The interrater reliability of a Dutch version of the Structured Clinical Interview for DSM-III-R Personality Disorders.

This study presents data on the interrater reliability of a Dutch version of the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Seventy outpatients were interviewed before the start of their treatment by one rater, while a second rater observed. Both raters were instructed to make independent ratings and the second rater was not allowed to participate in the discussion. On criterion level, interrater reliabilities appear to be very good, with a few exceptions (most reliabilities are higher than 0.75). However, all 5 observation criteria had poor interrater reliabilities. Agreement on personality disorder, on the whole, was excellent (overall kappa = 0.80). The possible reasons why relatively lower reliabilities are found with some criteria are discussed. Finally, problems encountered during the interviews are addressed and possible adjustments of the SCID-II are suggested.     

Acceptability,validity and reliability of the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS): a pilot study

This paper reports on the acceptability, reliability and validity of the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS), a new instrument exploring the interactive pathway between substance abuse and psychiatric disorders. Psychiatric outpatients with (n = 21) and without (n = 32) substance abuse comorbidity according to the DSM-IV, non-psychiatric subjects with opioid dependence (OD, n = 14) and normal controls (n = 33) were assessed with the SCI-SUBS. The presence or absence of psychiatric disorders was determined with the Structured Clinical Interview for DSM IV (SCID). The SCI-SUBS was well accepted by participants. The internal consistency of the domains was satisfactory (between 0.64 and 0.93). Domain scores of OD subjects were significantly higher than those of controls and of psychiatric patients without substance abuse. The cut-off point on the SCI-SUBS total score at which there was optimal discrimination between the presence and the absence of a DSM-IV diagnosis of substance abuse was 45. The pilot version of the SCI-SUBS has satisfactory internal consistency and construct validity.     

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.     

Acceptability and psychometric properties of the Structured Clinical interview for Anorexic‐Bulimic Spectrum (SCI‐ABS)

In this study we evaluated the psychometric properties of the Structured Clinical Interview for the Anorexic‐Bulimic Spectrum (SCI‐ABS), including internal consistency, concurrent validity, discriminant validity and test–retest reliability. We also determine acceptability and feasibility of administration of the interview. The SCI‐ABS was designed to assess typical and atypical symptoms, behaviours and temperament traits pertaining to eating disorders. The interview included 134 items grouped into nine domains, four of which were divided into subdomains. Data were collected from 372 subjects: 55 psychiatric patients with any eating disorder according to DSM‐IV criteria, 118 university students, 141 subjects working out in a gym, and 65 obstetrical patients. Concurrent validity of the instrument was assessed against the Eating Attitude Test (EAT) and the Eating Disorder Inventory (EDI). Thirty‐five subjects were also recruited to study the test–retest reliability and 25 women with any eating disorder were administered both the self‐report and the interview formats of the SCI‐ABS. Internal consistency of domains and subdomains was good. Mean domain and subdomain scores were significantly higher in patients with eating disorders, supporting the discriminant validity of the instrument. Correlation with EAT and EDI indicated good concurrent validity. Test–retest reliability was excellent and the agreement between the interview and self‐report formats was satisfactory. Copyright © 2000 Whurr Publishers Ltd.     

Reliability and validity of Japanese version of the Mini-International Neuropsychiatric Interview

The Mini-International Neuropsychiatric Interview (MINI) is a short, structured diagnostic interview used as a tool to diagnose 16 axis I (Diagnostic and Statistical Manual) DSM-IV disorders and one personality disorder. Its original version was developed by Sheehan and Lecrubier. We translated the MINI into Japanese, and investigated the reliability and validity of the Japanese version of MINI. Eighty-two subjects participated in the validation of the MINI versus the Structured Clinical Interview for DSM-III-R (SCID-P). One hundred and sixty-nine subjects participated in the validation of the MINI versus an expert's professional opinion. Seventy-seven subjects were interviewed by two investigators and subsequently readministered by a third interviewer blind to the results of initial evaluation 1-2 days later. In general, kappa values indicated good or excellent agreement between MINI and SCID-P diagnoses. Kappa values indicated poor agreement between MINI and expert's diagnoses for most diagnoses. Interrater and test-retest reliabilities were good or excellent. The mean durations of the interview were 18.8 min for MINI and 45.4 min for corresponding sections of SCID-P. Overall, the results suggest that the MINI Japanese version succeeds in reliably and validly eliciting symptom criteria used in making DSM-III-R diagnoses, and can be performed in less than half the time required for the SCID-P.     

Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta‐analysis

ObjectivesEstimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies.MethodsWe analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random‐effects meta‐analysis was used to compare prevalence with EPDS cutoffs versus the SCID.ResultsSeven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%–34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%–11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%–12.3%). EPDS ≥14 provided pooled prevalence closest to SCID‐based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: −13.7%, 12.3%).ConclusionEPDS ≥14 approximated SCID‐based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation.     

Reliability and validity of severity dimensions of psychopathology assessed using the Structured Clinical Interview for DSM‐5 (SCID)

This study examined whether the Structured Clinical Interview for DSM (SCID), a widely used semistructured interview designed to assess psychopathology categorically, can be adapted to identify reliable and valid severity dimensions of psychopathology. The present study also examined whether these severity dimensions have better psychometric properties (internal consistency, test–retest reliability, and concurrent and predictive validity) than categorical diagnoses. Participants (N = 234) were recruited from the community and clinics. Retest reliability and prospective predictive validity (symptoms and functioning 1 year later) were examined in subsamples of participants. Dimensional severity scales were created from an adapted version of the SCID for both current and lifetime major depression, alcohol, substance, post‐traumatic stress disorder, panic, agoraphobia, social anxiety, specific phobia, obsessive–compulsive disorder, and generalized anxiety disorder. The SCID's severity scales demonstrated substantial internal consistency (all Cronbach's αs >.80), test–retest reliability, and concurrent and predictive validity. Symptom severity scales demonstrated significant incremental validity over and above categorical diagnoses for both current and prospective outcomes. The psychometric properties of SCID‐identified symptom scales were far superior to the psychometrics of categorical diagnoses for both current and lifetime psychopathology. These results highlight the feasibility and utility of the SCID to assess reliable and valid symptom severity dimensions of both current and lifetime psychopathology.     

High interrater reliability for the Structured Clinical Interview for DSM-III-R Axis I (SCID-I)

The interrater reliability of the Structured Clinical Interview for DSM-III-R (SCID) was studied. Fifty-four audiotaped SCID interviews were rated independently by 3 raters. The highest interrater agreements were observed for schizophrenia (0.94), major depressive disorder (0.93), dysthymia (0.88), generalized anxiety disorder (0.95), panic disorder (0.88), alcohol use disorder (0.96) and other psychoactive substance use disorder (0.85). The remaining diagnoses of mood and anxiety disorders obtained acceptable interrater agreement (0.70-0.80), with an exception for obsessive-compulsive disorder (0.40). The poorest agreement was obtained for somatoform disorders ( -0.03). Lack of hierarchy in DSM-III-R allows for multiple Axis I diagnoses. Interrater reliability for multiple diagnoses was tested. Agreement was generally good for combinations of 2 diagnoses, and poorer when 3 diagnoses were combined. Our findings confirm that SCID yields highly reliable diagnoses. SCID is recommended for research on mental disorders.     

The Structured Interview for Schizotypy (SIS): a preliminary report

This article presents a new interview-based research instrument for assessing schizotypal symptoms and signs. The Structured Interview for Schizotypy (SIS), which was developed from experience gained in a large, controlled family study of schizophrenia in the west of Ireland and has been field-tested in three other locations, differs from previously available interviews in that it includes: (1) built-in contextual assessments of the pathological nature of certain symptoms (e.g., suspiciousness or ideas of reference); (2) multiple independently scored items, most with closed response options, per symptom scale; (3) extensive assessment of schizotypal signs; (4) symptom probes designed to make responding positively appear nondeviant; and (5) coverage of potentially relevant symptoms and signs not required in current criteria for schizotypal personality disorder. Schizotypal symptoms can be assessed with high reliability by the SIS. When sufficient variability is present, schizotypal signs are also reliably assessed by the SIS, although the reliability is generally lower than that found for symptoms. In three independent pilot studies, schizotypal symptoms and signs assessed by the SIS appear to discriminate significantly the relatives of schizophrenic patients from relatives of controls.     

