Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) supplement

Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully‐structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School‐age Children (K‐SADS). This assessment is carried out in the clinical reappraisal sub‐sample (n = 347) of the US National Comorbidity Survey Adolescent (NCS‐A) supplement, a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the United States. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K‐SADS diagnoses [area under the receiver operating characteristic curve (AUC) = 0.81–0.94], although the CIDI diagnoses are consistency somewhat higher than the K‐SADS diagnoses. Data are also presented on criterion‐level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes. Copyright © 2011 John Wiley & Sons, Ltd.     

Diagnostic validity across racial and ethnic groups in the assessment of adolescent DSM‐IV disorders

We examine differential validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) diagnoses assessed by the fully‐structured Composite International Diagnostic Interview Version 3.0 (CIDI) among Latino, non‐Latino Black, and non‐Latino White adolescents in comparison to gold standard diagnoses derived from the Schedule for Affective Disorders and Schizophrenia for School‐age Children (K‐SADS). Results are based on the National Comorbidity Survey Replication Adolescent Supplement, a national US survey of adolescent mental health. Clinicians re‐interviewed 347 adolescent/parent dyads with the K‐SADS. Sensitivity and/or specificity of CIDI diagnoses varied significantly by ethnicity/race for four of ten disorders. Modifications to algorithms sometimes reduced bias in prevalence estimates, but at the cost of reducing individual‐level concordance. These findings document the importance of assessing fully‐structured diagnostic instruments for differential accuracy in ethnic/racial subgroups. Copyright © 2012 John Wiley & Sons, Ltd.     

Attention deficit hyperactivity disorder: concordance of the adolescent version of the Composite International Diagnostic Interview Version 3.0 (CIDI) with the K‐SADS in the US National Comorbidity Survey Replication Adolescent (NCS‐A) supplement

This paper evaluates the internal consistency reliability and concurrent validity of the assessment of Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV) attention deficit hyperactivity disorder (ADHD) in the adolescent version of the World Health Organization (WHO) Composite International Diagnostic Interview Version 3.0 (CIDI). The CIDI is a lay‐administered diagnostic interview that was carried out in conjunction with the US National Comorbidity Survey Adolescent Supplement, a US nationally representative survey of 10,148 adolescents and their parents. Internal consistency reliability was evaluated using factor and item response theory analyses. Concurrent validity was evaluated against diagnoses based on blinded clinician‐administered interviews. Inattention and hyperactivity‐impulsivity items loaded on separate but correlated factors, with hyperactivity and impulsivity items forming a single factor in parent reports but separate factors in youth reports. We were able to differentiate hyperactivity and impulsivity factors for parents as well by eliminating a subset who endorsed zero ADHD items from the factor analysis. Although concurrent validity was relatively weak, decomposition showed that this was due to low validity of adolescent reports. A modified CIDI diagnosis based exclusively on parent reports generated a diagnosis that had good concordance with clinical diagnoses [area under the curve (AUC) = 0.78]. Implications for assessing ADHD using the CIDI and the effect of different informants on measurement are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Diagnostic Interview for Genetic Studies (DIGS): inter-rater and test-retest reliability and validity in a Spanish population.

OBJECTIVE: To test the reliability and validity of the DIGS in Spanish population. METHODS: Inter-rater and test-retest reliability of the Spanish version of DIGS was tested in 95 inpatients and outpatients. The resultant diagnoses were compared with diagnoses obtained by the LEAD (Longitudinal Expert All Data) procedure as "gold standard". The kappa statistic was used to measure concordance between blind inter-raters and between the diagnoses obtained by LEAD procedure and through the DIGS. RESULTS: Overall kappa coefficient for inter-rater reliability was 0.956. The kappa value for individual diagnosis varied from major depression=0.877 to schizophrenia=1. Test-retest reliability was 0.926. Kappa for all individual target diagnoses ranged from 0.776 (major depression) to 1. Kappa between LEAD procedure and DIGS ranged from 0.704 (major depression) to 0.825 (bipolar I disorder). CONCLUSION: Most of the DSM-IV major psychiatric disorders can be assessed with acceptable to excellent reliability with the Spanish version of the DIGS interview. The Spanish version of DIGS showed an acceptable to excellent concurrent validity. Giving the good reliability and validity of Spanish version of DIGS it should be considered to identify psychiatric phenotypes for genetics studies.     

