Psychometric analysis of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) and determinants of psychopathology in two outpatient clinics in Navarre (Spain)

Authors

  • Juan I. Arrarás Rehabilitation Unit. Servicio Navarro de Salud – Osasunbidea. Spain https://orcid.org/0000-0002-4415-2570
  • Manuel J. Cuesta Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain
  • Victor Peralta Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain
  • Gustavo J. Gil-Berrozpe Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain
  • Laura Barrado Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Olga Correa Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Rebeca Elorza Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Lorea González Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Irma Garmendia Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Lucía Janda Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Patricia Macaya Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Camino Núñez Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Pablo Sabater Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain
  • Aileen Torrejon Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain

DOI:

https://doi.org/10.23938/ASSN.1043

Keywords:

PDSQ, questionnaire, psychometric analyses, determinants, mental disorder

Abstract

Background. The self-report Psychiatric Diagnostic Screening Questionnaire PDSQ is designed to screen Axis I psychiatric disorders. We aim to determine its psychometric properties in Spanish outpatients and assess its relationship with two interviews (for psychopathology and for personality disorders) and clinical/demographic variables.

Methodology. We administered the study questionnaire, the Mini International Neuropsychiatric Interview Plus (MINI-Plus), the Standardised Assessment of Personality Abbreviated Scale (SAPAS), and the List of Threatening Experiences Questionnaire (LTE-Q) to 375 patients at two public outpatient centres. Reliability of the study questionnaire was evaluated (Cronbach’s alpha, a) and known-group validity measured by comparing groups based on demographic and clinical variables (binary logistic regression analysis) and MINI-Plus diagnoses (Mann-Whitney U). The diagnostic accuracy of the study questionnaire score was analysed taking the MINI-Plus diagnoses as the gold standard (ROC analysis).

Results. Internal consistency was adequate across all PDSQ scales (a >0.7; mean a=0.85). Known-group comparisons were satisfactory. Female and male patients showed higher prevalence of internalizing and externalizing diagnoses, respectively. Younger age, more life events and limitations, higher SAPAS scores, and lower economic levels were linked to a greater number of PDSQ diagnoses. Inter-group differences were found for all PDSQ scales based on the corresponding MINI-Plus diagnoses. Mean values of sensitivity, AUC, and negative predictive value were 88.7, 0.82, and 96.7, respectively.

Conclusions.  When applied to a sample of Spanish outpatients, the PDSQ exhibits satisfactory psychometric properties and adequate relationships with the psychopathology and personality interviews, and clinical and demographic variables. The study questionnaire is suitable for assessing comorbidity and psychopathology dimensions.

Downloads

Download data is not yet available.

Author Biographies

Juan I. Arrarás, Rehabilitation Unit. Servicio Navarro de Salud – Osasunbidea. Spain

  • Rehabilitation Unit. Servicio Navarro de Salud – Osasunbidea. Spain
  • Institute for Health Research of Navarre (IdiSNA). Spain

Manuel J. Cuesta, Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain

  • Institute for Health Research of Navarre (IdiSNA). Spain
  • Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain

Victor Peralta, Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain

  • Institute for Health Research of Navarre (IdiSNA). Spain
  • Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain

Gustavo J. Gil-Berrozpe, Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain

  • Institute for Health Research of Navarre (IdiSNA). Spain
  • Department of Psychiatry. Hospital Universitario de Navarra. Servicio Navarro de Salud – Osasunbidea. Spain

Laura Barrado, Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain

Mental Health Department. Servicio Navarro de Salud – Osasunbidea. Pamplona. Spain

References

AUTONELL J, VILA F, PINTO-MEZA A, VILAGUT G, CODONY M, ALMANSA J et al. One year prevalence of mental disorders comorbidity and associated socio-demographic risk factors in the general population of Spain. Results of the ESEMeD-Spain study. Actas Esp Psiquiatr 2007; 35: 4-11.

ZIMMERMAN M, SHEERAN T. Screening for principal versus comorbid conditions in psychiatric outpatients with the Psychiatric Diagnostic Screening Questionnaire. Psychol assessment 2003; 15: 110-114. http://doi.org/10.1037/1040-3590.15.1.110

RUSH AJ, ZIMMERMAN M, WISNIEWSKI SR, FAVA M, HOLLON SD, WARDEN D et al. Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features. J Affect Disord 2005; 87(1): 43-55. https://doi.org/10.1016/j.jad.2005.03.005

SHEEHAN DV, LECRUBIER Y, SHEEHAN K H, AMORIM P, JANAVS J, WEILLER E et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998; 59(Suppl 20): 22-33.

