Reliability of diagnosis in older psychiatric patients using the structured clinical interview for DSM-III-R

摘要

We conducted one of the few studies that has examined the reliability of the Structured Clinical Interview for DSM-III-R Axis I (SCID-I) with a mixed inpatient and outpatient population of adults 55 years old and over (range, 56–84 years; mean, 67.33 years). All SCID interviews were videotaped or audiotaped and were administered by Master's-level clinicians working toward their doctorate degrees in clinical psychology. Interrater reliability estimates (kappa and percentage agreement) were calculated for current major depressive episode (47 base rate) and the broad diagnostic categories of anxiety disorders (15 base rate) and somatoform disorders (12 base rate). Kappa values were .70, .77, and 1.0. Respective percentage agreement was 85 for major depression, 94 for anxiety disorders, and 100 for somatoform disorders. Overall percentage agreement was 91. We conclude that the SCID-I can be effectively administered by relatively inexperienced clinicians to diagnose older psychiatric patients reliably. Directions that future research might take are offere