Am J Psychiatry 1997; 154:1462-1464
Copyright © 1997 by American Psychiatric Association
False positive results: a challenge for psychiatric screening in primary care
AC Leon, L Portera, M Olfson, MM Weissman, RG Kathol, L Farber, DV Sheehan and AM Pleil
Department of Psychiatry, Cornell University Medical College, NY 10021, USA. acleon@med.cornell.edu
OBJECTIVE: The goal of this study was to characterize primary care patients
with false positive results on screens for mental disorders. METHOD: A
sample of 1,001 primary care patients completed self- administered screens
and structured interviews for DSM-IV diagnoses. RESULTS: A substantial
proportion of the patients with false positive screen results for at least
one diagnosis met the diagnostic criteria for other psychiatric disorders.
They also had significantly greater functional impairment and higher rates
of recent use of mental health services than the subjects with true
negative results on the screens. CONCLUSIONS: Although the positive
predictive values of screens for specific mental disorders are in line with
those of other medical screens, false positive results are not uncommon.
This may be due in part to the sensitivity of brief screening instruments
to nonspecific symptoms. The results suggest that as with other screens
used in primary care, patients with false positive results on screens for
mental disorders should receive clinical attention.