FIRST MB, GIBBON M, SPITZER RL, WILLIAMS JBW, BENJAMIN LS. User’s Guide for the Structured Clinical Interview for DSM-IV Axis II. Personality Disorders. Washington: American Psychiatric Press; 1997.

PÉREZ GÁLVEZ B, GARCÍA L, DE VICENTE MP, OLIVERAS MA. Validación del Psychiatric Diagnostic Screening Questionnaire (PDSQ) en una muestra de pacientes alcohólicos españoles. Adicciones 2010; 22(3): 199-205. https://www.adicciones.es/index.php/adicciones/article/download/180/178

CLARKE DE, KUHL EA. DSM-5 cross-cutting symptom measures: a step towards the future of psychiatric care? World Psychiatry 2014; 13(3): 314-316. https://doi.org/10.1002%2Fwps.20154

ZIMMERMAN M, CHELMINSKI I. A scale to screen for DSM-IV Axis I disorders in psychiatric out-patients: performance of the Psychiatric Diagnostic Screening Questionnaire. Psychol Med 2006; 36(11): 1601-1611. https://doi.org/10.1017/s0033291706008257

PERKEY H, SINCLAIR SJ, BLAIS M, STEIN MB, NEAL P, PIERSON AD et al. External validity of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) in a clinical sample. Psychiatry Res 2018; 261: 14-20. https://doi.org/10.1016/j.psychres.2017.12.011

ZIMMERMAN M, MATTIA JI. The Psychiatric Diagnostic Screening Questionnaire: development, reliability and validity. Compr Psychiatry 2001; 42: 175-189. https://doi.org/10.1053/comp.2001.23126

ZIMMERMAN M, MATTIA JI. A self-report scale to help make psychiatric diagnoses: the Psychiatric Diagnostic Screening Questionnaire. Arch Gen Psychiatry 2001; 58: 787-794. https://doi.org/10.1001/archpsyc.58.8.787

ZIMMERMAN M. What should the standard of care for psychiatric diagnostic evaluations be? J Nerv Ment Dis 2003; 191: 281-286. https://doi.org/10.1097/01.nmd.0000066149.40946.fa

RUSH AJ, ZIMMERMAN M, WISNIEWSKI SR, FAVA M, HOLLON SD, WARDEN D et al. Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features. J Affect Disord 2005; 87: 43-55. https://doi.org/10.1016/j.jad.2005.03.005

ZIMMERMAN M, SHEERAN T, CHELMINSKI I, YOUNG D. Screening for psychiatric disorders in outpatients with DSM-IV substance use disorders. J Subst Abuse Treat 2004; 26: 181-188. https://doi.org/10.1016/s0740-5472(03)00207-1

CASTEL S, RUSH B, KENNEDY S, FULTON K, TONEATTO T. Screening for mental health problems among patients with substance use disorders: preliminary findings on the validation of a self-assessment instrument. Can J Psychiatry 2007; 52: 22-27. https://doi.org/10.1177/070674370705200105

CIUCA A, ALBU M, PERŢE A, BUDĂU O MICLEA S, MICLEA M. The Romanian adaptation of the psychiatric diagnostic screening questionnaire (PDSQ). Cognition, Brain, Behavior 2011; 14: 69-93.

SAWAYA H, ATOUI M, HAMADEH A, ZEINOUN P, NAHAS Z. Adaptation and initial validation of the Patient Health Questionnaire - 9 (PHQ-9) and the Generalized Anxiety Disorder - 7 Questionnaire (GAD-7) in an Arabic speaking Lebanese psychiatric outpatient sample. Psychiatry Res 2016; 239: 2452-2452. https://doi.org/10.1016/j.psychres.2016.03.030

MILLER MB, VAN REEN E, BARKER DH, ROANE B, BORSARI B, MCGEARY JE et al. The impact of sleep and psychiatric symptoms on alcohol consequences among young adults. Addict Behav 2017; 66: 138-144. https://doi.org/10.1016/j.addbeh.2016.11.023

BARAZANDEH H, KISSANE DW, SAEEDI N, GORDON M. Schema modes and dissociation in borderline personality disorder/traits in adolescents or young adults. Psychiatry Res 2018; 261: 1-6. https://doi.org/10.1016/j.psychres.2017.12.023

LEUNG B, LETOURNEAU N, BRIGHT K, GIESBRECHT GF, NTANDA H, GAGNON L, APrON Team. Appraisal of the Psychiatric Diagnostic Screening Questionnaire in a perinatal cohort: The APrON study. Scand J Public Health 2017; 45: 658-665. https://doi.org/10.1177/1403494817717835

