The Reliability of Psychiatric Diagnosis Revisited

PubMed Central

Rankin, Eric; France, Cheryl; El-Missiry, Ahmed; John, Collin

2006-01-01

Background: The authors reviewed the topic of reliability of psychiatric diagnosis from the turn of the 20th century to present. The objectives of this paper are to explore the reasons of unreliability of psychiatric diagnosis and propose ways to improve the reliability of psychiatric diagnosis. Method: The authors reviewed the literature on the concept of reliability of psychiatric diagnosis with emphasis on the impact of interviewing skills, use of diagnostic criteria, and structured interviews on the reliability of psychiatric diagnosis. Results: Causes of diagnostic unreliability are attributed to the patient, the clinician and psychiatric nomenclature. The reliability of psychiatric diagnosis can be enhanced by using diagnostic criteria, defining psychiatric symptoms and structuring the interviews. Conclusions: The authors propose the acronym ‘DR.SED,' which stands for diagnostic criteria, reference definitions, structuring the interview, clinical experience, and data. The authors recommend that clinicians use the DR.SED paradigm to improve the reliability of psychiatric diagnoses. PMID:21103149

The role of complex emotions in inconsistent diagnoses of schizophrenia.

PubMed

Gara, Michael A; Vega, William A; Lesser, Ira; Escamilla, Michael; Lawson, William B; Wilson, Daniel R; Fleck, David E; Strakowski, Stephen M

2010-09-01

In the case of large-scale epidemiological studies, there is evidence of substantial disagreement when lay diagnoses of schizophrenia based on structured interviews are compared with expert diagnoses of the same patients. Reasons for this level of disagreement are investigated in the current study, which made use of advances in text-mining techniques and associated structural representations of language expressions. Specifically, the current study examined whether content analyses of transcribed diagnostic interviews obtained from 150 persons with serious psychiatric disorders yielded any discernable patterns that correlated with diagnostic inconsistencies of schizophrenia. In summary, it was found that the patterning or structure of spontaneous self-reports of emotion states in the diagnostic interview was associated with diagnostic inconsistencies of schizophrenia, irrespective of confounders; i.e., age of patient, gender, or ethnicity. In particular, complex emotion patterns were associated with greater disagreement between experts and trained lay interviewers than were simpler patterns.

Post-Traumatic Stress Disorder in Maltreated Youth: A Study of Diagnostic Comorbidity and Child Factors

ERIC Educational Resources Information Center

Linning, Lisa M.; Kearney, Christopher A.

2004-01-01

The study of post-traumatic stress disorder (PTSD) in maltreated youth has received increased attention, though extensive comparisons to maltreated youth without PTSD and administrations of anxiety-based structured diagnostic interviews remain needed. We examined maltreated youth with or without PTSD using structured diagnostic interviews and…

Reliability in the DSM-III field trials: interview v case summary.

PubMed

Hyler, S E; Williams, J B; Spitzer, R L

1982-11-01

A study compared the reliability of psychiatric diagnoses obtained from the live interviews and from case summaries, on the same patients, by the same clinicians, using the same DSM-III diagnostic criteria. The results showed that the reliability of the major diagnostic classes of DSM-III was higher when diagnoses were made from live interviews than when they were made from case summaries. We conclude that diagnoses based on information contained in traditionally prepared case summaries may lead to an underestimation of the reliability of diagnoses made based on information collected during a "live" interview.

Test-retest reliability of a standardized psychiatric interview (DIS/CIDI).

PubMed

Semler, G; Wittchen, H U; Joschke, K; Zaudig, M; von Geiso, T; Kaiser, S; von Cranach, M; Pfister, H

1987-01-01

The reliability of DSM-III diagnoses using an expanded version of the Diagnostic Interview Schedule (DIS), called the Composite International Diagnostic Interview (CIDI), was evaluated by examining 60 psychiatric inpatients on a test-retest basis. Acceptable agreement coefficients of (kappa) 0.5 or above were found for all but two disorders: dysthymic disorder and generalized anxiety disorder. The subclassification of DSM-III affective disorders also revealed some discrepancies between the test and the retest interviews. When compared with results from earlier versions of the DIS, diagnostic reliability was found to have improved for the DSM-III anxiety disorders in particular. These improvements can possibly be attributed to some changes in the wording of the respective items of this section. Several reasons for lowered test-retest reliability are discussed.

Convergent Validity of the Autism Spectrum Disorder-Diagnostic for Children (ASD-DC) and Autism Diagnostic Interview-Revised (ADI-R)

ERIC Educational Resources Information Center

Matson, Johnny L.; Hess, Julie A.; Mahan, Sara; Fodstad, Jill C.

2010-01-01

The purpose of this paper was to further establish the validity of the Autism Spectrum Disorder-Diagnostic for Children (ASD-DC). The methodology consisted of testing the similarity of findings between the ASD-DC and the Autism Diagnostic Interview-Revised (ADI-R), which proved to be statistically significant for subscale content scores on social,…

Insights into Chronic Functional Movement Disorders: The Value of Qualitative Psychiatric Interviews.

PubMed

Epstein, Steven A; Maurer, Carine W; LaFaver, Kathrin; Ameli, Rezvan; Sinclair, Stephen; Hallett, Mark

Patients with functional movement disorders (FMDs) are commonly seen by neurologists and psychosomatic medicine psychiatrists. Research literature provides scant information about the subjective experiences of individuals with this often chronic problem. To enhance our understanding of psychologic aspects of FMDs by conducting qualitative interviews of research subjects. In total, 36 patients with FMDs were recruited from the Human Motor Control clinic at the National Institutes of Health. Each subject participated in a qualitative psychiatric interview and a structured diagnostic psychiatric interview. Of our 36 subjects, 28 had current or lifetime psychiatric disorders in addition to conversion disorder and 22 had current disorders. Qualitative interviews provided rich information on patients' understanding of their illnesses and impaired cognitive processing of emotions. Our study supports the addition of open-ended qualitative interviews to delineate emotional dynamics and conceptual frameworks among such patients. Exploratory interviews generate enhanced understanding of such complex patients, above and beyond that gained by assessing DSM diagnostic comorbidities. Copyright © 2016 The Academy of Psychosomatic Medicine. All rights reserved.

Validation of a Brief Structured Interview: The Children's Interview for Psychiatric Syndromes (ChIPS).

PubMed

Young, Matthew E; Bell, Ziv E; Fristad, Mary A

2016-12-01

Evidence-based assessment is important in the treatment of childhood psychopathology. While researchers and clinicians frequently use structured diagnostic interviews to ensure reliability, the most commonly used instrument, the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS) is too long for most clinical applications. The Children's Interview for Psychiatric Syndromes (ChIPS/P-ChIPS) is a highly-structured brief diagnostic interview. The present study compared K-SADS and ChIPS/P-ChIPS diagnoses in an outpatient clinical sample of 50 parent-child pairs aged 7-14. Agreement between most diagnoses was moderate to high between the instruments and with consensus clinical diagnoses. ChIPS was significantly briefer to administer than the K-SADS. Interviewer experience level and participant demographics did not appear to affect agreement. Results provide further evidence for the validity of the ChIPS and support its use in clinical and research settings.

Interrelationship between Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) Classification in Children and Adolescents with Mental Retardation

ERIC Educational Resources Information Center

de Bildt, Annelies; Sytema, Sjoerd; Ketelaars, Cees; Kraijer, Dirk; Mulder, Erik; Volkmar, Fred; Minderaa, Ruud

2004-01-01

The interrelationship between the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule-Generic (ADOS-G) and clinical classification was studied in 184 children and adolescents with Mental Retardation (MR). The agreement between the ADI-R and ADOS-G was fair, with a substantial difference between younger and older…

Multisite Study of New Autism Diagnostic Interview-Revised (ADI-R) Algorithms for Toddlers and Young Preschoolers

ERIC Educational Resources Information Center

Kim, So Hyun; Thurm, Audrey; Shumway, Stacy; Lord, Catherine

2013-01-01

Using two independent datasets provided by National Institute of Health funded consortia, the Collaborative Programs for Excellence in Autism and Studies to Advance Autism Research and Treatment (n = 641) and the National Institute of Mental Health (n = 167), diagnostic validity and factor structure of the new Autism Diagnostic Interview (ADI-R)…

Ataques de nervios in the Puerto Rican Diagnostic Interview Schedule: the impact of cultural categories on psychiatric epidemiology.

PubMed

Guarnaccia, P J; Rubio-Stipec, M; Canino, G

1989-09-01

This paper examines the effect of the cultural category ataques de nervios on responses to the Puerto Rican Diagnostic Interview Schedule (DIS), a Spanish version of structured psychiatric diagnostic interview developed for the NIMH Epidemiologic Catchment Area study. An ataque de nervios scale was created from the Somatization items of the DIS to explore the effect of this culturally meaningful category of distress on responses to a standard psychiatric interview. Analysis of 1,513 cases from a representative sample of the island of Puerto Rico indicated that people reporting ataque symptoms fit the social characteristics described for ataques sufferers in the ethnographic literature. Qualitative data indicated that Puerto Ricans were reporting ataques de nervios in the panic section of the DIS. Questions are raised about the validity of the somatization and panic sections of the DIS in cross-cultural research with Hispanics.

The Use of the Autism Diagnostic Interview-Revised with a Latino Population of Adolescents and Adults with Autism

ERIC Educational Resources Information Center

Magana, Sandy; Smith, Leann E.

2013-01-01

Research shows that Latinos are less likely to be diagnosed with autism than their non-Latino counterparts. One factor that may contribute to these differences is that autism diagnostic instruments have not been adapted for the Latino population. The present study compared scores from the Autism Diagnostic Interview-Revised for two groups: 48…

The experiences of health-related quality of life in patients with nonspecific symptoms who undergo a diagnostic evaluation for cancer: a qualitative interview study.

