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Screening instruments for psychiatric morbidity in Chronic Fatigue Syndrome (CFS)

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By Morriss RK, Wearden AJ • www.ProHealth.com • July 25, 1998


Physicians require a screening instrument to detect psychiatric
disorders in patients with chronic fatigue syndrome (CFS).
Different threshold scores on the Hospital Anxiety and
Depression scale (HAD) and the mental health scale of the
Medical Outcome Survey (MOS) were compared with two gold
standards for the presence or absence of psychiatric disorder,
standard diagnostic criteria (DSM-III-R) and a threshold score
for the number of psychiatric symptoms at a standardized
psychiatric interview (Revised Clinical Interview Schedule
total cut-off score of 11/12). They were compared by use of
validating coefficients and receiver operating characteristics
in 136 consecutive CFS medical outpatients. The HAD scale at
cut-off of 9/10 was a valid and efficient screening instrument
for anxiety and depression by comparison with both gold
standards. The MOS mental health scale at its recommended
cut-off score of 67/68 yielded too many false-positives to be
recommended as a psychiatric screening instrument in CFS
patients.




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