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Diagnosing bipolar disorder in trauma exposed primary care patients
Author(s) -
Graves Ruth Elaine,
Alim Tanya N,
Aigbogun Notalelomwan,
Chrishon Kris,
Mellman Thomas A,
Charney Dennis S,
Lawson William B
Publication year - 2007
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2007.00449.x
Subject(s) - psychopathology , medicine , psychiatry , bipolar disorder , gold standard (test) , primary care , false positive paradox , mood , predictive value , african american , clinical psychology , family medicine , ethnology , machine learning , computer science , history
Objectives: Bipolar disorder (BD) is often under‐recognized in non‐psychiatric settings, especially in African Americans. The Mood Disorder Questionnaire (MDQ) is a screening instrument proposed to show adequate sensitivity and specificity for bipolar spectrum disorders. The current study is an examination of the usefulness of this instrument in a trauma exposed subgroup of mainly African American patients attending primary care clinics. Methods: The sample is a part of a larger study exploring traumatic stress exposure and psychopathology. Consenting patients in 3 academically affiliated primary care clinics were asked to complete the MDQ. Ninety percent of the participants were African American. Diagnostic performance was determined in a trauma exposed subgroup by employing the Structured Clinical Interview for DSM‐IV (SCID) as a gold standard. Results: Of the total group of 579 participants, 178 (30.7%) screened positive for BD along with 77 (33.7%) of the 228 trauma exposed subjects who were SCID interviewed. Only 13 (27%) of the MDQ positives met SCID criteria for BD and were true positives. The sensitivity was 61.9% and the specificity was 69%, with a positive predictive value of 16.8% and a negative predictive value of 94.7%. Conclusions: The MDQ was found to have low specificity in a predominately African American group of trauma exposed patients attending primary care.