The MDS-7: A Brief Mental Disorder Screener for Improved Diagnostic Accuracy

Objective: To demonstrate the problems with current methods of mental disorder diagnosis and to then provide a brief and accurate mental disorder screener suitable for use by general medical practitioners, psychiatrists, and other mental health professionals. Method: Expert review of inter-clinician diagnostic agreement studies followed by development of a new brief mental disorder screener. Results: Diagnostic agreement based on the typical in-office consultation is unacceptably low even for broad diagnoses and even lower for the diagnosis of specific disorders. Agreement, moreover, does not mean that the diagnosis is accurate. More accurate diagnosis can be obtained with the DSM-based SCID structured clinical interview but this requires extensive training and takes far too long to be usable in practice. A brief and accurate mental disorder screener is clearly needed, and the present author offers one in this article. Called the MDS-7, its brevity is attributable to the present author’s core symptoms principle, which states that if the presenting patient does not have the core symptoms of the disorder, then the patient cannot possibly have that disorder. Hierarchical scoring of the MDS-7 provides improved accuracy for differentially diagnosing mental disorders. Conclusions: The MDS-7, available in this article and easily translatable into other languages, provides a brief and more accurate way to make the initial diagnosis.