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Psychiatric diagnosis by telephone: is it an opportunity?

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Abstract

Background

For reasons of feasibility, diagnostic telephone interviews are frequently used in research of psychiatric morbidity. However, it is unknown whether diagnostic telephone interviews are as valid as diagnostic face-to-face interviews.

Research question

Are diagnostic telephone interviews for psychiatric disorders as valid as diagnostic face-to-face interviews?

Method

A systematic review of original studies in PubMed, PsychINFO and Embase was carried out. We included studies considering (1) the sensitivity and specificity of diagnostic telephone interviews using face-to-face interviews as a golden standard and (2) the agreement between diagnostic telephone and diagnostic face-to-face interviews. Eligible were studies in the general population, in patients at risk for psychiatric disorders and in psychiatric outpatients. We assessed risk of bias with the quality assessment of diagnostic accuracy studies (QUADAS) instrument.

Results

We included sixteen studies. The included studies were generally small with thirteen studies reporting about <100 participants. Specificity was generally high in populations with low or intermediate prevalence of psychiatric morbidity. Sensitivity was low in these populations, but slightly higher in samples with more psychiatric disorders. Studies with a higher risk of psychiatric disorders generally reported higher percentages of agreement and higher kappa values. Considering the QUADAS-2 criteria, most studies had a medium or high risk of bias, especially concerning patient selection and unbiased judgement of the test. Of the six studies with a medium or low risk of bias, the three studies assessing current anxiety and depressive disorders yielded kappa values between 0.69 and 0.84, indicating good agreement.

Discussion

There is insufficient evidence that diagnostic telephone interviews for the diagnosis of psychiatric disorders are valid, although results for depression and anxiety disorders seem promising.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. 117 Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Esther M. H. Muskens, Peter Lucassen, Wilke Groenleer & Chris van Weel

  2. Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia

    Chris van Weel

  3. University Center for Psychiatry and Interdisciplinary Center for Psychopathology of Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Richard Oude Voshaar

  4. Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Anne Speckens

Authors
  1. Esther M. H. Muskens
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  2. Peter Lucassen
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  3. Wilke Groenleer
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  4. Chris van Weel
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  5. Richard Oude Voshaar
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Corresponding author

Correspondence to Esther M. H. Muskens.

Appendix: PubMed search string

Appendix: PubMed search string

(bipolar disorders[mesh] OR bipolar disorders[tiab] OR bipolar disorder[tiab] OR “Anxiety Disorders”[Mesh] OR Anxiety Disorder[tiab] OR Anxiety Disorders[tiab] OR “depressive disorder”[Mesh] OR depressive disorder[tiab] OR depressive disorders[tiab] OR depression[tiab] OR depressions[tiab] OR Mental Disorders[tiab] OR mental disorder[tiab] OR DSM[tiab] OR “Diagnostic and Statistical Manual of Mental Disorders”[Mesh] OR psychiatric) AND (“Interview, Psychological”[Mesh] OR interview[tiab] OR interviews[tiab] OR interviewing[tiab] OR “Interviews as Topic”[Mesh] OR telephone-administered[tiab] OR face to face[tiab] OR questionnaires[mesh]) AND (“Diagnosis”[Mesh] OR Diagnosis[tiab] OR diagnoses[tiab] OR diagnostic[tiab] OR assessment[tiab] OR measuring[tiab]) AND (“Telephone”[Mesh] OR telephone[tiab] OR phone[tiab]).

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Muskens, E.M.H., Lucassen, P., Groenleer, W. et al. Psychiatric diagnosis by telephone: is it an opportunity?. Soc Psychiatry Psychiatr Epidemiol 49, 1677–1689 (2014). https://doi.org/10.1007/s00127-014-0861-9

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  • DOI: https://doi.org/10.1007/s00127-014-0861-9

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