Abstract
Despite the fact that, in today's psychiatric research and especially in epidemiological studies, diagnostic assessments are made with reliable standardized clinical interviews, recent articles have shown discrepancies in prevalence rates of DSM IV axis I disorders assessed with different, yet reliable, clinical standardized interviews, raising the problem of the clinical relevance of some of these instruments.
Within an epidemiological study, we developed a simple method for evaluating DSM IV axis I disorders with the aim of improving the clinical relevance of assessed diagnoses. This method is based on an evaluation performed by two clinicians. The first one used a short structured clinical interview (MINI v 5.0) and the second one completed the procedure with an open clinical interview, intended to be more clinically relevant. Finally, a consensus diagnosis is given by the two investigators. We conducted a survey in order to validate this method by measuring the agreement of diagnoses reported by two pairs of clinicians on a population of 20 inpatients. Results show that this double evaluation led to a high agreement (kappa ranging between 0.76 and 1.00) suggesting that the proposed evaluation procedure, which is intended to be more clinically relevant, is also highly reliable. Copyright © 2002 Whurr Publishers Ltd.
Keywords: validation, diagnostic procedure, kappa coefficient, DSM IV axis I disorder, standardized interview
Full Text
The Full Text of this article is available as a PDF (6.6 MB).
References
- American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Washington DC: American Psychiatric Association, 1994. [Google Scholar]
- Anthony JC, Folstein MF, Romanoski AJ, Von Korff MR, Nestadt G S, Kramer M, Gruenberg E. Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis: experience in eastern Baltimore. Arch Gen Psychiatry 1985; 42: 667–75. [DOI] [PubMed] [Google Scholar]
- Eaton Ww, Neufeld K, Chen LS, Cai G. A comparison of self report and clinical diagnostic interviews for depression: diagnostic interview schedule and schedules for clinical assessment in neuropsychiatry in the Baltimore Epidemiologic catchment area follow‐up. Arch Gen Psychiatry 2000; 57:217–22. [DOI] [PubMed] [Google Scholar]
- Helzer JE, Robins LN, Mcevoy LT, Spitznagel EL, Stoltzman RK, Farmer A, Brockington IF. A comparison of clinical and diagnostic interview schedule diagnoses: reexamination of lay‐interviewed cases in the general population. Arch Gen Psychiatry 1985; 42: 657–66. [DOI] [PubMed] [Google Scholar]
- Ihaka R, Gentleman RR. A Language for Data Analysis and Graphics. Journal of Computational and Graphical Statistics 1996; 5(3): 299–314. [Google Scholar]
- Murphy JM, Laird NM, Monson RR, Sobol AM, Leighton AH. A comparison of diagnostic interviews for depression in the Stirling County Study: challenges for psychiatric epidemiology. Arch Gen Psychiatry 2000; 57: 230–6. [DOI] [PubMed] [Google Scholar]
- Murphy JM, Monson RR, Laird NM, Sobol AM, Leighton AH. Identifying depression and anxiety in a forty‐year epidemiological investigation: the Stirling County Study. Int J Methods Psychiatr Res 1998; 7: 89–109. [Google Scholar]
- Murphy JM, Neff RK, Sobol AM, Rice JX, Olivier DC. Computer diagnosis of depression and anxiety: the Stirling County Study. Psychol Med 1985; 15: 99–112. [DOI] [PubMed] [Google Scholar]
- Narrow WE, Rae DS, Robins LN, Regier DA. Revised prevalence estimates of mental disorders in the United States. Arch Gen Psychiatry 2002; 59: 115–123. [DOI] [PubMed] [Google Scholar]
- Robins LN, Helzer JE, Croughan J, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry 1981; 8: 381–9. [DOI] [PubMed] [Google Scholar]
- Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini‐International Neuropsychiatric Interview (MINI: the development and validation of a structured diagnostic psychiatric interview for DSM‐IV and ICD‐10. J Clin Psychiatry 1998; 59 Suppl 20: 22–33; quiz 34–57. [PubMed] [Google Scholar]