Skip to main content
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1998 Jul;91(7):365–368. doi: 10.1177/014107689809100706

Screening instruments for psychiatric morbidity in chronic fatigue syndrome.

R K Morriss 1, A J Wearden 1
PMCID: PMC1296809  PMID: 9771495

Abstract

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.

Full text

PDF
365

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Deale A., Chalder T., Marks I., Wessely S. Cognitive behavior therapy for chronic fatigue syndrome: a randomized controlled trial. Am J Psychiatry. 1997 Mar;154(3):408–414. doi: 10.1176/ajp.154.3.408. [DOI] [PubMed] [Google Scholar]
  2. Euba R., Chalder T., Deale A., Wessely S. A comparison of the characteristics of chronic fatigue syndrome in primary and tertiary care. Br J Psychiatry. 1996 Jan;168(1):121–126. doi: 10.1192/bjp.168.1.121. [DOI] [PubMed] [Google Scholar]
  3. Farmer A., Chubb H., Jones I., Hillier J., Smith A., Borysiewicz L. Screening for psychiatric morbidity in subjects presenting with chronic fatigue syndrome. Br J Psychiatry. 1996 Mar;168(3):354–358. doi: 10.1192/bjp.168.3.354. [DOI] [PubMed] [Google Scholar]
  4. Farmer A., Jones I., Hillier J., Llewelyn M., Borysiewicz L., Smith A. Neuraesthenia revisited: ICD-10 and DSM-III-R psychiatric syndromes in chronic fatigue patients and comparison subjects. Br J Psychiatry. 1995 Oct;167(4):503–506. doi: 10.1192/bjp.167.4.503. [DOI] [PubMed] [Google Scholar]
  5. Fukuda K., Straus S. E., Hickie I., Sharpe M. C., Dobbins J. G., Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994 Dec 15;121(12):953–959. doi: 10.7326/0003-4819-121-12-199412150-00009. [DOI] [PubMed] [Google Scholar]
  6. Hanley J. A., McNeil B. J. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology. 1983 Sep;148(3):839–843. doi: 10.1148/radiology.148.3.6878708. [DOI] [PubMed] [Google Scholar]
  7. Herrmann C. International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. J Psychosom Res. 1997 Jan;42(1):17–41. doi: 10.1016/s0022-3999(96)00216-4. [DOI] [PubMed] [Google Scholar]
  8. Lewis G., Pelosi A. J., Araya R., Dunn G. Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med. 1992 May;22(2):465–486. doi: 10.1017/s0033291700030415. [DOI] [PubMed] [Google Scholar]
  9. McCabe C. J., Thomas K. J., Brazier J. E., Coleman P. Measuring the mental health status of a population: a comparison of the GHQ-12 and the SF-36 (MHI-5). Br J Psychiatry. 1996 Oct;169(4):516–521. doi: 10.1192/bjp.169.4.516. [DOI] [PubMed] [Google Scholar]
  10. Morriss R., Sharpe M., Sharpley A. L., Cowen P. J., Hawton K., Morris J. Abnormalities of sleep in patients with the chronic fatigue syndrome. BMJ. 1993 May 1;306(6886):1161–1164. doi: 10.1136/bmj.306.6886.1161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Schluederberg A., Straus S. E., Peterson P., Blumenthal S., Komaroff A. L., Spring S. B., Landay A., Buchwald D. NIH conference. Chronic fatigue syndrome research. Definition and medical outcome assessment. Ann Intern Med. 1992 Aug 15;117(4):325–331. doi: 10.7326/0003-4819-117-4-325. [DOI] [PubMed] [Google Scholar]
  12. Wearden A. J., Morriss R. K., Mullis R., Strickland P. L., Pearson D. J., Appleby L., Campbell I. T., Morris J. A. Randomised, double-blind, placebo-controlled treatment trial of fluoxetine and graded exercise for chronic fatigue syndrome. Br J Psychiatry. 1998 Jun;172:485–490. doi: 10.1192/bjp.172.6.485. [DOI] [PubMed] [Google Scholar]
  13. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES