Hierarchical screening for multiple mental disorders

Philip J. Batterham*, Alison L. Calear, Matthew Sunderl, Natacha Carragher, Helen Christensen, Andrew J. Mackinnon

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    10 Citations (Scopus)

    Abstract

    Background: There is a need for brief, accurate screening when assessing multiple mental disorders. Two-stage hierarchical screening, consisting of brief pre-screening followed by a battery of disorder- specific scales for those who meet diagnostic criteria, may increase the efficiency of screening without sacrificing precision. This study tested whether more efficient screening could be gained using two-stage. hierarchical screening than by administering multiple separate tests. Method: Two Australian adult samples (N= 1990) with high rates of psychopathology were recruited using Facebook advertising to examine four methods of hierarchical screening for four mental disorders: major depressive disorder, generalised anxiety disorder, panic disorder and social phobia. Results: Using 1(6 scores to determine whether full screening was required did not increase screening efficiency. However, pre-screening based on two decision tree approaches or item gating led to considerable reductions in the mean number of items presented per disorder screened, with estimated item reductions of up to 54%. The sensitivity of these hierarchical methods approached 100% relative to the full screening battery. Limitations: Further testing of the hierarchical screening approach based on clinical criteria and in other samples is warranted. Conclusions: The results demonstrate that a two-phase hierarchical approach to screening multiple mental disorders leads to considerable increases efficiency gains without reducing accuracy. Screening programs should take advantage of prescreeners based on gating items or decision trees to reduce the burden on respondents.

    Original languageEnglish
    Pages (from-to)229-236
    Number of pages8
    JournalJournal of Affective Disorders
    Volume151
    Issue number1
    DOIs
    Publication statusPublished - Oct 2013

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