PubMed

Moseholm, Ellen; Lindhardt, Bjarne Oerskov; Rydahl-Hansen, Susan

2017-09-01

The diagnostic phase of cancer can affect health-related quality of life (HRQoL). The aim of this study was to investigate how patients with nonspecific symptoms experience HRQoL while undergoing diagnostic evaluations for cancer. Twenty-one participants who had completed a fast-track evaluation for possible cancer at one of three hospitals in the Capital Region, Denmark were interviewed 2-4 weeks after completing diagnostic evaluations. The interviews were semi-structured and were supported by an interview guide based on the same themes as in The European Organisation for Research and Treatment of Cancer Quality of Life questionnaire (EORCT-QLQ-C30). Data analysis was based on qualitative content analysis by Krippendorff. The analysis generated six categories: symptoms, physical-, role-, emotional-, cognitive- and social functioning, and the diagnostic fast-track experience. From these categories, a main theme was identified: Health-related quality of life is not solely affected by the diagnostic process. The results provide a comprehensive understanding of HRQoL in the diagnostic phase of possible cancer, which can be used not only to enhance evidence-based care, but also in the interpretation of the EORTC-QLQ-C30 scores. Psycho-social support with a focus on individual informational needs during the diagnostic phase may be warranted. © 2016 Nordic College of Caring Science.

Can Questionnaire Reports Correctly Classify Relationship Distress and Partner Physical Abuse?

PubMed Central

Heyman, Richard E.; Feldbau-Kohn, Shari R.; Ehrensaft, Miriam K.; Langhinrichsen-Rohling, Jennifer; O’Leary, K. Daniel

2006-01-01

Relationship adjustment (e.g., Dyadic Adjustment Scale; DAS) and physical aggression (e.g., Conflict Tactics Scale) measures are used both as screening tools and as the sole criterion for classification. This study created face valid diagnostic interviews for relationship distress and physical abuse, through which one could compare preliminarily the classification properties of questionnaire reports. The DAS (and a global measure of relationship satisfaction) had modest agreement with a structured diagnostic interview; both questionnaires tended to overdiagnose distress compared with the interview. Results for partner abuse reiterated the need to go beyond occurrence of aggression as the sole diagnostic criterion, because men’s aggression was more likely than women’s to rise to the level of “abuse” when diagnostic criteria (injury or substantial fear) were applied. PMID:11458637

Formulations in Psychotherapy: Admission Interviews and the Conversational Construction of Diagnosis.

PubMed

Bonnin, Juan Eduardo

2017-09-01

In this article, we contribute to understanding the interactional aspects of making clinical diagnosis in mental health care. We observe that therapists, during the "problem presentation" sequence in clinical encounters, often use a specific form of diagnostic formulations to elicit more diagnostically relevant information. By doing so, they often substitute one type of verb with another, following a diagnostic hypothesis. Specifically, in interviews that arrive at a diagnosis of neurosis, therapists formulate with behavioral verbal processes; in interviews that arrive at a diagnosis of psychosis, they do so with material ones. Such formulations often prove useful to define clinical diagnoses. They can, however, also be dangerous in that they may favor the therapist's agenda over the patient's. Our analysis helps therapists not only better understand the diagnostic process but also reflect upon their own use of diagnostic formulations and become aware of the clinical effects of their interactional performance.

Impact of the Diagnostic Process on Parents of Infants and Preschool Children. Final Report.

ERIC Educational Resources Information Center

Tice, Terrence N.; Hanson, Janice L.

In an investigation of the impact of the psychological/educational diagnostic process on the parents of young children at risk for developmental delay, 18 families completed questionnaires and were interviewed concerning their child's evaluation. Transcribed interviews conducted 1-2 weeks after the evaluation and 4 months after the evaluations…

Violence and Victimization in the Refugee Patient. I. Special Issues in Diagnostic and Therapeutic Interviewing.

ERIC Educational Resources Information Center

Westermeyer, Joseph; And Others

This paper is intended for teachers, faculty instructors, and clinical supervisors whose trainees are evaluating and treating refugee patients. It addresses special issues in the diagnostic and therapeutic interviewing of refugee patients who have experienced various types of physical violence and victimization. After a brief introduction, a…

Clinical Diagnostic and Sociocultural Dimensions of Deliberate Self-Harm in Mumbai, India

ERIC Educational Resources Information Center

Parkar, Shubhangi R.; Dawani, Varsha; Weiss, Mitchell G.

2006-01-01

Patients' accounts complement psychiatric assessment of deliberate self-harm (DSH). In this study we examined psychiatric disorders, and sociocultural and cross-cultural features of DSH. SCID diagnostic interviews and a locally adapted EMIC interview were used to study 196 patients after DSH at a general hospital in Mumbai, India. Major depression…

Validation of existing diagnosis of autism in mainland China using standardised diagnostic instruments.

PubMed

Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Zhang, Zhixiang; Matthews, Fiona E; Baron-Cohen, Simon; Brayne, Carol

2015-11-01

Research to date in mainland China has mainly focused on children with autistic disorder rather than Autism Spectrum Conditions and the diagnosis largely depended on clinical judgment without the use of diagnostic instruments. Whether children who have been diagnosed in China before meet the diagnostic criteria of Autism Spectrum Conditions is not known nor how many such children would meet these criteria. The aim of this study was to evaluate children with a known diagnosis of autism in mainland China using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised to verify that children who were given a diagnosis of autism made by Chinese clinicians in China were mostly children with severe autism. Of 50 children with an existing diagnosis of autism made by Chinese clinicians, 47 children met the diagnosis of autism on the Autism Diagnostic Observation Schedule algorithm and 44 children met the diagnosis of autism on the Autism Diagnostic Interview-Revised algorithm. Using the Gwet's alternative chance-corrected statistic, the agreement between the Chinese diagnosis and the Autism Diagnostic Observation Schedule diagnosis was very good (AC1 = 0.94, p < 0.005, 95% confidence interval (0.86, 1.00)), so was the agreement between the Chinese diagnosis and the Autism Diagnostic Interview-Revised (AC1 = 0.91, p < 0.005, 95% confidence interval (0.81, 1.00)). The agreement between the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised was lower but still very good (AC1 = 0.83, p < 0.005). © The Author(s) 2015.

Reliability of criteria for borderline personality disorder: a comparison of DSM-III and the Diagnostic Interview for Borderline Patients.

PubMed

Frances, A; Clarkin, J F; Gilmore, M; Hurt, S W; Brown, R

1984-09-01

The authors compared the reliability of two methods of distinguishing borderline personality disorder--DSM-III and the Diagnostic Interview for Borderline Patients. The reference group, outpatients with other personality disorders and without major axis I pathology, was more difficult to distinguish from the patients with borderline personality disorder than such groups used in previous samples. The sensitivity and specificity of the Diagnostic Interview for Borderline Patients were calculated, with DSM-III used as a criterion. The findings confirm considerable overlap between borderline and schizotypal personality disorders, more impairment in functioning in borderline patients than in those with other personality disorders, and the high reliability with which borderline personality disorder can be diagnosed.

Recognition of psychiatric disorders in musculoskeletal and cardiovascular rehabilitation patients.

PubMed

Härter, Martin; Woll, Sonja; Reuter, Katrin; Wunsch, Alexandra; Bengel, Jürgen

2004-07-01

To investigate the detection rate of psychiatric disorders in rehabilitation inpatients with musculoskeletal and cardiovascular diseases (CVDs). Cross-sectional survey; analysis of medical charts and discharge reports, combined with standardized diagnostic interviews. Four orthopedic and 6 cardiovascular rehabilitation hospitals in southwest Germany. More than 1700 inpatients with different musculoskeletal disorders and CVDs participated in the survey. On the basis of their General Health Questionnaire score, 205 patients with musculoskeletal diseases and 164 patients with CVDs were selected randomly for standardized interviews. Discharge reports of interviewed patients were analyzed. Not applicable. Clinical interview (Composite International Diagnostic Interview [CIDI]) to obtain diagnoses of psychiatric disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Assessment of psychosocial burden and diagnoses of mental disorders, as well as admission to psychologic treatments, based on discharge reports of the attending physicians. The detection rate (sensitivity) of mental disorders was 48% in the orthopedic rehabilitation patients and 32% in the cardiovascular patients. Specificity was 80% in musculoskeletal patients and 87% in cardiovascular patients. Differential diagnostic competencies were lacking, and only half of the physicians' diagnoses corresponded to the CIDI diagnoses. The results showed a need for current DSM-IV or International Classification of Diseases, 10th edition, psychodiagnostics in medical rehabilitation to detect mental disorders in patients in the rehabilitation process at an earlier stage and to refer patients with comorbid mental disorders to adequate treatment.

Validation of a Brief Structured Interview: The Children’s Interview for Psychiatric Syndromes (ChIPS)

PubMed Central

Young, Matthew E.; Bell, Ziv E.; Fristad, Mary A.

2016-01-01

Evidence-based assessment is important in the treatment of childhood psychopathology (Jensen-Doss, 2011). While researchers and clinicians frequently use structured diagnostic interviews to ensure reliability, the most commonly used instrument, the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS; Kaufman et al., 1997), is too long for most clinical applications. The Children’s Interview for Psychiatric Syndromes, (ChIPS/P-ChIPS; Weller, Weller, Rooney, & Fristad, 1999a; 1999b) is a highly-structured brief diagnostic interview. The present study compared K-SADS and ChIPS/P-ChIPS diagnoses in an outpatient clinical sample of 50 parent-child pairs aged 7–14. Agreement between most diagnoses was moderate to high between instruments and with consensus clinical diagnoses. ChIPS was significantly briefer to administer than the K-SADS. Interviewer experience level and participant demographics did not appear to affect agreement. Results provide further evidence for the validity of the ChIPS and support its use in clinical and research settings. PMID:27761777

["Operationalised psychodynamic diagnostics in childhood and adolescence" (OPD-CA) in practice].

PubMed

Schulte-Markwort, Michael; Resch, Franz; Bürgin, Dieter

2004-02-01

"Operationalised psychodynamic diagnostics in childhood and adolescence" (OPD-CA) has been completed in its first version after years of development. In a first interview with a 13-year-old boy, the diagnostic instruments of OPD-CA are presented by means of examples. The text passages of the transcribed first interview are evaluated in four sections by representatives of the respective working groups regarding the axes--relationships, conflict, structure and preconditions for treatment--and the diagnostic conclusions resulting from this are presented, thus providing a direct insight into the specific psychodynamic diagnostics of OPD-CA.

