A comparison of self-reports of distress and affective disorder diagnoses in rheumatoid arthritis: A receiver operator characteristic analysis

Julia McQuillan, Judith Fifield, T. Joseph Sheehan, Susan Reisine, Howard Tennen, Victor Hesselbrock, Naomi Rothfield

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective. To compare 3 commonly used psychiatric symptom checklists (the Center for Epidemiological Studies Depression Scale [CES-D], the Positive and Negative Affect Schedule, and the Endler Multidimensional Anxiety Scales [EMAS]) to determine their sensitivity, specificity, and ability to discriminate between a disorder (Major Depression [MD], Generalized Anxiety Disorder [GAD]), and no disorder. To compare the checklists for their ability to discriminate between type of disorder (MD and GAD). To evaluate the discriminant ability of the subscales, particularly positive affect; whether the somatic items in the CES-D artificially inflate affective scores; and the optimal cut off score for the CES-D. Methods. We compared the 3 scales to diagnostic criterion of MD, GAD, and comorbid disorder using receiver operator characteristic (ROC) and logistic regression analyses. The sample consisted of a national panel of 415 individuals with rheumatoid arthritis (RA). Results. Each of the scales had high sensitivity and specificity (areas under the curve: CES-D = 0.92, negative affect = 0.88, positive affect and EMAS = 0.82). The CES-D, however, demonstrated better sensitivity and specificity than the positive affect and the EMAS, but not the negative affect scale. Conclusion. All 3 self-reports have high combined sensitivity and specificity as measures of affective disorders among RA patients.

Original languageEnglish (US)
Pages (from-to)368-376
Number of pages9
JournalArthritis Care and Research
Volume49
Issue number3
DOIs
StatePublished - Jun 15 2003

Keywords

  • Affective disorder
  • Distress
  • ROC

ASJC Scopus subject areas

  • Rheumatology

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