The PHQ-PD as a screening tool for panic disorder in the primary care setting in Spain

Roger Muñoz-Navarro, Antonio Cano-Vindel, Cristina Mae Wood, Paloma Ruíz-Rodríguez, Leonardo Adrián Medrano, Joaquín T. Limonero, Patricia Tomás-Tomás, Irene Gracia-Gracia, Esperanza Dongil-Collado, M. Iciar Iruarrizaga, Juan Antonio Moriana, Francisco Santolaya Ochando, Antonio Capafons Bonet, Ma Dolores Gómez Castillo, Fernando Chacón Fuertes, Gonzalo Jiménez Cabré, Estefanía Salgado Kvedaras, Jorge Perpiñá González, Carmen Abellán Maeso, Ana Ma Agudo RodrigoMa Del Mar Aguilar Uceda, Laura Agüero, Mónica Rodriguez-Enríquez, Ma Rosa Pizà, Ignasi Ramírez, Manuel Aires López, Ana María Alayeto Sánchez, Dolores Alfonso Doménech, Vicenta Almonacid Guinot, Sinuhe Alvarado Torres, Sonia Álvarez Gómez, Luisa Ma Andrés Arreaza, Ana María Arnaiz Kompanietz, Ma Pilar Arranz García, Eugenia Avelino Hidalgo, Ma José Ávila Sánchez, Josune Barbero Goicoetxea, Manuel Barragán Solís, Pilar Barroso López, Sofía Bauer Izquierdo, Carmen Benavente Torres, Pilar Bermejo Ortega, Greta Borrás Moreno, Alejandro Buendía Romero, Carlos Buiza Aguado, José Caballero Moral, Nieves Caparrós Ezpeleta, Alejandro Casado Martínez, Cristina Casado Rodríguez, Consuelo Castiblanque Ballesteros, Francisca Ceinós Vicente, Patricia Cordero Andrés, Ana Costa Alcaraz, Isabel De Andrés Cara, Victoria De La Riva Casares, Bárbara Díaz Gómez, Ma Dolores Domínguez Manrique, Soledad Escolar Llamazares, Encarnación Espinosa De Los Monteros Zayas, Aurora Fabero Jiménez, Ma Antonia Font Payeras, Ma Rosa Fraile Gómez, Mariona Fuster Forteza, Montserrat Gallart Aliu, Olvido García Jaén, Carmen García Palacios, Mar García-Moreno, Yolanda Garnica Cascales, Miguel Gárriz Vera, Ma Concepción Gómez Martín-Sonseca, Ma Francisca Gómez Rodríguez, César González Blanch Bosch, Ana Ma Hermosilla Pasamar, Fernando Hernández De Hita, Margarita Herrero Delgado, Josefa Jaimez Moreno, Amale Jáuregui Larrabeiti, Juan Agustín Jiménez Luque, Antonio Jiménez Moreno, Antonio León Dugo, Carlos Lillo De La Quintana, Joaquim L.Limonero García, María Lleras De Frutos, Anna Llorca Mestre, Francisco López Ortiz, Lourdes Luceño Moreno, Pilar Madrid Almoguera, Sonia Martín De La Sierra Fuentes, Rebeca Martínez Bustos, Ainoa Mateu Mullor, Mercedes Matilla Caballero, Rafael Medina Reyes, Itsaso Mendizábal Gallestegui, Susana Merino Martín, Gonzalo David Moneva Vicente, Ma Isabel Montejo Villa, Antonio Montero Cantero, Julio Montoya Fernández, Rosario Morales Moreno, Laura Morante Hernández

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Abstract

© 2016 Muñoz-Navarro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Panic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres. Method We compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entire PHQ test, including the PHQ-PD, to undergo the SCID-I. The sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios of the PHQ-PD were assessed. Results The operating characteristics of the PHQ-PD are moderate. The best cut-off score was 5 (sensitivity .77, specificity .72). Modifications to the questionnaire's algorithms improved test characteristics (sensitivity .77, specificity .72) compared to the original algorithm. The screening question alone yielded the highest sensitivity score (.83). Conclusion Although the modified algorithm of the PHQ-PD only yielded moderate results as a diagnostic test for panic disorder, it was better than the original. Using only the first question of the PHQ-PD showed the best psychometric properties (sensitivity). Based on these findings, we suggest the use of the screening questions for screening purposes and the modified algorithm for diagnostic purposes.
Original languageEnglish
Article numbere0161145
JournalPLoS ONE
Volume11
DOIs
Publication statusPublished - 1 Aug 2016

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