Diagnostic validity Polish language version of the questionnaire MINI-KID (Mini International Neuropsychiatry Interview for Children and Adolescent).

PubMed

Adamowska, Sylwia; Sylwia, Adamowska; Adamowski, Tomasz; Tomasz, Adamowski; Frydecka, Dorota; Dorota, Frydecka; Kiejna, Andrzej; Andrzej, Kiejna

2014-10-01

Since over forty years structuralized interviews for clinical and epidemiological research in child and adolescent psychiatry are being developed that should increase validity and reliability of diagnoses according to classification systems (DSM and ICD). The aim of the study is to assess the validity of the Polish version of MINI-KID (Mini International Neuropsychiatric Interview for Children and Adolescents) in comparison to clinical diagnosis made by a specialist in the field of child and adolescent psychiatry. There were 140 patients included in the study (93 boys, 66.4%, mean age 11.8±3.0 and 47 girls 33.5%, mean age 14.0±2.9). All the patients were diagnosed by the specialist in the field of child and adolescent psychiatry according to ICD-10 criteria and by the independent interviewer with the Polish version of MINI-KID (version 2.0, 2001). There was higher agreement between clinical diagnoses and diagnoses based on MINI-KID interview with respect to eating disorders and externalizing disorders (κ 0.43-0.56) and lower in internalizing disorders (κ 0.13-0.45). In the clinical interview, there was smaller number of diagnostic categories (maximum 3 diagnoses per one patient) in comparison to MINI-KID (maximum 10 diagnoses per one patient), and the smaller percentage of patients with one diagnosis (65,7%) in comparison to MINI-KID interview (72%). Our study has shown satisfactory validity parameters of MINI-KID questionnaire, promoting its use for clinical and epidemiological settings. The Mini International Neuropsychiatry Interview for Children and Adolescent (MINI-KID) is the first structuralized diagnostic interview for assessing mental status in children and adolescents, which has been translated into Polish language. Our validation study demonstrated satisfactory psychometric properties of the questionnaire, enabling its use in clinical practice and in research projects. Copyright © 2014 Elsevier Inc. All rights reserved.

Towards a Standard Psychometric Diagnostic Interview for Subjects at Ultra High Risk of Psychosis: CAARMS versus SIPS

PubMed Central

Fusar-Poli, P.; Cappucciati, M.; Rutigliano, G.; Lee, T. Y.; Beverly, Q.; Bonoldi, I.; Lelli, J.; Kaar, S. J.; Gago, E.; Rocchetti, M.; Patel, R.; Bhavsar, V.; Tognin, S.; Badger, S.; Calem, M.; Lim, K.; Kwon, J. S.; Perez, J.; McGuire, P.

2016-01-01

Background. Several psychometric instruments are available for the diagnostic interview of subjects at ultra high risk (UHR) of psychosis. Their diagnostic comparability is unknown. Methods. All referrals to the OASIS (London) or CAMEO (Cambridgeshire) UHR services from May 13 to Dec 14 were interviewed for a UHR state using both the CAARMS 12/2006 and the SIPS 5.0. Percent overall agreement, kappa, the McNemar-Bowker χ 2 test, equipercentile methods, and residual analyses were used to investigate diagnostic outcomes and symptoms severity or frequency. A conversion algorithm (CONVERT) was validated in an independent UHR sample from the Seoul Youth Clinic (Seoul). Results. There was overall substantial CAARMS-versus-SIPS agreement in the identification of UHR subjects (n = 212, percent overall agreement = 86%; kappa = 0.781, 95% CI from 0.684 to 0.878; McNemar-Bowker test = 0.069), with the exception of the brief limited intermittent psychotic symptoms (BLIPS) subgroup. Equipercentile-linking table linked symptoms severity and frequency across the CAARMS and SIPS. The conversion algorithm was validated in 93 UHR subjects, showing excellent diagnostic accuracy (CAARMS to SIPS: ROC area 0.929; SIPS to CAARMS: ROC area 0.903). Conclusions. This study provides initial comparability data between CAARMS and SIPS and will inform ongoing multicentre studies and clinical guidelines for the UHR psychometric diagnostic interview. PMID:27314005

Translation and Validation of the Developmental, Dimensional and Diagnostic Interview (3Di) for Diagnosis of Autism Spectrum Disorder in Thai Children

ERIC Educational Resources Information Center

Chuthapisith, Jariya; Taycharpipranai, Pasinee; Ruangdaraganon, Nichara; Warrington, Richard; Skuse, David

2012-01-01

This study aimed to examine the effectiveness of a translated version of the short version of the Developmental, Dimensional and Diagnostic Interview (3Di) in discriminating children with autism spectrum disorders (ASDs) from typically developing children. Two groups, comprising 63 children with clinically ascertained ASDs and 67 typically…

Utility of the 3Di Short Version for the Diagnostic Assessment of Autism Spectrum Disorder and Compatibility with DSM-5

ERIC Educational Resources Information Center

Slappendel, Geerte; Mandy, William; van der Ende, Jan; Verhulst, Frank C.; van der Sijde, Ad; Duvekot, Jorieke; Skuse, David; Greaves-Lord, Kirstin

2016-01-01

The Developmental Diagnostic Dimensional Interview-short version (3Di-sv) provides a brief standardized parental interview for diagnosing autism spectrum disorder (ASD). This study explored its validity, and compatibility with DSM-5 ASD. 3Di-sv classifications showed good sensitivity but low specificity when compared to ADOS-2-confirmed clinical…

Validation of the Developmental, Dimensional and Diagnostic Interview (3Di) among Chinese Children in a Child Psychiatry Clinic in Hong Kong

ERIC Educational Resources Information Center

Lai, Kelly Y. C.; Leung, Patrick W. L.; Mo, Flora Y. M.; Lee, Marshall M. C.; Shea, Caroline K. S.; Chan, Grace F. C.; Che, Kiti K. I.; Luk, Ernest S. L.; Mak, Arthur D. P.; Warrington, Richard; Skuse, David

2015-01-01

Autism spectrum disorder (ASD) is a disorder with high levels of co-morbidities. The Developmental, Dimensional and Diagnostic Interview (3Di) is a relatively new instrument designed to provide dimensional as well as categorical assessment of autistic behaviours among children with normal intelligence. Its sound psychometric properties and…

The Brief Child and Family Phone Interview (BCFPI): 2. Usefulness in Screening for Child and Adolescent Psychopathology

ERIC Educational Resources Information Center

Boyle, Michael H.; Cunningham, Charles E.; Georgiades, Katholiki; Cullen, John; Racine, Yvonne; Pettingill, Peter

2009-01-01

Background: This study examines the use of the Brief Child and Family Phone Interview (BCFPI) to screen for childhood psychiatric disorder based on Diagnostic Interview Schedule for Children Version IV (DISC-IV) classifications of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD),…

Video Taping and Abnormal Psychology: Dramatized Clinical Interviews.

ERIC Educational Resources Information Center

Lyons, Michael J.; And Others

1984-01-01

Students in an abnormal psychology course worked in teams to produce dramatizations of diagnostic interviews and then presented them in class. Positive and negative aspects of the activity are discussed. (RM)

Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.

PubMed

Levis, Brooke; Benedetti, Andrea; Riehm, Kira E; Saadat, Nazanin; Levis, Alexander W; Azar, Marleine; Rice, Danielle B; Chiovitti, Matthew J; Sanchez, Tatiana A; Cuijpers, Pim; Gilbody, Simon; Ioannidis, John P A; Kloda, Lorie A; McMillan, Dean; Patten, Scott B; Shrier, Ian; Steele, Russell J; Ziegelstein, Roy C; Akena, Dickens H; Arroll, Bruce; Ayalon, Liat; Baradaran, Hamid R; Baron, Murray; Beraldi, Anna; Bombardier, Charles H; Butterworth, Peter; Carter, Gregory; Chagas, Marcos H; Chan, Juliana C N; Cholera, Rushina; Chowdhary, Neerja; Clover, Kerrie; Conwell, Yeates; de Man-van Ginkel, Janneke M; Delgadillo, Jaime; Fann, Jesse R; Fischer, Felix H; Fischler, Benjamin; Fung, Daniel; Gelaye, Bizu; Goodyear-Smith, Felicity; Greeno, Catherine G; Hall, Brian J; Hambridge, John; Harrison, Patricia A; Hegerl, Ulrich; Hides, Leanne; Hobfoll, Stevan E; Hudson, Marie; Hyphantis, Thomas; Inagaki, Masatoshi; Ismail, Khalida; Jetté, Nathalie; Khamseh, Mohammad E; Kiely, Kim M; Lamers, Femke; Liu, Shen-Ing; Lotrakul, Manote; Loureiro, Sonia R; Löwe, Bernd; Marsh, Laura; McGuire, Anthony; Mohd Sidik, Sherina; Munhoz, Tiago N; Muramatsu, Kumiko; Osório, Flávia L; Patel, Vikram; Pence, Brian W; Persoons, Philippe; Picardi, Angelo; Rooney, Alasdair G; Santos, Iná S; Shaaban, Juwita; Sidebottom, Abbey; Simning, Adam; Stafford, Lesley; Sung, Sharon; Tan, Pei Lin Lynnette; Turner, Alyna; van der Feltz-Cornelis, Christina M; van Weert, Henk C; Vöhringer, Paul A; White, Jennifer; Whooley, Mary A; Winkley, Kirsty; Yamada, Mitsuhiko; Zhang, Yuying; Thombs, Brett D

2018-06-01

Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics. Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit. A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15-3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98-10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7-15) (OR = 0.96; 95% CI = 0.56-1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26-0.97). The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

Psychiatric comorbidity in autism spectrum disorder: Correspondence between mental health clinician report and structured parent interview.

