Normal controls are expensive to find: Methods to improve cost-effectiveness of the screening evaluation

• Published in: Psychiatry research Vol. 136; no. 1; pp. 69 - 78
• Main Authors: Schechter, Dianne, Lebovitch, Rochelle
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 15.07.2005; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Alcoholism - diagnosis; Alcoholism - economics; Alcoholism - rehabilitation; Anxiety Disorders - diagnosis; Anxiety Disorders - economics; Anxiety Disorders - epidemiology; Biological and medical sciences; Comparison subjects; Computer processing; Cost-Benefit Analysis; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - economics; Depressive Disorder, Major - epidemiology; Female; Fundamental and applied biological sciences. Psychology; Humans; Interview, Psychological; Male; Mass Screening - economics; Mass Screening - methods; Mental disorders; Middle Aged; Patient Selection; Psychiatric research; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychometrics. Statistics. Methodology; Recruitment; Research methodology; Volunteer; Comparison subjects; Mental disorders; Research methodology; Volunteer; Psychiatric research; Recruitment; Human; Evaluation; Healthy subject; Methodology; Medical screening; Volunteering; Scientific research; Mental disorder
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2005.06.002

A program for the recruitment of control subject is examined by considering the yield of healthy subjects as a function of the initial screening interview. All subjects who passed the screen also completed a diagnostic evaluation for lifetime history of mental disorders. Version 1 of the screen focused on excluding individuals who were currently mentally ill. Approximately 20% met criteria for Never Mentally Ill (NMI); 7% had one episode of a minor mental disorder (MMD); 43% were currently not mentally ill, but had a serious history of mental illness (CNMI); and 30% were currently mentally ill (CMI). Revision of the screen to exclude individuals with any history of treatment for mental illness significantly improved the proportion of NMI subjects (29%), and there was a trend for a decreased proportion of CMI subjects (25%). Additional revision of the screen to exclude individuals with a history of selected untreated mental disorders resulted in a significantly greater proportion of NMI subjects (50%), and a significantly lower proportion of CMI (17%) subjects. The results of this investigation demonstrate that the cost-effectiveness of the initial screen can be greatly improved by expanding the evaluation to include selected untreated as well as treated mental disorders.