Validity and Reliability of the Iranian Rapid Assessment for Psychiatric Illness Screening Instrument (IRA-PISI) in Primary Health Care

Abstract

Background: An estimated 25% to 30% of patients presenting to family physicians have psychiatric disorders (PDs). Accurate diagnosis of various PDs requires valid and well-designed screening tools and psychiatric interviews. There is no rapid and low-cost tool for PD screening in primary health care (PHC). Objectives: To determine the validity and psychometric properties of the Iranian Rapid Assessment for Psychiatric Illness Screening Instrument (IRA-PISI) in PHC. Methods: This psychometric study was performed among a convenience sample of 257 outpatients presenting to the first-line health services in Tabriz. Psychiatric interviews via DSM-5 were used as the gold standard. The validation process included the face validity (literature review and expert comments), content validity, estimating the best cutoff point, and measuring the sensitivity and specificity of the questionnaire compared to the psychiatric interview. Temporal and internal reliabilities were measured by test-retest and Cronbach's alpha coefficient, respectively. Results: The final questionnaire consisted of 14 items (with a score range of 14 to 70) after removing seven questions from the initial questionnaire (21 items) during the validation process. The sensitivity and specificity of the questionnaire compared to psychiatric interviews were 83.62% and 75.17%, respectively. The overall relevance and the best cutoff point (score) were 0.91% and 28, respectively. Interclass correlation coefficient (ICC) and Cronbach's alpha coefficient were 96% and 83%, respectively. The ICC of items/questions ranged from 89.3 to 100. Conclusions: The IRA-PISI has appropriate validity and reliability for screening common PDs among outpatients presenting to first-line healthcare providers.