PubMed

Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Dyson, Margaret; Garland, Ann; Brookman-Frazee, Lauren

2017-10-01

Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence between psychiatric diagnoses reported by mental health clinicians and those derived from a structured diagnostic interview and (2) identified predictors of agreement between clinician-reported and diagnostic interview-derived diagnoses in a sample of 197 children aged 4-14 years with autism spectrum disorder receiving mental health services. Data were drawn from a randomized effectiveness trial conducted in publicly funded mental health services. Non-autism spectrum disorder diagnoses were assessed using an adapted version of the Mini-International Neuropsychiatric Interview, parent version. Cohen's kappa was calculated to examine agreement between Mini-International Neuropsychiatric Interview, parent version and clinician-reported diagnoses of comorbid conditions. Children met criteria for an average of 2.83 (standard deviation = 1.92) Mini-International Neuropsychiatric Interview, parent version diagnoses. Agreement was poor across all diagnostic categories (κ values: 0.06-0.18). Logistic regression identified child gender and clinical characteristics as significant predictors of agreement for specific diagnoses. Results underscore the need for training mental health clinicians in targeted assessment of specific psychiatric disorders and prioritizing treatment development and testing for specific diagnoses to improve care for children with autism spectrum disorder served in publicly funded mental health settings.

Variability among Research Diagnostic Interview Instruments in the Application of "DSM-IV-TR" Criteria for Pediatric Bipolar Disorder

ERIC Educational Resources Information Center

Galanter, Cathryn A.; Hundt, Stephanie R.; Goyal, Parag; Le, Jenna; Fisher, Prudence W.

2012-01-01

Objective: The "DSM-IV-TR "criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and…

A prospective study of diagnostic conversion of major depressive disorder to bipolar disorder in pregnancy and postpartum.

PubMed

Sharma, Verinder; Xie, Bin; Campbell, M Karen; Penava, Debbie; Hampson, Elizabeth; Mazmanian, Dwight; Pope, Carley J

2014-02-01

The aim of the present study was to determine the rate of, and risk factors for, a change in diagnosis from major depressive disorder to bipolar disorder, and from bipolar II disorder to bipolar I disorder in pregnancy and postpartum. Patients with a prior history of major depressive disorder or bipolar II disorder were recruited between 24 and 28 weeks' gestation and followed through to one year postpartum. Diagnostic interviews were conducted using the Structured Clinical Interview for DSM-IV at study intake and repeated using the Mini-International Psychiatric Interview at one, three, six, and 12 months after childbirth. Fisher's exact test was used to assess the association between various risk factors and diagnostic switch. A total of 146 participants completed the intake interview and at least one follow-up interview postpartum. Of these, 92 were diagnosed with major depressive disorder and 54 with bipolar II disorder at intake. Six women (6.52%) experienced a diagnostic change from major depressive disorder to bipolar II disorder during the first six months after childbirth. There were no cases of switching to bipolar I disorder, but in one participant the diagnosis changed from bipolar II disorder to bipolar I disorder during the three months after childbirth. Bipolar switch was associated with a family history of bipolar disorder. The postpartum period appears to be a time of high risk for a new onset of hypomania in women with major depressive disorder. Our rate of diagnostic switching to bipolar II disorder (6.52%) is at least 11- to 18-fold higher than the rates of switching in similar studies conducted in both men and women. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Telepsychiatry: assessment of televideo psychiatric interview reliability with present- and next-generation internet infrastructures.

PubMed

Yoshino, A; Shigemura, J; Kobayashi, Y; Nomura, S; Shishikura, K; Den, R; Wakisaka, H; Kamata, S; Ashida, H

2001-09-01

We assessed the reliability of remote video psychiatric interviews conducted via the internet using narrow and broad bandwidths. Televideo psychiatric interviews conducted with 42 in-patients with chronic schizophrenia using two bandwidths (narrow, 128 kilobits/s; broad, 2 megabits/s) were assessed in terms of agreement with face-to-face interviews in a test-retest fashion. As a control, agreement was assessed between face-to-face interviews. Psychiatric symptoms were rated using the Oxford version of the Brief Psychiatric Rating Scale (BPRS), and agreement between interviews was estimated as the intraclass correlation coefficient (ICC). The ICC was significantly lower in the narrow bandwidth than in the broad bandwidth and the control for both positive symptoms score and total score. While reliability of televideo psychiatric interviews is insufficient using the present narrow-band internet infrastructure, the next generation of infrastructure (broad-band) may permit reliable diagnostic interviews.

Exploring Situational Awareness in Diagnostic Errors in Primary Care

PubMed Central

Singh, Hardeep; Giardina, Traber Davis; Petersen, Laura A.; Smith, Michael; Wilson, Lindsey; Dismukes, Key; Bhagwath, Gayathri; Thomas, Eric J.

2013-01-01

Objective Diagnostic errors in primary care are harmful but poorly studied. To facilitate understanding of diagnostic errors in real-world primary care settings using electronic health records (EHRs), this study explored the use of the Situational Awareness (SA) framework from aviation human factors research. Methods A mixed-methods study was conducted involving reviews of EHR data followed by semi-structured interviews of selected providers from two institutions in the US. The study population included 380 consecutive patients with colorectal and lung cancers diagnosed between February 2008 and January 2009. Using a pre-tested data collection instrument, trained physicians identified diagnostic errors, defined as lack of timely action on one or more established indications for diagnostic work-up for lung and colorectal cancers. Twenty-six providers involved in cases with and without errors were interviewed. Interviews probed for providers' lack of SA and how this may have influenced the diagnostic process. Results Of 254 cases meeting inclusion criteria, errors were found in 30 (32.6%) of 92 lung cancer cases and 56 (33.5%) of 167 colorectal cancer cases. Analysis of interviews related to error cases revealed evidence of lack of one of four levels of SA applicable to primary care practice: information perception, information comprehension, forecasting future events, and choosing appropriate action based on the first three levels. In cases without error, the application of the SA framework provided insight into processes involved in attention management. Conclusions A framework of SA can help analyze and understand diagnostic errors in primary care settings that use EHRs. PMID:21890757

Third-person Diagnostic Interview on the Cognitive Insight Level of Psychotic Patients with an Insight at the Denial Level.

PubMed

Mehdizadeh, Mahsa; Rezaei, Omid

2016-01-01

According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight.

Net Differences in Interview Data on Chronic Conditions and Information Derived from Medical Records. Vital and Health Statistics, Series 2, No. 57.

ERIC Educational Resources Information Center

Madow, William G.

The California study, based on data from a national survey, compared accuracy and completeness of information on 7,182 chronic health conditions of persons, 17 years of age or older, given in household interviews with diagnostic information given by group medical plan physicians. Overreporting referred to conditions reported in the interview which…

Minnesota Impulse Disorders Interview (MIDI): Validation of a structured diagnostic clinical interview for impulse control disorders in an enriched community sample.

PubMed

Chamberlain, Samuel R; Grant, Jon E

2018-07-01

Disorders of impulsivity are common, functionally impairing, and highly relevant across different clinical and research settings. Few structured clinical interviews for the identification and diagnosis of impulse control disorders exist, and none have been validated in a community sample in terms of psychometric properties. The Minnesota Impulse control disorders Interview (MIDI v2.0) was administered to an enriched sample of 293 non-treatment seeking adults aged 18-35 years, recruited using media advertisements in two large US cities. In addition to the MIDI, participants undertook extended clinical interview for other mental disorders, the Barratt impulsiveness questionnaire, and the Padua obsessive-compulsive inventory. The psychometric properties of the MIDI were characterized. In logistic regression, the MIDI showed good concurrent validity against the reference measures (versus gambling disorder interview, p < 0.001; Barratt impulsiveness attentional and non-planning scores p < 0.05), and good discriminant validity versus primarily non-impulsive symptoms, including against anxiety, depression, and obsessive-compulsive symptoms (all p > 0.05). Test re-test reliability was excellent (0.95). The MIDI has good psychometric properties and thus may be a valuable interview tool for clinical and research studies involving impulse control disorders. Further research is needed to better understanding the optimal diagnostic classification and neurobiology of these neglected disorders. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

Parent-Child Diagnostic Agreement on Anxiety Symptoms with a Structured Diagnostic Interview for Mental Disorders in Children.

PubMed

Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia

2017-01-01

Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years ( M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder ( k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder ( k = 0.24-0.52; k = 0.19-0.43) and corresponding diagnostic criteria ( k = 0.22-0.67; k = 0.24-0.41) were low to moderate with the highest agreement on separation anxiety disorder ( k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family-especially maternal depression and low social support-lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement.

Parent-Child Diagnostic Agreement on Anxiety Symptoms with a Structured Diagnostic Interview for Mental Disorders in Children

PubMed Central

Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia

2017-01-01

Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years (M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder (k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder (k = 0.24–0.52; k = 0.19–0.43) and corresponding diagnostic criteria (k = 0.22–0.67; k = 0.24–0.41) were low to moderate with the highest agreement on separation anxiety disorder (k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family—especially maternal depression and low social support—lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement. PMID:28396644

Asperger syndrome in adolescent and young adult males. Interview, self- and parent assessment of social, emotional, and cognitive problems.

PubMed

Cederlund, Mats; Hagberg, Bibbi; Gillberg, Christopher

2010-01-01

Descriptive and comparative follow-up studies of young adult males with Asperger syndrome (AS) diagnosed in childhood, using both interview, self- and parent assessment instruments for the study of aspects of emotional well-being, social functioning, and cognitive-practical skills have not been performed in the past. One-hundred males with AS diagnosed in childhood were approached for the assessment using the Asperger Syndrome Diagnostic Interview (ASDI), (personal and parent interview), the Leiter-R-Questionnaires, the Beck Depression Inventory (BDI), and the Dysexecutive Questionnaire (DEX). About 75% of the targeted group participated. The ASDI results came out significantly different at personal vs parent interviews in several key domains. In contrast, the Leiter-R-Questionnaires, showed no significant differences across the individuals with AS and their parents in the scoring of cognitive/social and emotional/adaptive skills. The BDI proved to be an adequate screening instrument for depression in that it correctly identified the vast majority of cases with clinical depression in the AS group. The DEX results suggested an executive function deficit problem profile in males with AS as severe as that reported in groups of individuals with traumatic brain injury and schizophrenia. Interviews (personal and collateral), and self-rating and parent-rating questionnaires all have a role in the comprehensive diagnostic process in AS and other autism spectrum disorders, and could be used as adjuncts when evaluating whether or not individuals meeting diagnostic symptom criteria for the condition have sufficient problems in daily life to warrant a clinical diagnosis of AS. Copyright 2009 Elsevier Ltd. All rights reserved.

