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Abstract
BackgroundPatients suspected of personality disorders (PDs) by general practitioners are frequently referred to psychiatric outpatient clinics (POCs). In that setting an effective screening instrument for PDs would be helpful due to resource constraints. This study evaluates the properties of The Iowa Personality Disorder Screen (IPDS) as a screening instrument for PDs at a POC.MethodsIn a cross-sectional design 145 patients filled in the IPDS and were examined with the SCID-II interview as reference. Various case-findings properties were tested, interference of socio-demographic and other psychopathology were investigated by logistic regression and relationships of the IPDS and the concept of PDs were studied by a latent variable path analysis.ResultsWe found that socio-demographic and psychopathological factors hardly disturbed the IPDS as screening instrument. With a cut-off ≥4 the 11 items IPDS version had sensitivity 0.77 and specificity 0.71. A brief 5 items version showed sensitivity 0.82 and specificity 0.74 with cut-off ≥ 2. With exception for one item, the IPDS variables loaded adequately on their respective first order variables, and the five first order variables loaded in general adequately on their second order variable.ConclusionOur results support the IPDS as a useful screening instrument for PDs present or absent in the POC setting.
Highlights
Patients suspected of personality disorders (PDs) by general practitioners are frequently referred to psychiatric outpatient clinics (POCs)
Several studies have indicated that the prevalence of personality disorders (PDs) is high in the setting of psychiatric outpatient clinics (POCs)
At POCs in Norway, such clinical competence is a limited resource and the pressure to evaluate patients is considerable, and for efficient and qualified diagnostic assessment of PD a psychometrically valid screening instrument for PDs would be very helpful in the POC setting
Summary
Patients suspected of personality disorders (PDs) by general practitioners are frequently referred to psychiatric outpatient clinics (POCs). Several studies have indicated that the prevalence of personality disorders (PDs) is high in the setting of psychiatric outpatient clinics (POCs). The variation in prevalence rate depends in part on practical matters like the referral practice of the general practitioners (GPs), and in part on research matters like the instruments used to assess PDs. Frequent co-morbidity of Axis I disorders and PDs regularly demands extensive diagnostic assessments [3,4], and PD as an influential but unacknowledged factor impedes the referral process [5]. At POCs in Norway, such clinical competence is a limited resource and the pressure to evaluate patients is considerable, and for efficient and qualified diagnostic assessment of PD a psychometrically valid screening instrument for PDs would be very helpful in the POC setting
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