SCALE TO IMPROVE MENTAL HEALTH DIAGNOSTIC ASSESSMENTS

本项目与NIMH研究课题《情绪与心理状态评估》相关。目标是开发一份筛选问卷，帮助临床医生诊断在门诊精神健康治疗的患者中最常见的DSM-IV轴I障碍。精神病学诊断筛选问卷（PDSQ）被设计成：1)足够简短，以便患者在入院前完成；2)足够广泛，以便在常规临床实践中捕捉更常见的疾病；3)便于快速手动评分，以便立即获得信息；4)直接基于DSM-IV诊断标准。第一阶段产生了一份121项的问卷，与其他精神病理学自我报告测量相比，问卷具有很强的心理测量特性和有效性证据。第一阶段还确定了在常规临床环境中使用PDSQ的可行性。构建PDSQ的最后一步，也是最重要的一步，需要根据心理健康诊断目标标准（半结构化诊断访谈）来验证其表现，以确定每个PDSQ子量表的敏感性、特异性、阳性和阴性预测值。建议的商业应用：目标市场包括心理健康专业人员、初级保健专业人员、健康维护组织、管理护理公司和企业。该工具预计将提高诊断准确性和面谈效率与评估过程中的精神卫生或初级保健设置。在企业环境中，该工具有望用于员工援助计划。

The proposed project is related to NIMH research topic Assessment of Emotional and Psychological States. The goal is to develop a screening questionnaire that assists clinicians in diagnosing the most common DSM-IV Axis I disorders seem in patients presenting for outpatient mental health treatment. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) has been constructed to be 1) brief enough to be completed by patients prior to their intake appointment, 2) sufficiently broad-based to capture the more frequent disorders seem in routine clinical practice, 3) amenable to quick hand scoring for immediate availability of information, and 4) directly based on DSM-IV diagnostic criteria. Phase I resulted in a 121- item questionnaire with strong psychometric properties and evidence of validity when compared to other self-report measures of psychopathology. Phase I also established the feasibility of using the PDSQ in routine clinical settings. The final, and most important, step in the construction of the PDSQ entails validating its performance up against the mental health diagnostic goal standard-a semi-structured diagnostic interview - to determine sensitivity, specificity, positive and negative predictive values for each PDSQ subscale. PROPOSED COMMERCIAL APPLICATION: The target markets include mental health professionals, primary care professionals, health maintenance organizations, managed care companies, and corporations. The instrument is expected to improve diagnostic accuracy and interview efficiency with the evaluation process in mental health or primary care settings. In the corporate setting, the instrument is expected to be used in employee assistance programs.