Bringing diagnostics to developing countries: an interview with Rosanna Peeling.

PubMed

Peeling, Rosanna

2015-01-01

Interview with Professor Rosanna Peeling, PhD by Claire Raison (Commissioning Editor) Professor Rosanna Peeling is Chair of Diagnostic Research at the London School of Hygiene and Tropical Medicine (London, UK) and founded the International Diagnostics Centre at the institution. Professor Peeling previously worked for the WHO in Geneva, Switzerland, and continues to work on innovations for molecular diagnostics for point-of-care use in developing countries, addressing challenges posed by lack of funding and resources, regulatory issues and under-developed healthcare systems in these locations. Here, she discusses her career, recent progress in the field and how connectivity will affect global healthcare.

Social anxiety disorder diagnostic criteria perform equally across age, comorbid diagnosis, and performance/interaction subtypes.

PubMed

Crome, Erica; Baillie, Andrew

2015-01-01

The prevalence of social anxiety disorder (SAD) is frequently higher in younger age groups and people with other anxiety or mood disorders; however, it is unclear whether these groups have a higher risk for developing SAD or are simply more likely to endorse diagnostic criteria than other people with similar levels of social anxiety. Explicitly testing the assumption all people respond to structured diagnostic interviews in comparable ways (measurement invariance) is essential in ensuring systematic response biases do not create spurious group differences. This research aims to systematically test whether age, comorbidity status, or types of social fears affect responses to a structured diagnostic interview. Responses from 1755 participants in a large-scale survey of mental health in Australia screening into the social phobia/SAD section of the Composite International Diagnostic Interview were used. Three series of multigroup confirmatory factor analyses for categorical data systematically tested for increasingly strict levels of measurement invariance. Overall, patterns of responding to diagnostic criteria were comparable across the groups, supporting assumptions of measurement invariance. Establishment of invariance supports the interpretation of differences between age, comorbidity status, and types of social situations feared as genuine differences in experience as opposed to measurement biases.

Autism Diagnostic Interview-Revised (ADI-R) Algorithms for Toddlers and Young Preschoolers: Application in a Non-US Sample of 1,104 Children

ERIC Educational Resources Information Center

de Bildt, Annelies; Sytema, Sjoerd; Zander, Eric; Bölte, Sven; Sturm, Harald; Yirmiya, Nurit; Yaari, Maya; Charman, Tony; Salomone, Erica; LeCouteur, Ann; Green, Jonathan; Bedia, Ricardo Canal; Primo, Patricia García; van Daalen, Emma; de Jonge, Maretha V.; Guðmundsdóttir, Emilía; Jóhannsdóttir, Sigurrós; Raleva, Marija; Boskovska, Meri; Rogé, Bernadette; Baduel, Sophie; Moilanen, Irma; Yliherva, Anneli; Buitelaar, Jan; Oosterling, Iris J.

2015-01-01

The current study aimed to investigate the Autism Diagnostic Interview-Revised (ADI-R) algorithms for toddlers and young preschoolers (Kim and Lord, "J Autism Dev Disord" 42(1):82-93, 2012) in a non-US sample from ten sites in nine countries (n = 1,104). The construct validity indicated a good fit of the algorithms. The diagnostic…

Information sharing during diagnostic assessments: what is relevant for parents?

PubMed

Klein, Sheryl; Wynn, Kerry; Ray, Lynne; Demeriez, Lori; LaBerge, Patricia; Pei, Jacqueline; St Pierre, Cherie

2011-05-01

ABSTRACT This descriptive qualitative study facilitates the application of family-centered care within a tertiary care interdisciplinary neurodevelopmental diagnostic assessment clinic by furthering an understanding of parent perceptions of the relevance of diagnostic information provision. An interdisciplinary assessment team completed an open-ended questionnaire to describe parent information provision. Parents from 9 families completed in-depth parent interviews following clinic attendance to discuss perceptions of information received. Interviews were audiotaped, transcribed, and coded by related themes. Parents did not perceive the information in the way professionals expected. Parents acknowledged receipt of comprehensive information relevant to the diagnosis but indicated that not all their needs were met. During the interviews, parents described the assessment process, preassessment information, and "steps in their journey." They noted that a strength-based approach and a focus on parental competency would support their coping efforts. Results underscore the need for professionals to be attentive to parents' individualized needs.

Third-person Diagnostic Interview on the Cognitive Insight Level of Psychotic Patients with an Insight at the Denial Level

PubMed Central

Mehdizadeh, Mahsa; Rezaei, Omid

2016-01-01

Objectives: According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. Materials and Methods: In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. Results: The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. Conclusion: According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight. PMID:27335517

Missed opportunities for diagnosis: lessons learned from diagnostic errors in primary care.

PubMed

Goyder, Clare R; Jones, Caroline H D; Heneghan, Carl J; Thompson, Matthew J

2015-12-01

Because of the difficulties inherent in diagnosis in primary care, it is inevitable that diagnostic errors will occur. However, despite the important consequences associated with diagnostic errors and their estimated high prevalence, teaching and research on diagnostic error is a neglected area. To ascertain the key learning points from GPs' experiences of diagnostic errors and approaches to clinical decision making associated with these. Secondary analysis of 36 qualitative interviews with GPs in Oxfordshire, UK. Two datasets of semi-structured interviews were combined. Questions focused on GPs' experiences of diagnosis and diagnostic errors (or near misses) in routine primary care and out of hours. Interviews were audiorecorded, transcribed verbatim, and analysed thematically. Learning points include GPs' reliance on 'pattern recognition' and the failure of this strategy to identify atypical presentations; the importance of considering all potentially serious conditions using a 'restricted rule out' approach; and identifying and acting on a sense of unease. Strategies to help manage uncertainty in primary care were also discussed. Learning from previous examples of diagnostic errors is essential if these events are to be reduced in the future and this should be incorporated into GP training. At a practice level, learning points from experiences of diagnostic errors should be discussed more frequently; and more should be done to integrate these lessons nationally to understand and characterise diagnostic errors. © British Journal of General Practice 2015.

The Spanish Diagnostic Interview Schedule. Reliability and comparison with clinical diagnoses.

PubMed

Burnam, M A; Karno, M; Hough, R L; Escobar, J I; Forsythe, A B

1983-11-01

The National Institute of Mental Health Diagnostic Interview Schedule (DIS) was translated into Spanish. The reliability of the Spanish instrument, its equivalence to the English version, and its agreement with clinical diagnoses were examined in a study of 90 bilingual (English-and Spanish-speaking) and 61 monolingual (Spanish-speaking only) patients from a community mental health center. The study design involved two independent DIS administrations and one independent clinical evaluation of each subject.

The Clinical Encounter as Local Moral World: Shifts of Assumptions and Transformation in Relational Context

PubMed Central

Alegría, Margarita

2013-01-01

In this study we consider the process of the clinical encounter, and present exemplars of how assumptions of both clinicians and their patients can shift or transform in the course of a diagnostic interview. We examine the process as it is recalled, and further elaborated, in post-diagnostic interviews as part of a collaborative inquiry during reflections with clinicians and patients in the northeastern United States. Rather than treating assumptions by patients and providers as a fixed attribute of an individual, we treat them as occurring between people within a particular social context, the diagnostic interview. We explore the diagnostic interview as a landscape in which assumptions occur (and can shift), navigate the features of this landscape, and suggest that our examination can best be achieved by the systematic comparison of views of the multiple actors in an experience-near manner. We describe what might be gained by this shift in assumptions and how it can make visible what is at stake for clinician and patient in their local moral worlds – for patients, acknowledgement of social suffering, for clinicians how assumptions are a barrier to engagement with minority patients. It is crucial for clinicians to develop this capacity for reflection when navigating the interactions with patients from different cultures, to recognize and transform assumptions, to notice ‘surprises’, and to elicit what really matters to patients in their care. PMID:19201074

Diagnostic Efficiency among Psychiatric Outpatients of a Self-Report Version of a Subset of Screen Items of the Structured Clinical Interview for DSM-IV-TR Personality Disorders (SCID-II)

ERIC Educational Resources Information Center

Germans, Sara; Van Heck, Guus L.; Masthoff, Erik D.; Trompenaars, Fons J. W. M.; Hodiamont, Paul P. G.

2010-01-01

This article describes the identification of a 10-item set of the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) items, which proved to be effective as a self-report assessment instrument in screening personality disorders. The item selection was based on the retrospective analyses of 495 SCID-II interviews. The…

Development of short-form and screening cutoff point of the Smartphone Addiction Inventory (SPAI-SF).

PubMed

Lin, Yu-Hsuan; Pan, Yuan-Chien; Lin, Sheng-Hsuan; Chen, Sue-Huei

2017-06-01

Smartphone addiction is considered a form of technological addiction that has attracted increasing attention. The present study developed and validated the short-form Smartphone Addiction Inventory (SPAI-SF) and established cutoff point for screening smartphone addiction based on diagnostic criteria established by psychiatric interview. A total of 268 participants completed an online survey that collected demographic data, smartphone use behaviours, and responses to the 26-item SPAI. Each participant also completed a psychiatric interview. Confirmatory factor analysis (CFA) revealed that the 10-item SPAI-SF replicated the structure of original 26-item SPAI accurately, yielding a four-factor model consisting of compulsive behaviour, functional impairment, withdrawal, and tolerance. For maximal diagnostic accuracy, a cutoff point of 24/25 best discriminated cases of smartphone addiction from diagnostic negatives. The present findings suggest that both the 26-item SPAI and SPAI-SF manifest the four constructs of behavioural addiction and the characteristics of smartphone addiction. The cutoff point determined by psychiatrists' diagnostic interview will be useful for clinical screening and epidemiologic research. Copyright © 2016 John Wiley & Sons, Ltd.

Strategies for diagnosing leg oedema in primary care: a qualitative study of GPs' approaches.

