Usefulness of the PERI demoralization scale to screen for psychiatric disorder in a community sample

The authors gave the PERI Demoralization Scale (PERI-D), a measure of nonspecific psychological distress, to 528 subjects drawn from a larger longitudinal community survey. Respondents also were interviewed using the Schedule for Affective Disorders and Schizophrenia (SADS), a structured clinical interview. Based on the SADS, subjects were given diagnoses based on Research Diagnostic Criteria (RDC). The results corroborate earlier findings of a modest relationship between self-reported symptoms of distress and the diagnosis of clinical psychiatric disorder. There was somewhat better fit between RDC diagnoses of depression, particularly major depression, and PERI-D symptom scores, suggesting the PERI-D items may be slightly more useful for detecting cases of depression in the community than for the broader range of psychiatric disorders. In general, the authors concur with earlier writers who suggest that brief psychiatric symptom scales may be useful as screening tests in community surveys, but such instruments do not in themselves provide good estimates of the prevalence of clinical psychiatric disorder in the community.