Post-traumatic stress disorder assessment with a structured interview: reliability and concordance with a standardized clinical interview

Epidemiologic studies of post-traumatic stress disorder (PTSD) have used the PTSD module of the NIMH Diagnostic Interview (DIS) in its various editions and modifications. Although the diagnoses of numerous disorders made by the DIS or the WHO – Composite International Diagnostic Interview (CIDI), which is modelled on the DIS, have been compared to clinical diagnoses, little is known about the performance of these instruments in diagnosing PTSD. In this study, we examine the test–retest reliability of a modified version of the PTSD section of the DIS-IV and the CIDI 2.1 and compare it with an independently conducted clinical interview in the 1996 Detroit Area Survey of Trauma, an epidemio-logical study of a representative sample of 2181 persons. A blind readministration of the structured interview was conducted by a lay interviewer 12–18 months after the initial interview, on 32 respondents classified as PTSD cases in the initial interview and on 23 non-cases who reported exposure to trauma. The clinical reappraisal was conducted blindly by two psychiatric social workers, using the Clinician Administered PTSD Scale for DSM-IV (CAPS-DX). The data were weighted to adjust for the oversampling of cases and the differential probabilities of selection of traumatic events across respondents with different numbers of events. The test–retest consistency of the structured interview was a kappa of 0.62 and an odds ratio of 42.5. The comparison of the structured interview with the clinical reappraisal showed agreement in 81% of the assessed sample. Positive predicted value was 0.75, negative predictive value was 0.97, and the odds ratio was 94.8 (all weighted values). Discrepant cases were mostly ‘false positives’ and, of these, the majority were subthreshold cases missing only one symptom in the CAPS-DX. Copyright © 1998 Whurr Publishers Ltd.     

Internal consistency and discriminant validity of the Structured Clinical Interview for Panic Agoraphobic Spectrum (SCI-PAS)

This paper reports on the feasibility, acceptability and psychometric properties of the Structured Clinical Interview for Panic-Agoraphobic Spectrum (SCI-PAS). This interview was designed to assess the lifetime presence of symptoms and other clinical features considered to comprise the panic-agoraphobic spectrum. The interview has 114 items grouped into nine domains. A total of 422 subjects, from 11 centres located throughout Italy, participated in this study. Data were collected from three groups of subjects: psychiatric patients meeting DSM-IV criteria for panic disorder (n = 141), cardiovascular patients (n = 140), including 29 with post-myocardial infarction, and university students (n = 141). The inter-rater reliability and the internal consistency of the SCI-PAS measures were assessed using the intra-class correlation coefficient and the Kuder-Richardson coefficient, respectively. Discriminant validity was assessed by comparing results in patients with panic disorder to those in the other groups. The interview required an average of 25 (±5) minutes to administer. Patients and clinicians found the scale to be highly useful, providing information not previously obtained. Internal consistency was good (>0.70) for six out of nine SCI-PAS domains. The inter-rater reliability was excellent (>0.70) for all the domains except for ‘other phobias’ (0.467). Patients with panic disorder scored significantly higher on each domain, and on the overall panic spectrum, than did the control subjects. In conclusion, the SCI-PAS is a useful clinical interview, which can be administered in a reasonable period of time. This assessment further demonstrates good internal consistency, discriminant validity, and inter-rater reliability. Copyright © 1999 Whurr Publishers Ltd.     

