Quality Measures Database

Changes to or the characteristics of the health status of an individual which may lead to distress, interference with daily activities, or contact with health services. This also includes symptom severity.

The Primary Care Evaluation of Mental Disorders (PRIME-MD) (Spitzer et al. 1994) is an instrument designed to assist the primary care physician in efficiently and accurately diagnosing the mental disorders that are most commonly seen in adults in primary care settings.

The PRIME-MD was specifically designed for use by nonpsychiatric primary care physicians. Because of its simplicity and efficiency in time of administration, it may also be useful as a quick assessment tool for psychiatrists evaluating patients with anxiety, depressive, or somatic symptoms. Its limitations are that it covers only a few of the psychiatric diagnoses encountered in psychiatric settings and it ignores certain aspects of the criteria for the disorders that it does cover, such as the impairment and differential diagnosis criteria.

PRIME-MD has two components: the one-page Patient Questionnaire (PQ), which is completed by the patient before he or she sees the physician, and the nine-page Clinician Evaluation Guide (CEG), which is a structured interview that the physician uses to follow up on items checked positive on the PQ.

Of the 16 diagnostic categories covered by the PRIME-MD system, 8 correspond to specific DSM-IV diagnoses: major depressive disorder, partial remission of major depressive disorder, dysthymic disorder, panic disorder, generalized anxiety disorder, bulimia nervosa (purging type), bulimia nervosa (nonpurging type), and multisomatoform disorder (a severe form of undifferentiated somatoform disorder). Five PRIME-MD diagnoses are subthreshold because they are characterized by fewer symptoms than are required for specific diagnoses. The subthreshold diagnoses are minor depressive disorder, anxiety disorder not otherwise specified, probable alcohol abuse or dependence, binge eating disorder, and somatoform disorder not otherwise specified. Finally, three rule-out (R/O) diagnoses are included: R/O bipolar disorder; R/O depressive disorder due to general medical condition, medication, or other drug; and R/O anxiety disorder due to general medical condition, medication, or other drug. The final diagnoses are checked off on a diagnostic summary sheet.

Spitzer RL, Williams JB, Kroenke K, Linzer M, deGruy FV 3rd, Hahn SR, Brody D, Johnson JG. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA. 1994 Dec 14;272(22):1749-56.
PMID: 7966923

V: Validated scale: Research has been conducted to determine it has at least some properties associated with a high quality scale

Ratings-based Rank Relevance 110 Actionability 100 Overall Importance 117		Stakeholder Rank Academics 106 Clinicians 118 Consumers 107 Decision Makers 114 �		Special Group Rank First Nations 93 Rural Areas 89 Federal Stakeholders 139
Regional Rank BC AB SK MB ON QC NB NS PE NL YT NT NU 89 96 100 59 106 124 69 91 124 91 24 132 57				Overall Rank        111