FAMILY PSYCHIATRIC SCREENING INSTRUMENT FOR EPIDEMIOLOGIC STUDIES - PILOT TESTING AND VALIDATION

Family history, a risk factor for psychiatric disorders, is infrequent ly assessed in epidemiologic studies due to time and cost constraints. We designed a brief computer-scorable instrument, the Family History Screen for Epidemiologic Studies (FHE), which collects a pedigree and screens for 15 DSM-III diagnoses in an informant and in his family mem bers, The FHE was administered to one informant in 77 families in whic h we had collected pedigrees, interviewed 77 informants and 239 relati ves using the Lifetime Anxiety version of the Schedule for Affective D isorders and Schizophrenia or the Epidemiologic version of the Schedul e for Affective Disorders and Schizophrenia for School-Aged Children, and performed best-estimate diagnoses. We evaluated the accuracy with which the FHE predicted best-estimate diagnoses, For adults reporting on themselves, the FHE demonstrated high levels of sensitivity and spe cificity for depression (67.4, 75.0) and panic (92.5, 89.2), and low s ensitivity and high specificity for substance abuse (33.3, 93.6). For informants reporting on adult relatives, sensitivity was low and speci ficity was high for depression (35.2, 84.9), panic (20.0, 91.7), and s ubstance abuse (42.1, 93.4). For informants reporting on children, per haps due to lower prevalence, sensitivity and specificity were poor. T he FHE is a good screen for psychiatric disorders in adult informants, but it is not useful for family history. It may be useful in primary care medical settings as a screen for psychiatric history.