinical symptom IRT scores for diagnosis and severity assessment of common mental disorders
verfasst von: Elena Olariu
José-Ignacio Castro-Rodriguez
Pilar Álvarez
Carolina Garnier
Marta Reinoso
Luis Miguel Martín-López
Jordi Alonso
Carlos G. Forero
Publikationsdatum: 01.04.2015
Verlag: Springer International Publishing
Erschienen in: Quality of Life Research / Ausgabe 4/2015
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-014-0814-5

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

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Validation of clinical symptom IRT scores for diagnosis and severity assessment of common mental disorders

Abstract

Purpose

Methods

Results

Conclusions

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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