Principles of screening applied to psychiatric disorders

Abstract

The morbidity and mortality caused by psychiatric illness is a significant public health problem. The use of a psychiatric screening questionnaire has been one strategy to improve the recognition and treatment of psychiatric disorders in general medical settings. This paper discusses how well psychiatric screening procedures fulfill criteria outlined by the World Health Organization for evaluating the utility of general medical screening efforts. Current research on the utility of screening for psychiatric disorders is reviewed, and the lack of data on the treatment of psychiatric disorders is identified in the general medical sector is emphasized. The randomized clinical trial is offered as the best method to test the efficacy of screening by eliminating various biases outlined in the paper. Quantitative concepts such as positive predictive value and receiver operator characteristic analysis are discussed. The need for more research on the efficacy of early treatment of psychiatric disorders is emphasized.