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Detection of a Psychiatric Diagnosis in Heart Transplant Candidates with the MBHI
Authors:Robert G Harper  Ranjit C Chacko  Doreen Kotik-Harper  James Young  Jennifer Gotto
Institution:(1) Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, 77030;(2) Memorial Hospital Family Practice Residency Program and Department of Family Medicine, University of Texas Health Sciences Center, USA;(3) Section of Heart Failure and Transplant Medicine, The Cleveland Clinic, USA;(4) Anderson Hospital, USA
Abstract:The utility of the Millon Behavioral Health Inventory (MBHI) in screening for the formal diagnosis of a psychiatric disorder was investigated in a sample of 90 heart transplant candidates, a population at risk for psychiatric disturbance. Psychiatric disorders were identified in 71% of patients, the majority being adjustment disorder. Sensitivity and specificity rates of >70% were determined in discriminant function analyses, for presence or absence of a psychiatric condition. When Axis I conditions were differentiated as ldquomildrdquo (adjustment reaction only) or ldquosevererdquo (all other Axis I conditions, including comorbid Axis II disorders), the MBHI correctly identified every severe case as a probable psychiatric diagnosis. The rate of ldquoclinically significantrdquo elevations on certain MBHI scales and severity of Axis I psychiatric condition was also significantly associated. These findings suggest that the MBHI may have potential utility in identifying high-risk patients with diagnosable psychiatric conditions and help justify mental health consultation referrals at a time when managed care entities are vigorously rationing ancillary services with medically ill populations.
Keywords:heart transplant  psychiatric diagnosis  Millon Behavioral Health Inventory
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