Cross‐prevalence of migraine and bipolar disorder

Ortiz A, Cervantes P, Zlotnik G, van de Velde C, Slaney C, Garnham J, Turecki G, O’Donovan C, Alda M. Cross‐prevalence of migraine and bipolar disorder.
Bipolar Disord 2010: 12: 397–403. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S. Objective: In two related studies, we explored the prevalence of migraine and its associated clinical characteristics in patients with bipolar disorder (BD) as well as psychiatric morbidity in patients treated for migraine. Method: The first study included 323 subjects with BD type I (BD I) or BD type II (BD II), diagnosed using the Schedule for Affective Disorders and Schizophrenia, Lifetime version (SADS‐L) format, or the Structured Clinical Interview for DSM‐IV Axis I Disorders (SCID). Migraine history was assessed by means of a structured questionnaire. In a second sample of 102 migraine patients, we investigated current and lifetime psychiatric morbidity using the SADS‐L. Statistical analyses were conducted using nonparametric analysis and log‐linear models. Results: A total of 24.5% of BD patients had comorbid migraine; those with BD II had a higher prevalence (34.8%) compared to BD I (19.1%) (p < 0.005). BD patients with comorbid migraine had significantly higher rates of suicidal behaviour, social phobia, panic disorder, generalized anxiety disorder, and obsessive‐compulsive disorder (all p < 0.05). In the sample of migraine patients, 34.3% had a current psychiatric diagnosis, and 73.5% had a lifetime psychiatric diagnosis. The prevalence of BD I was 4.9%, and 7.8% for BD II. Discussion: Migraine is prevalent within the BD population, particularly among BD II subjects. It is associated with an increased risk of suicidal behaviour and comorbid anxiety disorders. Conversely, migraine sufferers have high rates of current and lifetime psychopathology. A greater understanding of this comorbidity may contribute to our knowledge of the underlying mechanisms of BD.     

A Structured Clinical Interview for Kleptomania (SCI‐K): preliminary validity and reliability testing

Kleptomania presents difficulties in diagnosis for clinicians. This study aimed to develop and test a DSM‐IV‐based diagnostic instrument for kleptomania. To assess for current kleptomania the Structured Clinical Interview for Kleptomania (SCI‐K) was administered to 112 consecutive subjects requesting psychiatric outpatient treatment for a variety of disorders. Reliability and validity were determined. Classification accuracy was examined using the longitudinal course of illness. The SCI‐K demonstrated excellent test‐retest (Phi coefficient = 0.956 (95% CI = 0.937, 0.970)) and inter‐rater reliability (phi coefficient = 0.718 (95% CI = 0.506, 0.848)) in the diagnosis of kleptomania. Concurrent validity was observed with a self‐report measure using DSM‐IV kleptomania criteria (phi coefficient = 0.769 (95% CI = 0.653, 0.850)). Discriminant validity was observed with a measure of depression (point biserial coefficient = −0.020 (95% CI = −0.205, 0.166)). The SCI‐K demonstrated both high sensitivity and specificity based on longitudinal assessment. The SCI‐K demonstrated excellent reliability and validity in diagnosing kleptomania in subjects presenting with various psychiatric problems. These findings require replication in larger groups, including non‐psychiatric populations, to examine their generalizability. Copyright © 2006 John Wiley & Sons, Ltd.     

Translation and validation of the 15‐item Myasthenia Gravis Quality of life scale in Dutch

Introduction: The 15‐item Myasthenia Gravis Quality of Life (MG‐QOL15) scale has been developed to assess the health‐related quality of life of patients with myasthenia gravis (MG). The aim of this study was to translate the original English version into Dutch and to test the test–retest reliability and construct validity. Methods: Fifty patients with MG were included. Test–retest reliability and internal consistency were assessed using the intraclass correlation coefficient (ICC) and the Cronbach α. Construct validity was assessed by testing 5 predefined hypotheses. Results: A good test–retest reliability was confirmed with an ICC of 0.866. The Cronbach α was 0.93. The predefined hypotheses were confirmed in 80% of cases, which points to good construct validity. Discussion: The Dutch MG‐QOL15 has good test–retest reliability and good construct validity. It can be used for research in a Dutch‐speaking population. It is also suitable for monitoring individual patients in clinical practice. Muscle Nerve 57 : 206–211, 2018     

Validation of the Korean version of the Eppendorf Schizophrenia Inventory as a screening measure to detect adolescents at ultra‐high risk for psychosis

Aim: No validated self‐report scale is available for use as a screening tool to detect non‐help‐seeking adolescents at ultra‐high risk (UHR) for psychosis in a community setting. The study aims to examine the reliability and validity of the Korean version of the Eppendorf Schizophrenia Inventory (K‐ESI) for assessing adolescents at UHR for psychosis in a community setting. Methods: In the first study, to confirm the reliability and discriminant validity of the K‐ESI, community sample (782 adolescents, 281 young adults, 122 early and middle‐aged adults) and outpatients with schizophrenia (109) were recruited. A single cross‐sectional survey was performed using the K‐ESI for the community sample and the K‐ESI and Positive and Negative Syndrome Scale for patients. In the second study, the Korean version of Youth Self Report (K‐YSR) was administered initially to 1002 students. Of the 217 students whose scores were equal to or higher than the cut‐off point of the K‐YSR, 120 who agreed to an in‐depth evaluation were interviewed using the Comprehensive Assessment of At‐Risk Mental States to confirm the predictive validity of the K‐ESI. Results: The K‐ESI showed good internal consistency and excellent test–retest reliability and discriminant validity. However, the factor structure in adolescents was substantially different from that of the original ESI. The best cut‐off point for the K‐ESI to identify UHR adolescents was 29, with a sensitivity of 77% and a specificity of 70%. Conclusion: The results revealed that the K‐ESI can be used as a valid and reliable instrument to identify adolescents at UHR for psychosis in a community setting.     

Parent–child agreement and prevalence estimates of diagnoses in childhood: Direct interview versus family history method

Diagnostic information on children is typically elicited from both children and their parents. The aims of the present paper were to: (1) compare prevalence estimates according to maternal reports, paternal reports and direct interviews of children [major depressive disorder (MDD), anxiety and attention‐deficit and disruptive behavioural disorders]; (2) assess mother–child, father–child and inter‐parental agreement for these disorders; (3) determine the association between several child, parent and familial characteristics and the degree of diagnostic agreement or the likelihood of parental reporting; (4) determine the predictive validity of diagnostic information provided by parents and children. Analyses were based on 235 mother–offspring, 189 father–offspring and 128 mother–father pairs. Diagnostic assessment included the Kiddie‐schedule for Affective Disorders and Schizophrenia (K‐SADS) (offspring) and the Diagnostic Interview for Genetic Studies (DIGS) (parents and offspring at follow‐up) interviews. Parental reports were collected using the Family History – Research Diagnostic Criteria (FH‐RDC). Analyses revealed: (1) prevalence estimates for internalizing disorders were generally lower according to parental information than according to the K‐SADS; (2) mother–child and father–child agreement was poor and within similar ranges; (3) parents with a history of MDD or attention deficit hyperactivity disorder (ADHD) reported these disorders in their children more frequently; (4) in a sub‐sample followed‐up into adulthood, diagnoses of MDD, separation anxiety and conduct disorder at baseline concurred with the corresponding lifetime diagnosis at age 19 according to the child rather than according to the parents. In conclusion, our findings support large discrepancies of diagnostic information provided by parents and children with generally lower reporting of internalizing disorders by parents, and differential reporting of depression and ADHD by parental disease status. Follow‐up data also supports the validity of information provided by adolescent offspring. Copyright © 2009 John Wiley & Sons, Ltd.     

Psychometric evaluation of a Dutch version of the Mini PAS‐ADD for assessing psychiatric disorders in adults with different levels of intellectual disability

Background People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. Method A Dutch version of the Mini PAS‐ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and criterion validity based on a large‐scale random sample (n = 377) and a clinical sample (n = 99) of adults with ID. Results The Dutch version of the Mini PAS‐ADD showed moderate internal consistency, and moderate concordance among informants. Both aspects of the reliability were comparable for different levels of ID. A factor analysis largely confirmed the scale structure. Concurrent validity with the Reiss Screen for Maladaptive Behavior was high for the Depression, Psychosis and Autism scale. The outcome of the criterion‐validity analysis indicated high specificity. The sensitivity for specific psychiatric disorders by the corresponding scales was moderate, but the general sensitivity for the presence of psychopathology on the basis of any of the scales was satisfying. Conclusions The present research reconfirmed the use of the Mini PAS‐ADD as a primary screening device for the identification of mental health problems among people with ID.     

Reliability and validity of the self‐report version of the Panic Disorder Severity Scale in Korea

Background: The self‐report version of the Panic Disorder Severity Scale (PDSS‐SR) has been developed recently and has demonstrated good psychometric properties. However, there is no cross‐cultural evaluation of this scale. The purpose of this study was to confirm the reliability and validity of the PDSS‐SR in Korean subjects. Methods: We studied 148 patients with principal DSM‐IV diagnoses of panic disorder who underwent formal structured diagnostic assessment and the PDSS interview. The participants completed self‐report measures including the PDSS‐SR, Anxiety Sensitivity Index‐Revised, Albany Panic and Phobia Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, and Spielberger State–Trait Anxiety Inventory‐Trait Version. Results: The PDSS‐SR had a single‐factor structure, with all seven items having salient loadings. Cronbach's α for the PDSS‐SR was .88 and intraclass correlation coefficient was .71 between PDSS‐SR and PDSS. Also, the scale showed excellent 1‐day test–retest reliability and demonstrated significant correlation with other anxiety‐related measures. In addition, the PDSS‐SR was sensitive to change with pharmacological treatment. Conclusions: The findings of this study strongly support the reliability and validity of the PDSS‐SR. It is expected that this scale will be helpful in clinical settings and research protocols in Korea. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Psychiatric disorders in people with 22q11.2 Deletion Syndrome: A population‐based prevalence study in Ireland

Background : 22q11.2 Deletion Syndrome (22q11.2 DS) is a common micro‐deletion syndrome associated with intellectual disability, brain abnormalities and a complex spectrum of psychiatric disorders in both adults and children. Many previous studies have shown that adults with 22q11.2 DS have approximately thirty times greater risk for the developing schizophrenia compared to the general population. Furthermore, studies of children and adolescents with 22q11.2 DS have found high rates of psychotic symptoms, ADHD and anxiety disorders. In this study we initially aim to characterize the psychiatric and neuropsychological phenotype of all individuals in Ireland with 22q11.2 DS and then correlate our findings with genetic association studies and brain imaging. We then intend to undertake a longitudinal study to assess for risk factors of future psychotic illness. Methods : Forty‐four individuals with 22q11.2 DS (Mean age = 14 years, SD = 9) were compared to 25 non‐affected sibling controls (Mean age = 12 years, SD = 4). Psychiatric phenotype assessment was performed using a range of standardized clinical assessments including, the Diagnostic Interview Schedule for Children (DISC), Psychotic Supplement of K‐SADS, Comprehensive Assessment of At Risk Mental State (CAARMS), the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), Child Behaviour Checklist (CBCL) and the Social Communication Questionnaire (SCQ). Results : Preliminary data indicates that individuals in the 22q11.2 DS group have a higher prevalence of psychiatric disorders including; ADHD (41%), psychotic symptoms (19%), schizophrenia (2.7%), specific phobias (38%), depressive episodes (11%), and anxiety disorders (32%). Conclusion : This is the first stage in a longitudinal follow‐up study of individuals with 22q11.2DS in Ireland. Our preliminary results are consistent with previous findings of high rates of psychiatric disorders in people with 22q11.2DS. The challenge remains to identify precursor symptoms in childhood that predicts the later development of psychiatric disorders, particularly schizophrenia in this vulnerable group.     

Brain GABA levels across psychiatric disorders: A systematic literature review and meta‐analysis of 1H‐MRS studies

The inhibitory gamma‐aminobutyric acid (GABA) system is involved in the etiology of most psychiatric disorders, including schizophrenia, autism spectrum disorder (ASD) and major depressive disorder (MDD). It is therefore not surprising that proton magnetic resonance spectroscopy (¹H‐MRS) is increasingly used to investigate in vivo brain GABA levels. However, integration of the evidence for altered in vivo GABA levels across psychiatric disorders is lacking. We therefore systematically searched the clinical ¹H‐MRS literature and performed a meta‐analysis. A total of 40 studies (N = 1,591) in seven different psychiatric disorders were included in the meta‐analysis: MDD (N = 437), schizophrenia (N = 517), ASD (N = 150), bipolar disorder (N = 129), panic disorder (N = 81), posttraumatic stress disorder (PTSD) (N = 104), and attention deficit/hyperactivity disorder (ADHD) (N = 173). Brain GABA levels were lower in ASD (standardized mean difference [SMD] = ?0.74, P = 0.001) and in depressed MDD patients (SMD = ?0.52, P = 0.005), but not in remitted MDD patients (SMD = ?0.24, P = 0.310) compared with controls. In schizophrenia this finding did not reach statistical significance (SMD = ?0.23, P = 0.089). No significant differences in GABA levels were found in bipolar disorder, panic disorder, PTSD, and ADHD compared with controls. In conclusion, this meta‐analysis provided evidence for lower brain GABA levels in ASD and in depressed (but not remitted) MDD patients compared with healthy controls. Findings in schizophrenia were more equivocal. Even though future ¹H‐MRS studies could greatly benefit from a longitudinal design and consensus on the preferred analytical approach, it is apparent that ¹H‐MRS studies have great potential in advancing our understanding of the role of the GABA system in the pathogenesis of psychiatric disorders. Hum Brain Mapp 37:3337–3352, 2016. © 2016 Wiley Periodicals, Inc.     

Reliability and Validity of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): Portuguese Version

This study examined the test–retest reliability, consensual, convergent and divergent validities, sensitivity, specificity, positive and negative predictive values, and accuracy of the Portuguese version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL). Eighty-nine children/adolescents (65 psychiatric outpatients and 24 healthy controls) were interviewed with K-SADS-PL and completed measures of depressive and anxiety symptoms. The child’s parent/caretaker completed the Child Behavior Checklist. Good to excellent values were obtained for test–retest reliability and consensual validity. For the convergent validity, moderate correlations between the K-SADS-PL and the corresponding self-report measures were observed. Divergent validity was acceptable for the K-SADS-PL diagnoses. The lowest values of sensitivity, specificity, and accuracy of the K-SADS-PL were 88, 88, and 91, respectively. The Portuguese version of K-SADS-PL proved to be a valid and reliable assessment instrument for children and adolescents, and was sensitive, specific and accurate when diagnosing mood, anxiety, adjustment, and attention-deficit/hyperactivity disorders.

     

The Reliability and Validity of the Korean Version of the Mood and Feelings Questionnaire for Depression in Youth: A Cross-Cultural Perspective

We aimed to assess cross-cultural differences in depressive symptoms and the validity of the Korean version of the Mood and Feelings Questionnaire (MFQ). Four hundred and sixty-four children and adolescents (aged 7–19, 278 girls) with any psychiatric diagnosis, 290 of whom had major depressive disorder, were included. The levels of depressive symptoms in children and adolescents were evaluated by children/adolescents and their parents. We conducted Pearson’s r and Cronbach’s α, confirmative factor analysis and item response theory tests. The Korean version of the MFQ demonstrated excellent criterion validity and discriminant validity. There were no cultural differences in the clinical manifestations of depression in youth from Western countries and Korea. Korean youths with depression were more likely to complain of cognitive and emotional symptoms than somatic symptoms. The Korean version of the MFQ demonstrated promising psychometric properties in a clinical sample of children and adolescents.

     

Translation and validation of the arabic version of the revised 15‐item myasthenia gravis quality‐of‐life questionnaire

Introduction: We sought to translate, culturally adapt, and assess the Arabic version of the 15‐item myasthenia gravis quality‐of‐life revised scale (MGQOL15R). Methods: We assessed reliability with Cronbach α; reproducibility with intraclass correlation coefficient (ICC); validity with Spearman correlations for myasthenia gravis (MG)‐specific activities of daily living (MG‐ADL), MG composite (MGC) score, and MG manual muscle test (MG‐MMT) and with MGQOL15R in patients with different disease severity through the Kruskal–Wallis test; and sensitivity to change with Wilcoxon signed‐rank test. Results: In 65 enrolled patients, the mean MGQOL15R score was 10.84 ± 8.11 (α = 0.94, ICC = 0.95). The correlation coefficients between MGQOL15R and MGC, MG‐ADL, and MG‐MMT scores were 0.75, 0.75, and 0.74, respectively (P < 0.001). MGQOL15R scores were significantly higher (worse) in patients with more severe disease at baseline and significantly lower (better) in improved patients at follow‐up. Discussion: The Arabic version of MGQOL15R is valid, reliable, stable, and sensitive to changes. Muscle Nerve 57 : 581–585, 2018     

The acceptance of the K‐SADS‐PL – potential predictors for the overall satisfaction of parents and interviewers

The presented study investigated the interviewee (parents) and interviewer acceptance of the semi‐structured diagnostic interview Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children Present Lifetime version (KSADS‐PL; German version). Seventeen certified interviewers conducted 231 interviews (interviewers conducted several interviews; interviewees were only questioned once). Interviewees and interviewers anonymously rated their acceptance right after the interview was finished. The nested data structure was analysed regarding an individual interviewer bias and potential predictors of overall satisfaction. Therefore, factors improvable by interviewer training were included, as well as fixed factors which cannot be improved by professional training. The overall satisfaction was evaluated as highly positive with significant higher interviewee and interviewer ratings in the research as compared to the clinical recruitment setting. An individual bias of the interviewer on his or her own acceptance over time, but not on the evaluation of the corresponding interviewee was found. Neither the professional background nor the gender of the interviewer had a significant contribution in predicting these differences. The interviewer model showed no significant change over time and only the interview duration and the interviewee acceptance were significant predictors for interviewer overall satisfaction. Regarding the interviewee model, just the interviewer acceptance was a significant predictor. Copyright Copyright © 2015 John Wiley & Sons, Ltd.     

Validity and reliability of the Structured Clinical Interview for Obsessive‐Compulsive Spectrum (SCI‐OBS) and of the Structured Clinical Interview for Social Phobia Spectrum (SCI‐SHY)

This paper reports on the psychometric properties of the Structured Clinical Interview for Obsessive‐Compulsive Spectrum (SCI‐OBS) and the Structured Clinical Interview for Social Phobia Spectrum (SCI‐SHY). Interviews were administered to 135 patients with psychiatric disorders and 119 controls. During the same session, subjects were given the Mini International Neuropsychiatric Interview (MINI), the Liebowitz Social Anxiety Scale (LSAS), the Checklist for Obsessions and Compulsions and the Yale‐Brown Obsessive‐Compulsive Scale (Y‐BOCS). Patients and raters also answered specific questions on acceptability and usefulness of the interviews. Inter‐rater reliability was assessed by administering the interviews to 36 patients with psychiatric disorders and 12 controls. The internal consistency of all domains of the interviews was from moderate to substantial (Kuder‐Richardson coefficient >0.60). Discriminant validity was excellent. The concurrent validity of the SCI‐SHY versus the LSAS and of the SCI‐OBS versus the Checklist for Obsessions and Compulsions was satisfactory. However, no association was found between Y‐BOCS and the SCI‐OBS domains. Inter‐rater reliability was substantial. Both interviews were rated as meaningful and clear by most subjects. Raters' attitudes toward the utility of these interviews for understanding patients and their foreseeable use in their practice varied, but most were in favour of administering them as self‐report instruments. Copyright © 2000 Whurr Publishers Ltd.     

A Persian translation of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: psychometric properties

Objective

The aim of this study is to assess the reliability and validity of a Persian translation of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders (SCID-I) through a multicenter study in a clinical population in Iran.

Method

The sample consisted of 299 subjects admitted to outpatient or inpatient services of 3 psychiatric centers in Tehran, Iran. The SCID was administered by trained interviewers. To study the test-retest reliability, a second independent SCID interview was administered to 104 of the entire sample within 3 to 7 days of the first interviews. For the assessment of validity, the SCID diagnoses were compared with the consensus clinical diagnoses made by 2 psychiatrists for all 299 patients.

Results

Diagnostic agreements between test and retest SCID administration were fair to good for most diagnostic categories. Overall weighted κ was 0.52 for current diagnoses and 0.55 for lifetime diagnoses. Specificity values for most psychiatric disorders were high (>0.85); the sensitivity values were somewhat lower.

Conclusions

The Persian translation of the SCID yields diagnoses with acceptable to good reliability and validity in a clinical population in Iran. This supports the cross-cultural use of the instrument.     

Secondary mania due to AIDS and cryptococcal meningitis in a 78‐year‐old patient

We report a 78‐year‐old man without past psychiatric history who experienced his first manic episode successfully treated with quetiapine and lorazepam, but was ultimately found to have AIDS and Cryptococcus neoformans meningitis. Our presented case highlights the importance of comprehensive differential diagnoses to rule out secondary causes of psychiatric symptoms presenting for the first time in elderly patients.