Expressed Emotion about children: reliability and validity of a Camberwell Family Interview for Childhood (CFI‐C)

A Camberwell Family Interview for Childhood (CFI‐C) was developed by adding questions about the family impact of the child's problems to a semi‐structured interview on child psychiatric symptoms. The whole CFI‐C took under an hour to administer; the questions about family impact added 15–20 minutes. The inter‐rater reliability was good (kappa 0.64–1.0). Mothers of 25 boys aged four to nine years referred with disruptive behaviour, and 25 matched controls were interviewed twice in five months. Test‐retest stability was fair to good (kappa 0.36–1.0). Discriminant validity between referred and control samples was strong for critical comments, positive comments and warmth, but not significant for emotional overinvolvement or hostility. The same three scales showed strong discriminant validity between child symptom domains, being strongly correlated with conduct symptoms (kappa = 0.49–0.71) but not emotional symptoms (kappa = 0.10–0.17). Sensitivity to change with treatment was shown by a reduction in the mean number of critical comments from 4.7 to 2.9, an increase in positive comments from 2.3 to 3.9, and an increased score on the warmth scale from 2.1 to 2.6. The CFI‐C is a useful instrument for the study of the relationship between parenting style and child psychiatric symptoms. Copyright © 2000 Whurr Publishers Ltd.     

Development and validation of the Diagnostic Interview Adjustment Disorder (DIAD)

Adjustment disorders (ADs) are under‐researched due to the absence of a reliable and valid diagnostic tool. This paper describes the development and content/construct validation of a fully structured interview for the diagnosis of AD, the Diagnostic Interview Adjustment Disorder (DIAD). We developed the DIAD by partly adjusting and operationalizing DSM‐IV criteria. Eleven experts were consulted on the content of the DIAD. In addition, the DIAD was administered by trained lay interviewers to a representative sample of disability claimants (n = 323). To assess construct validity of the DIAD, we explored the associations between the AD classification by the DIAD and summary scores of the Kessler Psychological Distress 10‐item Scale (K10) and the World Health Organization Disability Assessment Schedule (WHODAS) by linear regression. Expert agreement on content of the DIAD was moderate to good. The prevalence of AD using the DIAD with revised criteria for the diagnosis AD was 7.4%. The associations of AD by the DIAD with average sum scores on the K10 and the WHODAS supported construct validity of the DIAD. The results provide a first indication that the DIAD is a valid instrument to diagnose AD. Further studies on reliability and on other aspects of validity are needed. Copyright © 2014 John Wiley & Sons, Ltd.     

The Composite International Diagnostic Interview (CIDI-Auto): problems and remedies for diagnosing panic disorder and social phobia

In a recent study of treatment for panic disorder in primary care, the Composite International Diagnostic Interview (CIDI-Auto) was used to provide psychiatric diagnoses. However, during and after data collection, it was discovered that the CIDI appeared to place, or fail to place, a substantial number of people into diagnostic categories in ways that conflicted with the investigators' clinical experience. The wording of questions in the panic module, coupled with a lack of structured follow-up probes, resulted in apparent false negatives for panic disorder. Moreover, patients who would otherwise meet criteria for panic disorder or social phobia did not receive a diagnosis based on rules that may be discordant with clinical practice and, at times, the design of the DSM-IV. For this study, changes were made to the interview, including additional probes for the panic disorder module and modification of the decision rules used to assign or rule out diagnoses of panic disorder and social phobia. The changes resulted in greater inclusion of patients in the panic disorder and social phobia diagnostic categories and we argue that these changes to the CIDI-Auto increase the clinical validity of this instrument. We did not examine the false positive rate for the unmodified or modified CIDI, but this is an important issue that needs to be evaluated in future research.     

人格障碍诊断问卷(SCID-Ⅱ)第2版的信度和效度

目的评价人格障碍诊断问卷SCID-Ⅱ(第2版)中文译本的信度和效度。方法对125 例精神障碍患者及45名正常人进行量表评定,并进行重测和评定者间一致性检验,及与临床诊断一致性检验。结果SCID-Ⅱ(第2版)各分量表内部一致性系数中位数为0．70;重测一致性Kappa值中位数为0．70,评定者间一致性Kappa值中位数为0．86;与临床诊断的一致率达90．7％。结论SCID-Ⅱ (第2版)各分量表内部一致性尚好,重测和评定者间的一致性良好,与临床诊断的一致率较好,可以推广使用,但仍需进一步大样本的研究分析。