O’CONNOR PJ, HERRING MP, MCDOWELL CP, DISHMAN RK. Physical activity is indirectly associated with pain in college women through associations with somatization and panic disorder symptoms: a cross-sectional study. Ann Epidemiol 2019; 33: 37-43. https://doi.org/10.1016/j.annepidem.2019.02.008

SUNG SC, MA J, EARNEST A, RUSH AJ, LIM LEC, ONG MEH. Screening for panic-related anxiety in emergency department patients with cardiopulmonary complaints: A comparison of two self-report instruments. Psychiatry Res 2018; 263: 7-14. https://doi.org/10.1016/j.psychres.2018.02.031

CASSANO P, CHANG T, TRINH NH, BAER L, FAVA M, MISCHOULON D. Differential impact of isolated psychotic symptoms on treatment outcome of major depressive disorder in the STAR*D cohort of Whites, Blacks and Latinos. J Affect Disord 2013; 5; 150: 578-584. https://doi.org/10.1016/j.jad.2013.02.012

GORDON BR, MCDOWELL CP, LYONS M, HERRING MP. Resistance exercise training among young adults with analogue generalized anxiety disorder. J Affect Disord 2020; 281: 153-159. https://doi.org/10.1016/j.jad.2020.12.020

GRISBROOK MA, DEWEY D, CUTHBERT C, MCDONALD S, NTANDA H, GIESBRECHT GF et al. Associations among caesarean section birth, post-traumatic stress, and postpartum depression symptoms. Int J Environ Res Public Health 2022; 19(8): 4900. https://doi.org/10.3390/ijerph19084900

NDETEI DM, MUTISO VN, WEISZ JR, OKOTH CA, MUSYIMI C, MUIA EN et al. Socio-demographic, economic and mental health problems were risk factors for suicidal ideation among Kenyan students aged 15 plus. J Affect Disord 2022; 302: 74-82. https://doi.org/10.1016/j.jad.2022.01.055

CUESTA MJ, ARRARAS JI, GIL-BERROZPE GJ, PERALTA V, BARRADO L, CORREA O et al. The network structure of self-reported psychopathological dimensions in common mental disorders (CMDs). Eur J Psychiatry 2023; 37 (2): 100-108. https://doi.org/10.1016/j.ejpsy.2022.11.003

MORAN P, LEESE M, LEE T, WALTERS P, THORNICROFT G, MANN A. Standardised Assessment of Personality - Abbreviated Scale (SAPAS): preliminary validation of a brief screen for personality disorder. Br J Psychiatry 2003; 183: 228-232. https://doi.org/10.1192/bjp.183.3.228

BRUGHA TS, CRAGG D. The List of Threatening Experiences: the reliability and validity of a brief life events questionnaire. Acta Psychiatr Scand 1990; 82(1): 77-81. https://doi.org/10.1111/j.1600-0447.1990.tb01360.x

HESSE M, MORAN P. Screening for personality disorder with the Standardised Assessment of Personality: Abbreviated Scale (SAPAS): further evidence of concurrent validity. BMC Psychiatry 2010; 10: 10. https://doi.org/10.1186/1471-244X-10-10

MOTRICO E, MORENO-KÜSTNER B, DE DIOS LUNA J, TORRES-GONZÁLEZ F, KING M, NAZARETH I. Psychometric properties of the List of Threatening Experiences--LTE and its association with psychosocial factors and mental disorders according to different scoring methods. J Affect Disord 2013; 150(3): 931-940. https:/doi.org/10.1016/j.jad.2013.05.017

FERRANDO L, BOBES J, GILBERT M, SOTO M. MINI: Mini-International Neuropsychiatric Interview. Versión en español 5.0.0 DSMIV. Madrid: Instituto IAP, 1998. https://www.fundacionforo.com/pdfs/mini.pdf

FAYERS P, MACHIN D. Quality of Life: assessment, analysis and interpretation of patient-reported outcomes. 2nd ed. Chichester: John Wiley & Sons Ltd, 2007.

HARO JM, PALACÍN C, VILAGUT G, MARTÍNEZ M, BERNAL M, LUQUE I et al. Prevalence of mental disorders and associated factors: results from the ESEMeD-Spain study. Med Clin 2006; 126(12): 445-451. https://doi.org/10.1157/13086324

MAESTRE-MIQUEL C, LÓPEZ-DE-ANDRÉS A, JI Z, DE MIGUEL-DIEZ J, BROCATE A, SANZ-ROJO S et al. Gender differences in the prevalence of mental health, psychological distress and psychotropic medication consumption in Spain: A nationwide population-based study. Int J Environ Res Public Health 2021; 18(12): 6350. https://doi.org/10.3390/ijerph18126350

Observatorio Español sobre Droga y Toxicomania (OEDYLT) 2019. Informe 2019. Alcohol, tabaco y drogas ilegales en España. Madrid: Ministerio de Sanidad, Consumo y Bienestar Social, 2019. https://pnsd.sanidad.gob.es/profesionales/sistemasInformacion/informesEstadisticas/pdf/2019OEDA-INFORME.pdf

American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. DSM-5. 5a ed. Washington D.C: American Psychiatric Association, 2013.

