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Biomedical subjects

S C Marcus

Publications and source records attributed to S C Marcus.

23 records · Page 2Linked to original sources
PubMed1996

A short computer interview for obtaining psychiatric diagnoses.

OBJECTIVE: To determine whether a short computer interview could be used in place of a full diagnostic interview to obtain psychiatric diagnoses, the authors examined the short interview's sensitivity, specificity, and diagnostic agreement with the full interview. METHODS: Patients recently discharged from a university psychiatric service were interviewed in two back-to-back sessions, one in which a full diagnostic interview was used and the other in which a short computer interview was used. Based on diagnoses derived from both interviews, the sensitivity and specificity of the short interview and kappa values reflecting the diagnostic agreement of the two interviews were calculated. RESULTS: The short interview had high sensitivity and specificity and excellent diagnostic agreement with the full interview for most disorders. It also had a significantly shorter administration time. However, it missed a substantial percentage of cases of generalized anxiety disorder and misclassified as in remission a substantial proportion of patients with active cases of post-traumatic stress disorder. CONCLUSIONS: With few exceptions, the short interview may be substituted for the full interview when missing an active case is not important or when a count of individual symptoms and subtyping of disorders are not needed. Such uses include screening subjects for inclusion in a study and obtaining an overview of a patient's lifetime psychiatric status.

Adult↗
PubMedDate not supplied

Diagnostic certainty of a voluntary bipolar disorder case registry.

BACKGROUND: Strategies for identifying and recruiting persons with bipolar disorder are of importance as interest in studying this relatively uncommon, but highly disabling illness increases. The development and implementation of a bipolar disorder case registry and the assessment of diagnostic certainty of the resulting sample are described. METHODS: Eight hundred and four individuals who self-reported a history of bipolar disorder were recruited. Telephone interviewers gathered demographic information and clinical, medical and treatment history information. One hundred randomly-selected registrants completed an in-person structured diagnostic interview. Self-report of diagnosis was compared to the results of the diagnostic interview. RESULTS: Ninety three percent of registrants interviewed met criteria for a lifetime bipolar spectrum diagnosis; of those, 76.3% were diagnosed with bipolar I disorder. Agreement between self-reported and SCID diagnoses was 93%, indicating that self-report of a bipolar diagnosis is highly reliable. Two-thirds had experienced at least one other lifetime Axis I diagnosis, with substance abuse/dependence (55.9%) and panic disorder (19.4%) the most common comorbidities. LIMITATIONS: Since nearly all of the sample have previously been diagnosed as having bipolar disorder by a professional, the sample's representativeness of the population as a whole may be somewhat limited. CONCLUSIONS: Persons with bipolar disorder can accurately identify themselves as having the disorder via a telephone interview, indicating that a case registry method is a useful strategy for recruiting very large samples of persons with this disorder. Such large samples will allow for further study of treatment variations among patient subgroups, of pathways to treatment, and of the effectiveness of new treatments.

Adolescent↗
PubMedDate not supplied

Referrals to psychiatrists. Assessing the communication interface between psychiatry and primary care.

The Study of Outpatient Referral Patterns was conducted in 1998 to examine the nature of the communication relationship between psychiatrists and primary care physicians regarding outpatient referrals. Nationally representative psychiatrists were surveyed (N = 542) regarding their aggregate experience with outpatient referrals from non-psychiatric physicians in the previous 60 days. Data regarding frequency and type of information and mode of communication were gathered. Results indicate that primary care physicians represent a significant source of referrals to psychiatrists and that psychiatrists are generally satisfied with the communication interface with the referring physicians. Psychiatrists' level of satisfaction was related to the quantity and quality of information provided by referring physicians.

Ambulatory Care↗
PubMedDate not supplied

Comparing the national economic burden of five chronic conditions.

Using a nationally representative sample of 23,230 U.S. residents, we examine patterns of economic burden across five chronic conditions: mood disorders, diabetes, heart disease, asthma, and hypertension. Almost half of U.S. health care costs in 1996 were borne by persons with one or more of these five conditions; of that spending amount, only about one-quarter was spent on treating the conditions themselves and the remainder on coexistent illnesses. Each condition demonstrated substantial economic burden but also unique characteristics and patterns of service use driving those costs. The findings highlight the differing challenges involved in understanding needs and improving care across particular chronic conditions.

Absenteeism↗