PubMed

Diederich, Judith; Hartel, Simone; Baum, Erika; Bösner, Stefan

2014-12-01

The symptom leg oedema represents a broad range of possible underlying aetiologies. The background of leg oedema is multifactorial and usually the GP is the first contact point for patients presenting with this symptom. GPs rely on patient history and physical examination as their main diagnostic tools. To identify GPs' diagnostic approaches and heuristics in patients presenting with leg oedema. Interviews with 15 GPs (20-30 min) using a semi-structured interview-guideline were conducted. GPs described their individual diagnostic strategies concerning all patients presenting with leg oedema they had prospectively identified during the previous four weeks. Interviews were taped and transcribed verbatim. Qualitative analysis was conducted by two independent raters. GPs applied a variety of diagnostic approaches, which can be grouped in active and passive strategies. Active strategies comprised the use of decision rules and guidelines, Bayesian arguing, problem dichotomisation and discrepancy heuristics. Passive approaches included test of time, therapy as diagnosis, and taking patient assumptions into account. When dealing with leg oedema, GPs use prior information of individual patients in a specific way. There is a broad variety of diagnostic approaches that can be grouped in 'active' and 'passive' behaviour. Approaches mostly match with established diagnostic strategies in primary care.

[Multi-centre clinical assessment of the Russian language version of the Diagnostic Interview for Psychoses].

PubMed

Smirnova, D A; Petrova, N N; Pavlichenko, A V; Martynikhin, I A; Dorofeikova, M V; Eremkin, V I; Izmailova, O V; Osadshiy, Yu Yu; Romanov, D V; Ubeikon, D A; Fedotov, I A; Sheifer, M S; Shustov, A D; Yashikhina, A A; Clark, M; Badcock, J; Watterreus, A; Morgan, V; Jablensky, A

2018-01-01

The Diagnostic Interview for Psychoses (DIP) was developed to enhance the quality of diagnostic assessment of psychotic disorders. The aim of the study was the adaptation of the Russian language version and evaluation of its validity and reliability. Ninety-eight patients with psychotic disorders (89 video recordings) were assessed by 12 interviewers using the Russian version of DIP at 7 clinical sites (in 6 cities of the Russian Federation). DIP ratings on 32 cases of a randomized case sample were made by 9 interviewers and the inter-rater reliability was compared with the researchers' DIP ratings. Overall pairwise agreement and Cohen's kappa were calculated. Diagnostic validity was evaluated on the basis of comparing the researchers' ratings using the Russian version of DIP with the 'gold standard' ratings of the same 62 clinical cases from the Western Australia Family Study Schizophrenia (WAFSS). The mean duration of the interview was 47±21 minutes. The Kappa statistic demonstrated a significant or almost perfect level of agreement on the majority of DIP items (84.54%) and a significant agreement for the ICD-10 diagnoses generated by the DIP computer diagnostic algorithm (κ=0.68; 95% CI 0.53,0.93). The level of agreement on the researchers' diagnoses was considerably lower (κ=0.31; 95% CI 0.06,0.56). The agreement on affective and positive psychotic symptoms was significantly higher than agreement on negative symptoms (F(2,44)=20.72, p<0.001, η2=0.485). The diagnostic validity of the Russian language version of DIP was confirmed by 73% (45/62) of the Russian DIP diagnoses matching the original WAFSS diagnoses. Among the mismatched diagnoses were 80 cases with a diagnosis of F20 Schizophrenia in the medical documentation compared to the researchers' F20 diagnoses in only 68 patients and in 62 of the DIP computerized diagnostic outputs. The reported level of subjective difficulties experienced when using the DIP was low to moderate. The results of the study confirm the validity and reliability of the Russian version of the DIP for evaluating psychotic disorders. DIP can be recommended for use in education and training, clinical practice and research as an important diagnostic resource.

A Review of 20 Years of Research on Overdiagnosis and Underdiagnosis in the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) Project

PubMed Central

2016-01-01

The Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project represents an integration of research methodology into a community-based outpatient practice affiliated with an academic medical centre. The MIDAS project is the largest clinical epidemiological study using semi-structured interviews to assess a wide range of psychiatric disorders in a general clinical outpatient practice. In an early report from the MIDAS project, we found that across diagnostic categories clinicians using unstandardized, unstructured clinical interviews underrecognized diagnostic comorbidity, compared with the results of semi-structured interviews. Moreover, we found that the patients often wanted treatment for symptoms of disorders that were diagnosed as comorbid, rather than principal, conditions. This highlighted the importance, from the patient’s perspective, of conducting thorough diagnostic interviews to diagnose disorders that are not related to the patient’s chief complaint because patients often desire treatment for these additional diagnoses. While several of the initial papers from the MIDAS project identified problems with the detection of comorbid disorders in clinical practice, regarding the diagnosis of bipolar disorder we observed the emergence of an opposite phenomenon—clinician overdiagnosis. The results from the MIDAS project, along with other studies of diagnosis in routine clinical practice, have brought to the forefront the problem with diagnosis in routine clinical practice. An important question is what do these findings suggest about the community standard of care in making psychiatric diagnoses, and whether and how the standard of care should be changed? The implications are discussed. PMID:27253697

A Review of 20 Years of Research on Overdiagnosis and Underdiagnosis in the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) Project.

PubMed

Zimmerman, Mark

2016-02-01

The Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project represents an integration of research methodology into a community-based outpatient practice affiliated with an academic medical centre. The MIDAS project is the largest clinical epidemiological study using semi-structured interviews to assess a wide range of psychiatric disorders in a general clinical outpatient practice. In an early report from the MIDAS project, we found that across diagnostic categories clinicians using unstandardized, unstructured clinical interviews underrecognized diagnostic comorbidity, compared with the results of semi-structured interviews. Moreover, we found that the patients often wanted treatment for symptoms of disorders that were diagnosed as comorbid, rather than principal, conditions. This highlighted the importance, from the patient's perspective, of conducting thorough diagnostic interviews to diagnose disorders that are not related to the patient's chief complaint because patients often desire treatment for these additional diagnoses. While several of the initial papers from the MIDAS project identified problems with the detection of comorbid disorders in clinical practice, regarding the diagnosis of bipolar disorder we observed the emergence of an opposite phenomenon-clinician overdiagnosis. The results from the MIDAS project, along with other studies of diagnosis in routine clinical practice, have brought to the forefront the problem with diagnosis in routine clinical practice. An important question is what do these findings suggest about the community standard of care in making psychiatric diagnoses, and whether and how the standard of care should be changed? The implications are discussed. © The Author(s) 2016.

Brief Report: Prevalence of Psychiatric Disorders in Pregnant Teenagers

ERIC Educational Resources Information Center

Mitsuhiro, Sandro Sendin; Chalem, Elisa; Barros, Marina Carvalho Moraes; Guinsburg, Ruth; Laranjeira, Ronaldo

2009-01-01

Purpose: To evaluate the prevalence of ICD-10 psychiatric disorders in a population of pregnant teenage women from a Brazilian public hospital. Method: 1000 pregnant teenage women were evaluated using the Composite International Diagnostic Interview, a structured interview which establishes diagnoses according to the International Classification…

Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder.

PubMed

Alavi, Seyyed Salman; Mohammadi, Mohammad Reza; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

2016-04-01

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under "impulse control disorder not elsewhere classified". This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. The content validity of the semi- structured clinical interview matched the DSM-IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including "SMS pathological use" and "High monthly cost of using the mobile phone" were added to promote its validity. Internal reliability (Kappa) and test-retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder.

The sodium pentothal hypnosis interview with follow-up treatment for complex regional pain syndrome.

PubMed

Simon, E P; Dahl, L F

1999-08-01

A patient who was unresponsive to multiple conservative medical treatments for complex regional pain syndrome was assessed using a novel approach--the sodium pentothal hypnosis interview. The interview suggested that his pain was centrally generated. The patient's pain symptoms resolved with hypnotherapeutic treatment. Indications for this procedure and implications for assessment and treatment are discussed. This case raises more questions than it answers, and leaves the reader to struggle with current difficulties in diagnostic decision-making.

Clinical Dental Faculty Members' Perceptions of Diagnostic Errors and How to Avoid Them.

PubMed

Nikdel, Cathy; Nikdel, Kian; Ibarra-Noriega, Ana; Kalenderian, Elsbeth; Walji, Muhammad F

2018-04-01

Diagnostic errors are increasingly recognized as a source of preventable harm in medicine, yet little is known about their occurrence in dentistry. The aim of this study was to gain a deeper understanding of clinical dental faculty members' perceptions of diagnostic errors, types of errors that may occur, and possible contributing factors. The authors conducted semi-structured interviews with ten domain experts at one U.S. dental school in May-August 2016 about their perceptions of diagnostic errors and their causes. The interviews were analyzed using an inductive process to identify themes and key findings. The results showed that the participants varied in their definitions of diagnostic errors. While all identified missed diagnosis and wrong diagnosis, only four participants perceived that a delay in diagnosis was a diagnostic error. Some participants perceived that an error occurs only when the choice of treatment leads to harm. Contributing factors associated with diagnostic errors included the knowledge and skills of the dentist, not taking adequate time, lack of communication among colleagues, and cognitive biases such as premature closure based on previous experience. Strategies suggested by the participants to prevent these errors were taking adequate time when investigating a case, forming study groups, increasing communication, and putting more emphasis on differential diagnosis. These interviews revealed differing perceptions of dental diagnostic errors among clinical dental faculty members. To address the variations, the authors recommend adopting shared language developed by the medical profession to increase understanding.

The "Pathological Gambling and Epidemiology" (PAGE) study program: design and fieldwork.

PubMed

Meyer, Christian; Bischof, Anja; Westram, Anja; Jeske, Christine; de Brito, Susanna; Glorius, Sonja; Schön, Daniela; Porz, Sarah; Gürtler, Diana; Kastirke, Nadin; Hayer, Tobias; Jacobi, Frank; Lucht, Michael; Premper, Volker; Gilberg, Reiner; Hess, Doris; Bischof, Gallus; John, Ulrich; Rumpf, Hans-Jürgen

2015-03-01

The German federal states initiated the "Pathological Gambling and Epidemiology" (PAGE) program to evaluate the public health relevance of pathological gambling. The aim of PAGE was to estimate the prevalence of pathological gambling and cover the heterogenic presentation in the population with respect to comorbid substance use and mental disorders, risk and protective factors, course aspects, treatment utilization, triggering and maintenance factors of remission, and biological markers. This paper describes the methodological details of the study and reports basic prevalence data. Two sampling frames (landline and mobile telephone numbers) were used to generate a random sample from the general population consisting of 15,023 individuals (ages 14 to 64) completing a telephone interview. Additionally, high-risk populations have been approached in gambling locations, via media announcements, outpatient addiction services, debt counselors, probation assistants, self-help groups and specialized inpatient treatment facilities. The assessment included two steps: (1) a diagnostic interview comprising the gambling section of the Composite International Diagnostic Interview (CIDI) for case finding; (2) an in-depth clinical interview with participants reporting gambling problems. The in-depth clinical interview was completed by 594 participants, who were recruited from the general or high-risk populations. The program provides a rich epidemiological database which is available as a scientific use file. Copyright © 2015 John Wiley & Sons, Ltd.

