Computer screening detects depression
A new computer-based screening method may offer a solution for the problem of undetected and untreated depression. The Symptom Driven Diagnostic System for Primary Care, developed by the Kalamazoo, MI-based Pharmacia & Upjohn Company, was found to successfully detect depression and other major mental disorders in a study1 of Kaiser Permanente patients in Oakland, CA.
The system consists of a computer program that asks 26 "yes/no" questions designed to screen for major depression, panic disorder, substance dependence, obsessive-compulsive disorder, suicide ideation or attempt, and generalized anxiety disorder. The screening is followed by a brief diagnostic interview administered by a nurse. Finally, a one-page summary of symptoms and diagnosis is generated for the physician.
In the Kaiser study conducted by researchers from Columbia University in New York City, 1,001 patients who made office visits seeking routine medical care answered the questionnaire. About 20% of the patients were diagnosed with one or more of those disorders, and 46% of those patients said they had never been told by a physician that they had such a problem. Results were compared with independent assessments by mental health professionals, and most diagnoses were confirmed.
"Most patients with psychiatric disorders are treated by primary care physicians, but those physicians usually are not trained in that area and also are too overworked to be able to help," says lead author Myrna Weissman, PhD, professor of psychology and epidemiology at the College of Physicians and Surgeons and School of Public Health of Columbia University. "We need better, more efficient ways to screen for psychiatric disorders."
Weissman says the advantages of this system are that it reduces the physician's time, facilitates diagnosis, and provides for confirmation of that diagnosis. Screening in such a way should be done for all new patients and for those presenting a history of mental disorders, she says. It also could be used to follow patients over time, to triage patients into specialty clinics, and to educate physicians.
[For more information on computerized depression screening, contact Myrna Weissman, PhD, professor of psychology and epidemiology, School of Public Health, Columbia University, 722 West 168th St., New York, NY 10032. Telephone: (212) 543-5880.]
Reference1. Weissman Myrna, et al., A diagnostic aid for detecting mental disorders in primary care. Gen Hosp Psychiatry 1998; 20:1-11.
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