A cross-sectional testing of The Iowa Personality Disorder Screen in a psychiatric outpatient setting

BMC Psychiatry

Alv A Dahl²  Øystein Sørebø³  Ingrid Olssøn¹ 

[1] Department of Psychiatry, Innlandet Hospital Trust, N-2318 Hamar, Norway;Department of Oncology, Oslo University Hospital and University of Oslo, N-0310 Oslo, Norway;Schools of Business and Social Sciences, Buskerud University College, N-3511 Hønefoss, Norway

关键词: Psychometrics;    Iowa Personality Disorder Screen;    Screening instrument;    Personality disorders;   

Others  :  1124531
DOI  :  10.1186/1471-244X-11-105

 received in 2011-02-07, accepted in 2011-06-28,  发布年份 2011

【 摘 要 】

Background

Patients 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.

Methods

In 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.

Results

We 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.

Conclusion

Our results support the IPDS as a useful screening instrument for PDs present or absent in the POC setting.

【 授权许可】

   
2011 Olssøn et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Zimmerman M, Chelminski I, Young D: The frequency of personality disorders in psychiatric patients. Psychiat Clin N Am 2008, 31:405-420.
• [2]Alnaes R, Torgersen S: DSM-III symptom disorders (Axis I) and personality disorders (Axis II) in an outpatient population. Acta Psychiatr Scand 1988, 78:348-355.
• [3]McGlashan TH, Grilo CM, Skodol AE, et al.: The Collaborative Longitudinal Personality Disorders Study: baseline axis I/II and II/II diagnostic co-occurrence. Acta Psychiatr Scand 2000, 102:256-264.
• [4]Lenzenweger MF, Lane MC, Loranger AW, Kessler RC: DSM-IV personality disorders in the National Comorbidity Survey Replication. Biol Psychiatry 2007, 62:553-564.
• [5]Strathdee G, Brown RM, Doig RJ: Psychiatric clinics in primary care. The effect on general practitioner referral patterns. Soc Psychiatry Psychiatr Epidemiol 1990, 25:95-100.
• [6]Farmer R, Nelson-Grey R: Personality disorder and depression: hypothetical relations, empirical findings, and methodological considerations. Clin Psychol Rev 1990, 10:453-476.
• [7]Alneas R, Torgersen S: Personality and personality disorders predict development and relapses of major depression. Acta Psychiatr Scand 1997, 95:336-342.
• [8]Wilberg T, Karterud S, Urnes O, Pedersen G, Friis S: Outcomes of poorly functioning patients with personality disorders in a day treatment program. Psychiatr Serv 1998, 49:1462-1467.
• [9]Moran P, Walsh E, Tyrer P, Burns T, Creed F, Fahy T: The impact of co-morbid personality disorder on violence in psychosis- data from the UK700 trial. Br J Psychiatry 2003, 182:129-134.
• [10]Newton-Howes G, Tyrer P, Johnsen T: Personality disorder and the outcome of depression: Meta-analyses of published studies. Br J Psychiatry 2006, 188:13-20.
• [11]Zimmerman M: Diagnosing Personality-Disorders - A Review of Issues and Research Methods. Arch Gen Psychiatry 1994, 51:225-245.
• [12]Langbehn DR, Pfohl BM, Reynolds S, et al.: The Iowa Personality Disorder Screen: Development and preliminary validation of a brief screening interview. J Pers Dis 1999, 13:75-89.
• [13]Trull TJ, Amdur M: Diagnostic efficiency of the Iowa Personality Disorder Screen items in a nonclinical sample. J Pers Dis 2001, 15:351-357.
• [14]Morse JQ, Pilkonis PA: Screening for personality disorders. J Pers Dis 2007, 21:179-198.
• [15]Germans S, Van Heck GL, Langbehn DR, Hodiamont PPG: The Iowa Personality Disorder Screen. Preliminary results of the validation of a self-administered version in a Dutch population. Eur J Psychol Assess 2010, 26:11-18.
• [16]First MB, Gibbon M, Spitzer RL, Williams JBW, Benjamin LS: Structured Clinical Interview for the DSM-IV Axis II Personality Disorders (SCID-II). American Psychiatric Press, Washington, DC; 1997. Norwegian version 2004
• [17]Derogatis LR: SCL-90-R: administration, scoring and procedures manual. Mineapolis, MN: National Computer Systems; 1994.
• [18]Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L: The Hopkins Symptom Checklist (HSCL). A measure of primary symptom dimensions. Modern Probl Pharmacopsychiat 1974, 7:79-110.
• [19]Pedersen G, Karterud S: Is SCL-90R helpful for the clinician in assessing DSM-IV symptom disorders? Acta Psychciatr Scand 2004, 110:215-24.
• [20]American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th edition. American Psychiatric Press, Washington, DC; 1994.
• [21]Sheehan DV, Lecrubier Y, Janvas J, et al.: Mini International Psychiatric Interview (MINI) version 5.0.0. Tampa, FL; University of South Florida Institute for Research in Psychiatry, and Paris, France: INSERM-Hôpital de la Salpetière; 2006. Norwegian version 2007
• [22]Pedersen G, Hagtvet KA, Karterud S: Generalizability studies of the Global Assessment of Functioning-Split version. Compr Psychiat 2007, 48:88-94.
• [23]Wetzels M, Odekerken-Schroder G, Van Oppen C: Using PLS Path Modeling for Assessing Hierarchical Construct Models: Guidelines and Empirical Illustration. MIS Quarterly 2009, 33:177-195.
• [24]Olssøn I, Dahl AA: Somatic morbidity and health care utilisation are strongly associated with personality problems. Eur Psychiatr 2009, 24:442-9.
• [25]Tenenhaus M, Esposito Vinzi, Chatelin Y-M, Lauro C: PLS path modeling. Computat Stat Data Anal 2005, 48:159-205.
• [26]Cohen J: Statistical power for the behavioral sciences. 2nd edition. Erlbaum, Hillsdale: NJ; 1988.
• [27]Esposito Vinzi V, Chin WW, Henseler J, Wang H: Handbook of Partial Least Squares: Concepts, Methods and Applications (Springer Handbooks of Computational Statistics Series, vol II). Springer: Berlin/Heidelberg; 2010.
• [28]Torgersen S, Kringlen E, Cramer V: The Prevalence of Personality Disorders in a Community Sample. Arch Gen Psychiatry 2001, 58:590-596.
• [29]Goodwin R, Hoven C, Lyons J, et al.: Mental health service utilization in the United States. The role of personality factors. Soc Psychiatry Psychiatr Epidemiol 2002, 37:561-666.
• [30]Zimmerman M: Integrating the assessment methods of researchers in routine clinical practice: the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project. In Standardized evaluation in clinical practice. Volume 22. Edited by First M. Washington, DC: American Psychiatric Publishing, Inc; 2003::29-74.