SynopsisA new diagnostic instrument, The Diagnostic Interview Schedule, was evaluated for use by lay interviewers by comparing its DSM-III diagnoses when given by lay interviewers with results obtained through an independent interview by a psychiatrist using the same schedule, his clinical judgement after the interview, his clinical judgement after both the interview and a free question period, and with diagnoses on the medical chart.
The CIDI-SAM is a fully-structured interview that ascertains DSM-III, DSM-III-R, Feighner, RDC and ICD-10 diagnoses for alcohol, tobacco and nine classes of psychoactive drugs. It was designed at the request of the WHO/ADAMHA Task Force on Psychiatric Assessment instruments to expand the substance abuse sections of the CIDI. Using a test-retest design, the diagnostic and item reliabilities of this instrument were tested in a sample of 39 patients in substance abuse treatment at three St. Louis treatment facilities. Kappa values and their 95% confidence intervals, and Yule's Y values are reported. The average kappa for DSM-III substance disorders was 0.84, for DSM-III-R it was 0.82. We report, on the average, excellent kappa values for individual alcohol and drug symptoms. We also ascertained from the respondent's themselves the reasons why answers to specific questions might have been discordant. The findings from this unique 'discrepancy interview' are reported.
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