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

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


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