Prevalence of Asperger syndrome among patients of an Early Intervention in Psychosis team.

PubMed

Davidson, Conor; Greenwood, Nick; Stansfield, Alison; Wright, Stephen

2014-05-01

There is a lack of systematic studies into comorbidity of Asperger syndrome and psychosis. To determine the prevalence of Asperger syndrome among patients of an early intervention in psychosis service. This study was a cross-sectional survey consisting of three phases: screening, case note review and diagnostic interviews. All patients on caseload (n = 197) were screened using the Autism Spectrum Disorder in Adults Screening Questionnaire. The case notes of patients screened positive were then reviewed for information relevant to Asperger syndrome. Those suspected of having Asperger syndrome were invited for a diagnostic interview. Thirty patients were screened positive. Three of them already had a diagnosis of Asperger syndrome made by child and adolescent mental health services. After case note review, 13 patients were invited to interview. Four did not take part, so nine were interviewed. At interview, four were diagnosed with Asperger syndrome. In total, seven patients had Asperger syndrome. Thus, the prevalence rate in this population is at least 3.6%. The results suggest that the prevalence of Asperger syndrome in first-episode psychosis is considerably higher than that in the general population. Clinicians working in early intervention teams need to be alert to the possibility of Asperger syndrome when assessing patients. © 2013 Wiley Publishing Asia Pty Ltd.

The psychiatric interview: validity, structure, and subjectivity.

PubMed

Nordgaard, Julie; Sass, Louis A; Parnas, Josef

2013-06-01

There is a glaring gap in the psychiatric literature concerning the nature of psychiatric symptoms and signs, and a corresponding lack of epistemological discussion of psycho-diagnostic interviewing. Contemporary clinical neuroscience heavily relies on the use of fully structured interviews that are historically rooted in logical positivism and behaviorism. These theoretical approaches marked decisively the so-called "operational revolution in psychiatry" leading to the creation of DSM-III. This paper attempts to examine the theoretical assumptions that underlie the use of a fully structured psychiatric interview. We address the ontological status of pathological experience, the notions of symptom, sign, prototype and Gestalt, and the necessary second-person processes which are involved in converting the patient's experience (originally lived in the first-person perspective) into an "objective" (third person), actionable format, used for classification, treatment, and research. Our central thesis is that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects. We claim that in order to perform faithful distinctions in this particular domain, we need a more adequate approach, that is, an approach that is guided by phenomenologically informed considerations. Our theoretical discussion draws upon clinical examples derived from structured and semi-structured interviews. We conclude that fully structured interview is neither theoretically adequate nor practically valid in obtaining psycho-diagnostic information. Failure to address these basic issues may have contributed to the current state of malaise in the study of psychopathology.

[Clinical diagnostics of ADHD in preschool-aged children].

PubMed

Merkt, Julia; Petermann, Franz

2015-03-01

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders in childhood and adolescence and has many negative consequences for both the child and the family. Early identification of children with ADHD would be helpful for the prevention of long-term consequences. This review appraises questionnaires and clinical interviews that can be used for the diagnosis of ADHD in preschool-aged children (3-5 years). We compare and discuss both German and international methods. The role of questionnaires and clinical interviews in the diagnostic process of ADHD is discussed.

The convergence of personality disorder diagnoses across different methods among monolingual (Spanish-speaking only) Hispanic patients in substance use treatment.

PubMed

Samuel, Douglas B; Añez, Luis M; Paris, Manuel; Grilo, Carlos M

2014-04-01

Methods for diagnosing personality disorders (PDs) within clinical settings typically diverge from those used in treatment research. Treatment groups in research studies are routinely diagnosed using semistructured interviews or self-report questionnaires, yet these methods show poor agreement with clinical diagnoses recorded in medical charts or assigned by treating clinicians, reducing the potential for evidence-based practice. Furthermore, existing research has been limited by focusing on primarily White and English-speaking participants. Our study extended prior research by comparing 4 independent methods of PD diagnosis, including self-report questionnaire, semistructured interview, chart diagnoses, and ratings by treating clinicians, within a clinical series of 130 monolingual (Spanish only) Hispanic persons (69% male; M age 37.4), in treatment for substance use. The authors examined the convergence of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) PD diagnoses across these methods. PD diagnoses appeared infrequently within medical charts but were diagnosed at higher levels by independent treating clinicians, self-report questionnaires, and semistructured interviews. Nonetheless, diagnostic concordance between clinical diagnoses and the other methods were poor (κ < .20). Convergence of PD diagnoses across diagnostic methods for Spanish-speaking Hispanic persons are comparable to other groups allaying concerns about cross-cultural application of PD diagnoses. Additionally, the results of this study echo previous research in suggesting that clinicians' PD diagnoses overlap little with self-report questionnaires or semistructured diagnostic interviews and suggest that PDs are underdiagnosed using standard diagnostic approaches. Implications for the clinical application of empirically supported research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved

Suicide Attempts in an African Schizophrenia Population: An Assessment of Demographic Risk Factors

ERIC Educational Resources Information Center

Niehaus, D.J.H.; Laurent, C.; Jordaan, E.; Koen, L.; Oosthuizen, P.; Keyter, N.; Muller, J. E.; Mbanga, N. I.; Deleuze, J.-F.; Mallet, J.; Stein, D. J.; Emsley, R.

2004-01-01

This study investigated demographic variables, including affected sibling pair status, as risk factors for suicidal behavior in schizophrenia patients of African (Xhosa) descent. Xhosa subjects with schizophrenia were interviewed with the Diagnostic Interview for Genetic Studies (DIGS) and then stratified into two groups: those with ( n = 90) and…

Autism Spectrum Traits in Children with Anxiety Disorders

ERIC Educational Resources Information Center

van Steensel, Francisca J. A.; Bogels, Susan M.; Wood, Jeffrey J.

2013-01-01

The aim of this study was to examine ASD traits in children with clinical anxiety in early development, as well as current manifestations. Parents of 42 children with an anxiety disorder (but no known diagnosis of ASD) and 42 typically developing children were interviewed using the Autism Diagnostic Interview (ADI-R). They also completed…

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI).

PubMed

Øhre, Beate; Saltnes, Hege; von Tetzchner, Stephen; Falkum, Erik

2014-05-22

There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen's kappa and "observed agreement". There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and "observed agreement" was above 88%. The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language.

[Inter-rater reliability and validity of the OPD-CA axes structure and conflict].

PubMed

Benecke, Cord; Bock, Astrid; Wieser, Elke; Tschiesner, Reinhard; Lochmann, Martha; Küspert, Felicia; Schorn, Robert; Viertler, Bernhard; Steinmayr-Gensluckner, Maria

2011-01-01

The manual of the Operationalized Psychodynamic Diagnostics in childhood and adolescence (OPD-CA) is an instrument meanwhile widespread in the clinical practice to assess psychodynamic dimensions. Publications of inter-rater agreement and validity are still outstanding. This study assessed the interrater-reliability and validity for the axis structure and the axis conflict. 60 adolescents between 14 and 17 years, with and without psychic disorders, were diagnosed with the Operationalized Psychodynamic Diagnostics in childhood and adolescence (Arbeitskreis OPD-KJ, 2007) and SCID-II-interviews and questionnaires. A partial sample of 36 OPD-CA-interviews was the data basis for the assessment of inter-rater agreement. Calculations of validity for axis structure and axis conflict were made with the whole sample. Inter-rater agreement for the axis structure and the axis conflict showed good to very good weighted Kappa coefficients among the trained raters. Validity of the axis structure showed good results. The Operationalized Psychodynamic Diagnostics in childhood and adolescence (OPD-CA) allows a reliable diagnostic of axis structure and axis conflict, if the ratings are done on the basis of semistructured videotaped interviews by trained raters. The axis structure shows validity, while the results concerning the validity of the axis conflict remain unclear.

Alcohol dependence: international policy implications for prison populations.

PubMed

Jones, Gail Yvonne; Hoffmann, Norman G

2006-11-08

In light of the emphasis on drug abuse, this study explored the relative prevalence of substance use disorders among United Kingdom (UK) prison inmates in the context of findings from a general inmate population in the United States (US). The lead author of the report conducted a structured diagnostic interview with 155 new admissions to one of two prisons in the UK using the CAAPE (Comprehensive Addiction And Psychological Evaluation), a structured diagnostic interview, to ensure consistent assessments. The US sample consisted of 6,881 male inmates in a state prison system evaluated with an automated version of the SUDDS-IV (Substance Use Disorder Diagnostic Schedule-IV) interview. Alcohol dependence emerged as the most prevalent substance use disorder in both UK prisons and in the US sample. Relative frequencies of abuse and dependence for alcohol and other drugs revealed that dependence on a given substance was more prevalent than abuse ad defined by the current diagnostic criteria. Despite the emphasis on drugs in correctional populations, alcohol dependence appears to be the most prominent substance use disorder among the incarcerated in both the US and UK and must be considered in developing treatment programs and policy priorities.

Reliability of DSM-III anxiety disorder categories using a new structured interview.

PubMed

Di Nardo, P A; O'Brien, G T; Barlow, D H; Waddell, M T; Blanchard, E B

1983-10-01

The reliability of DSM-III anxiety disorder diagnoses was determined using a new structured interview, the Anxiety Disorders Interview Schedule (ADIS). Two interviewers examined 60 consecutive outpatients at an anxiety disorders clinic and assigned primary and secondary diagnoses based on the ADIS. The kappa statistic, calculated on the basis of perfect matches on primary diagnoses, indicated good agreement for anxiety, affective, and adjustment disorders, as well as for the specific anxiety disorder categories of agoraphobia, panic, social phobia, and obsessive-compulsive disorder, but not for generalized anxiety disorder. We evaluated the causes for diagnostic disagreement, particularly in relation to the difficult differentiation between generalized anxiety disorder and other anxiety disorders.

