Skip to main content
PMC home page
International Journal of Methods in Psychiatric Research logoLink to International Journal of Methods in Psychiatric Research
. 2009 Jun 8;18(2):84–95. doi: 10.1002/mpr.280

Lessons learned from the clinical reappraisal study of the Composite International Diagnostic Interview with Latinos

Margarita Alegria 1,2,✉, Patrick E Shrout 3, Maria Torres 4, Roberto Lewis‐Fernández 5, Jamie M Abelson 6, Meris Powell 7, Alejandro Interian 8, Julia Lin 1,2, Mara Laderman 1, Glorisa Canino 9
PMCID: PMC2729144  NIHMSID: NIHMS107634  PMID: 19507168

Abstract

Given recent adaptations of the World Health Organization's World Mental Health Composite International Diagnostic Interview (WMH‐CIDI), new methodological studies are needed to evaluate the concordance of CIDI diagnoses with clinical diagnostic interviews. This paper summarizes lessons learned from a clinical reappraisal study done with US Latinos. We compare CIDI diagnoses with independent clinical diagnosis using the World Mental Health Structured Clinical Interview for DSM‐IV (WMH‐SCID 2000). Three sub‐samples stratified by diagnostic status (CIDI positive, CIDI negative, or CIDI sub‐threshold for a disorder) based on nine disorders were randomly selected for a telephone re‐interview using the SCID. We calculated sensitivity, specificity, and weight‐adjusted Cohen's kappa. Weighted 12 month prevalence estimates of the SCID are slightly higher than those of the CIDI for generalized anxiety disorder, alcohol abuse/dependence, and drug abuse/dependence. For Latinos, CIDI‐SCID concordance at the aggregate disorder level is comparable, albeit lower, to other published reports. The CIDI does very well identifying negative cases and classifying disorders at the aggregate level. Good concordance was also found for major depressive episode and panic disorder. Yet, our data suggests that the CIDI presents problems for assessing post‐traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD). Recommendations on how to improve future versions of the CIDI for Latinos are offered. Copyright © 2009 John Wiley & Sons, Ltd.

Keywords: concordance, reliability, validity, diagnosis, CIDI, SCID, Latinos

Full Text

The Full Text of this article is available as a PDF (185.7 KB).

