A comparison of self-reports of distress and affective disorder diagnoses in rheumatoid arthritis: A receiver operator characteristic analysis
Article first published online: 3 JUN 2003
Copyright © 2003 by the American College of Rheumatology
Arthritis Care & Research
Volume 49, Issue 3, pages 368–376, 15 June 2003
How to Cite
McQuillan, J., Fifield, J., Sheehan, T. J., Reisine, S., Tennen, H., Hesselbrock, V. and Rothfield, N. (2003), A comparison of self-reports of distress and affective disorder diagnoses in rheumatoid arthritis: A receiver operator characteristic analysis. Arthritis & Rheumatism, 49: 368–376. doi: 10.1002/art.11116
- Issue published online: 3 JUN 2003
- Article first published online: 3 JUN 2003
- Manuscript Accepted: 10 JUL 2002
- Manuscript Received: 5 FEB 2002
- Arthritis Foundation
- NIAMS Grant. Grant Number: AR-20621
- Affective disorder;
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.
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).
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.
All 3 self-reports have high combined sensitivity and specificity as measures of affective disorders among RA patients.