Development and validation of the Client Diagnostic Questionnaire (CDQ): a mental health screening tool for use in HIV/AIDS service settings

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Abstract
This study examines the validity, feasibility, and utility of the Client Diagnostic Questionnaire (CDQ), a brief diagnostic screening tool designed for use by non-mental health professionals and designed specifically to assess the range of psychiatric disorders known to be prevalent among persons infected with HIV or at high risk of infection: depression, anxiety, PTSD, substance abuse. Non-clinically trained personnel administered the CDQ to a diverse sample of 260 HIV infected individuals at six primary care or social service agencies; a second interview was conducted by an experienced mental health clinician. There was good agreement between positive screen on the CDQ and diagnosis made by an independent mental health professional. For the diagnosis of any disorder, sensitivity = 91%, specificity = 78%, and overall accuracy = 85%. Clients who screened positive for disorder based on the CDQ interview had significantly impaired mental health functioning compared to individuals without CDQ screening diagnosis. CDQ was well received by both clients and agency staff. Findings support the feasibility and utility of the CDQ. The CDQ can be used by providers in a range of service settings to identify persons in need of formal mental health assessment and treatment, to more effectively target scarce mental health resources, and to reduce the negative impact of unrecognized disorder on the health and well-being of individuals in their care.

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