Article Figures & Data
Figures
- Figure 1.
Summary of 224 participants with a diagnosis by MINI.
Note: No mood or anxiety disorder = 423 (65.4%).
Tables
Diagnosis by MINI Characteristic No Disorder n=423 (65.4%) Depression Without Anxiety n=27 (4.2%) Depression With Anxiety n=78 (12.1%) Bipolar Disorder n=60 (9.3%) Anxiety Without Depression n=59 (9.1%) Total N=647 GED = general equivalency diploma; MINI = Mini International Neuropsychiatric Interview. a Employment status, marital status, education, and income were not collected on the first 99 participants. For all variables, percentages were calculated for participants with available data. Mean age (SD) [range], y 46.4 (16.6) [18–92] 44.9 (14.6) [19–70] 45.0 (12.4) [19–70] 41.2 (10.7) [18–63] 41.0 (13.8) [21–72] 45.2 (15.4) [18–92] Women, % 69.5 85.2 71.8 78.3 66.1 70.9 Race, % White 67.4 59.3 65.4 60.0 76.3 66.9 Black 27.4 40.7 32.1 35.0 18.6 28.4 Other 5.2 0 2.5 5.0 5.1 4.6 Marital status, %a Married 53.8 29.2 40.0 26.0 46.0 47.8 Single 26.2 29.2 24.6 38.0 30.0 27.6 Divorced 9.6 12.5 21.5 14.0 12.0 11.8 Separated 1.4 12.5 10.8 2.0 2.0 3.1 Widowed 4.2 8.3 1.5 4.0 2.0 3.9 Living with partner 4.8 8.3 1.5 16.0 8.0 5.9 Education, %a Without high school 2.9 4.4 6.1 6.3 4.1 3.8 Diploma or GED 30.6 47.8 48.5 54.2 36.7 36.2 High school diploma/GED 13.5 26.1 18.2 6.3 20.4 14.6 Associate/technical degree 29.4 13.0 18.2 27.1 26.5 26.8 College diploma 23.6 8.7 9.1 6.3 12.2 18.6 Graduate degree Household’s gross income, %a ≤$14,999 10.9 17.4 31.8 50.0 14.3 17.6 $15,000–39,999 24.6 39.1 31.8 27.1 26.5 26.5 $40,000–59,999 11.8 8.7 1.5 8.3 20.4 10.8 ≥60,000 40.4 8.7 19.7 4.2 28.6 32.2 Not know/refused 12.3 26.1 15.2 10.4 10.2 12.9 Employment status, %a Unemployed 13.8 43.5 35.4 50.0 18.4 21.4 Employed 69.3 47.8 47.7 45.8 71.4 63.8 Retired, not working 17.0 8.7 16.9 4.2 10.2 14.8 Diagnosis by MINI Test Result Depression (n=142) Bipolar (n=60) Anxiety (n=182) PTSD (n=41) Any Diagnosis (n=224) CI=confidence interval; LR = likelihood ratio; M-3 = My Mood Monitor checklist; MINI = Mini International Neuropsychiatric Interview; PTSD=post-traumatic stress disorder. a If any diagnosis cut-off score was met, the screen was considered positive. b Number with a positive screen and who have that diagnosis by MINI/total number with a positive screen by M-3. c Number with a negative screen and who do not have that diagnosis by MINI/total number with a negative screen by M-3. M-3 subscore cutoff (≥) 5 2 3 2 Any positive screena Question No. 1–7 20–23 8–19 13–16 1–23 Sensitivity (95% CI) 0.84 (0.77–0.89) 0.88 (0.77–0.95) 0.82 (0.75–0.87) 0.88 (0.74–0.96) 0.83 (0.77–0.88) Specificity (95% CI) 0.80 (0.76–0.83) 0.70 (0.66–0.74) 0.78 (0.74–0.81) 0.76 (0.73–0.80) 0.76 (0.72–0.80) Positive LR (95% CI) 4.19 (3.47–5.06) 2.94 (2.53–3.44) 3.65 (3.05–4.39) 3.69 (3.08–4.44) 3.48 (2.90–4.16) Negative LR (95% CI) 0.20 (0.14–0.29) 0.17 (0.08–0.33) 0.23 (0.17–0.32) 0.16 (0.07–0.36) 0.22 (0.17–0.30) Positive M-3 screen, % 34 35 39 28 44 Diagnosed by MINI, % 22 9 28 6 35 Positive predictive value (95% CI) [n/n]b 0.54 (0.47–0.61) [119/220] 0.23 (0.18–0.29) [53/229] 0.59 (0.53–0.65) [149/253] 0.20 (0.15–0.27) [36/180] 0.65 (0.59–0.70) [186/287] Negative predictive value (95% CI) [n/n]c 0.95 (0.92–0.96) [404/427] 0.98 (0.96–0.99) [411/418] 0.92 (0.88–0.94) [361/394] 0.99 (0.97–1.0) [462/467] 0.89 (0.86–0.92) [322/360] - Table 3.
Comparison of Sensitivity and Specificity of M-3 With Reference Standard Instruments
Outcome PHQ-942 Depression Mood Disorder Questionnaire43 Bipolar CAPS44 PTSD GAD-721 Anxiety CAPS = Clinician-Administered PTSD Scale; GAD-7 = 7-item Generalized Anxiety Disorder scale; M-3 = My Mood Monitor checklist; PHQ-9 = 9-item Patient Health Questionnaire; PTSD = post-traumatic stress disorder. Note: The sensitivity and specificity for any diagnosis by the M-3 (depression, bipolar, anxiety, or PTSD) was 0.83 and 0.76, respectively. Existing instrument Sensitivity 0.88 0.73 0.74 0.77 Specificity 0.88 0.90 0.84 0.82 M-3 Sensitivity 0.84 0.88 0.88 0.82 Specificity 0.80 0.70 0.76 0.78
Supplemental Figure
Supplemental Figure. My Mood Monitor (M-3)checklist.
Files in this Data Supplement:
- Supplemental data: Figure - PDF file, 1 page, 87 KB
The Article in Brief
Feasibility and Diagnostic Validity of the M-3 Checklist: a Brief, Self-Rated Screen for Depressive, Bipolar, Anxiety, and Post-Traumatic Stress Disorders in Primary Care
Bradley N. Gaynes , and colleagues
Background Mood and anxiety disorders are the most common psychiatric conditions seen in primary care, yet they remain underdetected and undertreated. This study tests the M-3 checklist, a new 1-page, patient-rated, 27-item tool developed to screen for multiple psychiatric disorders in primary care.
What This Study Found A 1-page, 27-item checklist that can be completed in a few minutes accurately indicates whether a patient has any of 4 common psychiatric illnesses, including major depression, bipolar disorder, anxiety disorder, and post-traumatic stress disorder. Testing showed the checklist was as accurate as currently used screening instruments that test for single disorders.
Implications
- Primary care clinicians need to consider multiple psychiatric disorders among their patients, rather than just depression or anxiety alone. The M-3 potentially can reduce missed psychiatric diagnoses and facilitate proper treatment of identified cases.
