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A Self-Report Scale to Help Make Psychiatric Diagnoses
The Psychiatric Diagnostic Screening Questionnaire
Mark Zimmerman, MD;
Jill I. Mattia, PhD
Arch Gen Psychiatry. 2001;58:787-794.
Background The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is a brief,
psychometrically strong, self-report scale designed to screen for the most
common DSM-IV Axis I disorders encountered in outpatient
mental health settings. In the present report, we describe the diagnostic
performance (sensitivity, specificity, and positive and negative predictive
values) of the PDSQ in an outpatient setting.
Methods Six hundred thirty psychiatric outpatients presenting for treatment
were evaluated with the Structured Clinical Interview for DSM-IV after completing the PDSQ. Patients arrived approximately 20
minutes before the scheduled time of the appointment to complete the scale.
Diagnostic raters were blind to responses on the scale.
Results The PDSQ's subscales' diagnostic performance varied in a predictable
manner according to the cutoff score—as the threshold for case identification
increased, subscale sensitivity decreased and specificity increased. Mean
subscale sensitivities of 80%, 85%, and 90% resulted in mean subscale specificities
of 78%, 73%, and 66%, respectively, and negative predictive values of 95%,
96%, and 97%. Receiver operating curves were determined for each subscale
and all areas under the curve were significant.
Conclusions The PDSQ is a diagnostic aid designed to be used in clinical practice
to facilitate the efficiency of conducting initial diagnostic evaluations.
From a clinical perspective, it is most important that a diagnostic aid have
good sensitivity, so that most cases are detected, and high negative predictive
value, so that most noncases on the measure are indeed noncases. Our results
indicate that most of the PDSQ subscales were able to achieve this goal.
From the Department of Psychiatry and Human Behavior, Brown University
School of Medicine, Rhode Island Hospital, Providence.
Reprints: Mark Zimmerman, MD, Department of Psychiatry, Rhode Island
Hospital, 235 Plain St, Suite 501, Providence, RI 02905 (e-mail: mzimmerman{at}lifespan.org).
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