BARBAGLIA G, VILAGUT G, ARTAZCOZ L, HARO JM, FERRER M, FORERO CG et al. Association between annual earnings and mental disorders in Spain: individual and societal-level estimates. Soc Psychiatry Psychiatr Epidemiol 2012; 47(11): 1717-1725. https://doi.org/10.1007/s00127-012-0485-x

MARCH-LLANES J, MARQUÉS-FEIXA L, MEZQUITA L, FAÑANÁS L, MOYA-HIGUERAS J. Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis. Eur Child Adolesc Psychiatr 2017; 26: 1409-1422. https://doi.org/10.1007/s00787-017-0996-9

EISENBARTH H, GODINEZ D, DU PONT A, CORLEY RP, STALLINGS MC, RHEE SH. The influence of stressful life events, psychopathy, and their interaction on internalizing and externalizing psychopathology. Psychiatry Res 2019; 272: 438-446. https://doi.org/10.1016/j.psychres.2018.12.145

HUANG Y, KOTOV R, DE GIROLAMO G, PRETI A, ANGERMEYER M, BENJET C et al. DSM-IV personality disorders in the WHO world mental health surveys. Br J Psychiatry 2009; 195: 46-53. https://doi.org/10.1192/bjp.bp.108.058552

KÖHNE ACJ, ISVORANU AM. A network perspective on the comorbidity of personality disorders and mental disorders: an illustration of depression and borderline personality disorder. Front Psychol 2021; 6; 12: 680805. https://doi.org/10.3389/fpsyg.2021.680805

The European statistics on income, social inclusion and living conditions. Eurostat, Luxemburgo: European Commission; 2023. https://ec.europa.eu/eurostat/web/income-and-living-conditions/overview

Instituto Nacional de Estadística. Encuesta continua de hogares, 2020. Madrid: Ministerio de Asuntos Económicos y Transformación Digital, 2021. https://www.ine.es/dyngs/INEbase/es/operacion.htm?c=Estadistica_C&cid=1254736176952&menu=ultiDatos&idp=1254735572981

ROCA M, GILI M, GARCIA-GARCIA M, SALVA J, VIVES M, GARCIA CAMPAYO J et al. Prevalence and comorbidity of common mental disorders in primary care. J Affect Disord 2009; 119: 52-58. https://doi.org/10.1016/j.jad.2009.03.014

MCGRATH JJ, LIM CCW, PLANA-RIPOLL O, HOLTZ Y, AGERBO E, MOMEN NC et al. Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries. Epidemiol Psychiatr Sci 2020; 12; 29: e153. https://doi.org/10.1017/S2045796020000633

WATSON D, O'HARA MW, STUART S. Hierarchical structures of affect and psychopathology and their implications for the classification of emotional disorders. Depress Anxiety 2008; 25: 282-288. https://doi.org/10.1002/da.20496

HÜSING P, LÖWE B, PIONTEK K, SHEDDEN-MORA M. Somatoform disorder in primary care: The influence of co-morbidity with anxiety and depression on health care utilization. J Eval Clin Pract 2018; 24: 892-900. https://doi.org/10.1111/jep.12898

WONG QJJ, RAPEE RM. The aetiology and maintenance of social anxiety disorder: A synthesis of complimentary theoretical models and formulation of a new integrated model. J Affect Disord 2016; 203: 84-100. https://doi.org/10.1016/j.jad.2016.05.069

Ministerio de Sanidad, Consumo y Bienestar Social. Encuesta Nacional de Salud ENSE de España 2017. https://www.sanidad.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm

Downloads

Published

2023-08-30

How to Cite

Arrarás, J. I., Cuesta, M. J., Peralta, V., Gil-Berrozpe, . G. J. ., Barrado, L., Correa, O., Elorza, R., González, L., Garmendia, I., Janda, L., Macaya, P., Núñez, C., Sabater, P., & Torrejon, A. (2023). Psychometric analysis of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) and determinants of psychopathology in two outpatient clinics in Navarre (Spain). Anales Del Sistema Sanitario De Navarra, 46(2), e1043. https://doi.org/10.23938/ASSN.1043

Issue

Section

Research articles