REFERENCES

  1. Alarcon R.D. (1995) Culture and psychiatric diagnosis: Impact on DSM‐IV and ICD‐10. The Psychiatric Clinics of North America, 18, 449–465. [PubMed] [Google Scholar]
  2. Alegría M., Takeuchi D., Canino G., Duan N., Shrout P., Meng X.‐L. et al (2004) Considering context, place and culture: The National Latino and Asian American Study. International Journal of Methods in Psychiatric Research, 13(4), 208–220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. American Psychiatric Association (APA) . (1994) Diagnostic and Statistical Manual of Mental Disorders – 4th Edition, American Psychiatric Association. [Google Scholar]
  4. Andrews G. (2000) Case ascertainment: The Composite International Diagnostic Interview. Australian and New Zealand Journal of Psychiatry, 34, S161–S163. [DOI] [PubMed] [Google Scholar]
  5. Andrews G., Peters L. (1998) The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry & Psychiatric Epidemiology, 33, 80–88. [DOI] [PubMed] [Google Scholar]
  6. Andrews G., Peters L., Guzman A., Bird K. (1995) A comparison of two structured diagnostic interviews: CIDI and SCAN. Australian and New Zealand Journal of Psychiatry, 29, 124–132. [DOI] [PubMed] [Google Scholar]
  7. Antai‐Otong D. (2002) Culture and traumatic events. Journal of the American Psychiatric Nurses Association, 8(6), 203–208. [Google Scholar]
  8. Bravo M., Canino G., Rubio‐Stipec M., Woodbury M. (1991) A cross‐cultural adaptation of a diagnostic instrument: The DIS adaptation in Puerto Rico. Culture, Medicine and Psychiatry, 15, 1–18. [DOI] [PubMed] [Google Scholar]
  9. Brugha T., Jenkins R., Taub N., Meltzer H., Bebbington P. (2001) A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Psychological Medicine, 31, 1001–1013. [DOI] [PubMed] [Google Scholar]
  10. Canino G., Shrout P.E., Rubio‐Stipec M., Bird H.R., Bravo M., Ramirez R. et al (2004) The DSM‐IV rates of child and adolescent disorders in Puerto Rico: Prevalence, correlates, service use, and the effects of impairment. Archives of General Psychiatry, 61(1), 85–93. [DOI] [PubMed] [Google Scholar]
  11. Colpe L., Merikangas K., Cuthbert B., Bourdon K. (2004) Guest editorial. International Journal of Methods in Psychiatric Research, 13(4), 193–194. [Google Scholar]
  12. Correll C., Linden M. (2005) Psychotropic drug presentation in medical and lay press journals. Pharmacopsychiatry, 38(4), 161–165. [DOI] [PubMed] [Google Scholar]
  13. Elsass P. (2001) Individual and collective traumatic memories: A qualitative study of post‐traumatic stress disorder symptoms in two Latin American localities. Transcult Psychiatry, 38(3), 306–316. [Google Scholar]
  14. Feder M. (2007) Variance Estimation of the Survey‐weighted Kappa Measure of Agreement, JSM Proceedings. [Google Scholar]
  15. First M.B., Spitzer R.L., Gibbon M., Williams J. (1998) Structured Clinical Interview for DSM‐IV Axis I Disorders, Patient Edition (SCID‐I/P, Version 2.0, 9/98 revision), Biometrics Research Department, New York State Research Institute. [Google Scholar]
  16. Fleiss J.L., Levin B., Paik M.C. (2003) Statistical Methods for Rates and Proportions, 4th Edition, Hoboken, NJ: John Wiley & Sons. [Google Scholar]
  17. Grant B. (1996) Prevalence and correlates of drug use and DSM‐IV drug dependence in the United States: Results of the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse, 8(2), 195–210. [DOI] [PubMed] [Google Scholar]
  18. Haro J., Arbabzadeh‐Bouchez S., Brugha T., Girolamo G., Guyer M., Jin R. et al (2006) Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. International Journal of Methods in Psychiatric Research, 15(4), 167–180. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Hernandez P. (2002) Trauma in war and political persecution: Expanding the concept. American Journal of Orthopsychiatry, 72(1), 16–25. [PubMed] [Google Scholar]
  20. Hernandez P., Gangsei D., Engstrom D. (2007) Vicarious resilience: A new concept in work with those who survive trauma. Family Process, 46(2), 229–241. [DOI] [PubMed] [Google Scholar]
  21. Jackson J., Torres M., Caldwell C., Neighbors H., Nesse R., Taylor R.J. et al (2004) The National Survey of American Life: A study of racial, ethnic and cultural influences on mental disorders and mental health. International Journal of Methods in Psychiatric Research, 13(4), 196–207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Janca A., Robins L., Bucholz K., Early T., Shayka J. (1992) Comparison of Composite International Diagnostic Interview and clinical DSM‐III‐R criteria checklist diagnoses. Acta Psychiatrica Scandinavica, 85, 440–443. [DOI] [PubMed] [Google Scholar]
  23. Kessler R., Merikangas K. (2004) The National Comorbidity Survey Replication (NCS‐R): Background and aims. International Journal of Methods in Psychiatric Research, 13(2), 60–68. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Kessler R., Ustun T. (2004) The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13(2), 93–121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Kessler R., Abelson J., Demler O., Escobar J., Gibbon M., Guyer M. et al (2004) Clinical calibration of DSM‐IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Inverview (CIDI). International Journal of Methods in Psychiatric Research, 13(2), 122–139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Kleinman A. (1987) Anthropology and psychiatry: The role of culture in cross‐cultural research on illness. British Journal of Psychiatry, 151, 447–454. [DOI] [PubMed] [Google Scholar]
  27. Komiti A.A., Jackson H.J., Judd F.K., Cockram A.M., Kyrios M., Yeatman R. et al (2001) A comparison of the Composite International Diagnostic Interview (CIDI‐Auto) with clinical assessment in diagnosing mood and anxiety disorders. Australian and New Zealand Journal of Psychiatry, 35, 224–230. [DOI] [PubMed] [Google Scholar]
  28. Kurdyak A., Gnam W. (2005) Small signal, big noise: Performance of the CIDI depression module. Canadian Jounral of Psychiatry, 50(13), 851–856. [DOI] [PubMed] [Google Scholar]
  29. Mellsop G., Varghese F., Joshua S., Hicks A. (1982) The reliability of axis II of DSM‐III. American Journal of Psychiatry, 139, 1360–1361 [DOI] [PubMed] [Google Scholar]
  30. Peters L., Andrews G. (1995) Procedural calidity of the computerized version of the Composite International Diagnostic Interview (CIDI‐Auto) in the anxiety disorders. Psychological Medicine, 25(6), 1269–1280. [DOI] [PubMed] [Google Scholar]
  31. Spitzer R., Fleiss J. (1974) A re‐analysis of the reliability of psychiatric diagnosis. British Journal of Psychiatry, 125, 341–347. [DOI] [PubMed] [Google Scholar]
  32. Wittchen H. (1994) Reliability and validity studies of the WHO‐Composite International Diagnostic Interview (CIDI): A critical review. Psychiatry Research, 28, 57–84. [DOI] [PubMed] [Google Scholar]
  33. Wittchen H., Kessler R., Zhao S., Abelson J. (1995) Reliability and clinical validity of UM‐CIDI DSM‐III‐R generalized anxiety disorder. Journal of Psychiatric Research, 29(2), 95–110. [DOI] [PubMed] [Google Scholar]
  34. World Health Organization (WHO) . (1995) Composite International Diagnostic Interview (CIDI), version 2.1, WHO. [Google Scholar]
  35. World Mental Health Survey Consortium . (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Journal of the American Medical Association, 291(21), 2581–2590. [DOI] [PubMed] [Google Scholar]

Articles from International Journal of Methods in Psychiatric Research are provided here courtesy of Wiley

RESOURCES