DSM-III field trials: II. Initial experience with the multiaxial system.

PubMed

Spitzer, R L; Forman, J B

1979-06-01

The multiaxial system of DSM-III includes nondiagnostic data that are valuable in understanding possible etiological factors and in treatment planning and prognosis. The authors describe the reliability of axis IV--severity of psychosocial stressors--and axis V--highest level of adaptive functioning in the past year--for 281 adult patients interviewed in phase one of the DSM-III field trials. The kappa coefficient of agreement for axis IV was .62 for joint interviews and .58 for separate interviews, which the authors consider at least fair. Reliability for axis V was quite good, .80 for joint interviews and .69 for separate interviews. Eighty-one percent of the participating clinicians judged the multiaxial system to be a useful addition to traditional diagnostic evaluation, although many indicated that they had difficulty quantifying severity of psychosocial stressors.

Negotiating knowledge: parents' experience of the neuropsychiatric diagnostic process for children with autism.

PubMed

Carlsson, Emilia; Miniscalco, Carmela; Kadesjö, Björn; Laakso, Katja

2016-05-01

Parents often recognize problems in their child's development earlier than health professionals do and there is new emphasis on the importance of involving parents in the diagnostic process. In Gothenburg, Sweden, over 100 children were identified as having an autism spectrum disorder (ASD) in 2009-11 through a general population language and autism screening of 2.5 year olds at the city's child healthcare centres. To increase understanding of parents' lived experience of the neuropsychiatric diagnostic process, i.e. the period from the initial screening at age 2.5 years to the 2-year follow-up of the ASD diagnosis. A qualitative design, a phenomenological hermeneutic method, was used. Interviews were conducted with parents of 11 children who were diagnosed with ASD 2 years prior. The parents were interviewed about their experiences of the neuropsychiatric diagnostic process, i.e. the time before the screening, the time during the neuropsychiatric multidisciplinary evaluation and the time after diagnosis. The interviews lasted for 45-130 min, and an interview guide with set questions was used. Most of the interviews were conducted at the parents' homes. The essence that emerged from the data was negotiating knowledge, and the three themes capturing the parents' experiences of going through the process of having their child diagnosed with ASD were seeking knowledge, trusting and challenging experts, and empowered but alone. The parents expected intervention to start directly after diagnosis but felt they had to fight to obtain the resources their child needed. After the process, they described that they felt empowered but still alone, i.e. although they received useful and important information about their child, they were left to manage the situation by themselves. As for clinical implications, the study points to the necessity of developing routines to support the parents during and after the diagnostic process. Recommended measures include developing a checklist outlining relevant contacts and agencies, establishing a coordinator responsible for each child, dividing the summary meeting at the clinic into two parts, making more than one visit to the preschool, and providing a parental training programme. © 2016 Royal College of Speech and Language Therapists.

Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder

PubMed Central

Alavi, Seyyed Salman; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

2016-01-01

Objective: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under “impulse control disorder not elsewhere classified”. This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Method: Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. Results: The content validity of the semi- structured clinical interview matched the DSM–IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including “SMS pathological use” and “High monthly cost of using the mobile phone” were added to promote its validity. Internal reliability (Kappa) and test–retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. Conclusion: The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder. PMID:27437008

Psychiatric comorbidity in DSM-III-R hypochondriasis.

PubMed

Barsky, A J; Wyshak, G; Klerman, G L

1992-02-01

Forty-two DSM-III-R hypochondriacs from a general medical clinic were compared with a random sample of 76 outpatients from the same setting. Patients completed a research battery that included a structured diagnostic interview (Diagnostic Interview Schedule) and self-report questionnaires to measure personality disorder caseness, functional impairment, and hypochondriacal symptoms. Psychiatric morbidity in the hypochondriacal sample significantly exceeded that of the comparison sample. Hypochondriacs had twice as many lifetime Axis I diagnoses, twice as many Diagnostic Interview Schedule symptoms, and three times the level of personality disorder caseness as the comparison group. Of the hypochondriacal sample, 88% had one or more additional Axis I disorders, the overlap being greatest with depressive and anxiety disorders. One fifth of the hypochondriacs had somatization disorder, but the two conditions appeared to be phenomenologically distinct. Hypochondriacal patients with coexisting anxiety and/or depressive disorder (secondary hypochondriasis) did not differ greatly from hypochondriacal patients without these comorbid conditions (primary hypochondriasis). Because the nature of hypochondriasis remains unclear and requires further study, we suggest that its nosologic status not be altered in DSM-IV.

Will This Net Work?: Development of a Diagnostic Interview

ERIC Educational Resources Information Center

Knight, Rose; Wright, Vince

2014-01-01

Spatial visualisation is a subset of spatial ability and is exemplified in predicting whether or not a net will fold to form a target solid. The researchers examined video of interviews to explore the schemes of Year 5 students for determining the validity of nets for a cube and pyramid. Findings suggest the significance of imaged actions, shown…

Between a ROC and a Hard Place: Decision Making and Making Decisions about Using the SCQ

ERIC Educational Resources Information Center

Corsello, Christina; Hus, Vanessa; Pickles, Andrew; Risi, Susan; Cook, Edwin H., Jr.; Leventhal, Bennett L.; Lord, Catherine

2007-01-01

Background: The Social Communication Questionnaire (SCQ), formerly the Autism Screening Questionnaire (ASQ), is based on a well-validated parent interview, the Autism Diagnostic Interview (ADI). It has shown promise as a screening measure for autism spectrum disorders (ASDs) in a research-referred older sample, though recent studies with younger…

The Standard for Clinicians’ Interview in Psychiatry (SCIP): A Clinician-administered Tool with Categorical, Dimensional, and Numeric Output—Conceptual Development, Design, and Description of the SCIP

PubMed Central

Nasrallah, Henry; Muvvala, Srinivas; El-Missiry, Ahmed; Mansour, Hader; Hill, Cheryl; Elswick, Daniel; Price, Elizabeth C.

2016-01-01

Existing standardized diagnostic interviews (SDIs) were designed for researchers and produce mainly categorical diagnoses. There is an urgent need for a clinician-administered tool that produces dimensional measures, in addition to categorical diagnoses. The Standard for Clinicians’ Interview in Psychiatry (SCIP) is a method of assessment of psychopathology for adults. It is designed to be administered by clinicians and includes the SCIP manual and the SCIP interview. Clinicians use the SCIP questions and rate the responses according to the SCIP manual rules. Clinicians use the patient’s responses to questions, observe the patient’s behaviors and make the final rating of the various signs and symptoms assessed. The SCIP method of psychiatric assessment has three components: 1) the SCIP interview (dimensional) component, 2) the etiological component, and 3) the disorder classification component. The SCIP produces three main categories of clinical data: 1) a diagnostic classification of psychiatric disorders, 2) dimensional scores, and 3) numeric data. The SCIP provides diagnoses consistent with criteria from editions of the Diagnostic and Statistical Manual (DSM) and International Classification of Disease (ICD). The SCIP produces 18 dimensional measures for key psychiatric signs or symptoms: anxiety, posttraumatic stress, obsessions, compulsions, depression, mania, suicidality, suicidal behavior, delusions, hallucinations, agitation, disorganized behavior, negativity, catatonia, alcohol addiction, drug addiction, attention, and hyperactivity. The SCIP produces numeric severity data for use in either clinical care or research. The SCIP was shown to be a valid and reliable assessment tool, and the validity and reliability results were published in 2014 and 2015. The SCIP is compatible with personalized psychiatry research and is in line with the Research Domain Criteria framework. PMID:27800284

The Standard for Clinicians' Interview in Psychiatry (SCIP): A Clinician-administered Tool with Categorical, Dimensional, and Numeric Output-Conceptual Development, Design, and Description of the SCIP.

PubMed

Aboraya, Ahmed; Nasrallah, Henry; Muvvala, Srinivas; El-Missiry, Ahmed; Mansour, Hader; Hill, Cheryl; Elswick, Daniel; Price, Elizabeth C

2016-01-01

Existing standardized diagnostic interviews (SDIs) were designed for researchers and produce mainly categorical diagnoses. There is an urgent need for a clinician-administered tool that produces dimensional measures, in addition to categorical diagnoses. The Standard for Clinicians' Interview in Psychiatry (SCIP) is a method of assessment of psychopathology for adults. It is designed to be administered by clinicians and includes the SCIP manual and the SCIP interview. Clinicians use the SCIP questions and rate the responses according to the SCIP manual rules. Clinicians use the patient's responses to questions, observe the patient's behaviors and make the final rating of the various signs and symptoms assessed. The SCIP method of psychiatric assessment has three components: 1) the SCIP interview (dimensional) component, 2) the etiological component, and 3) the disorder classification component. The SCIP produces three main categories of clinical data: 1) a diagnostic classification of psychiatric disorders, 2) dimensional scores, and 3) numeric data. The SCIP provides diagnoses consistent with criteria from editions of the Diagnostic and Statistical Manual (DSM) and International Classification of Disease (ICD). The SCIP produces 18 dimensional measures for key psychiatric signs or symptoms: anxiety, posttraumatic stress, obsessions, compulsions, depression, mania, suicidality, suicidal behavior, delusions, hallucinations, agitation, disorganized behavior, negativity, catatonia, alcohol addiction, drug addiction, attention, and hyperactivity. The SCIP produces numeric severity data for use in either clinical care or research. The SCIP was shown to be a valid and reliable assessment tool, and the validity and reliability results were published in 2014 and 2015. The SCIP is compatible with personalized psychiatry research and is in line with the Research Domain Criteria framework.

The Eating Disorder Assessment for DSM-5 (EDA-5): Development and Validation of a Structured Interview for Feeding and Eating Disorders

PubMed Central

Sysko, Robyn; Glasofer, Deborah R.; Hildebrandt, Tom; Klimek, Patrycja; Mitchell, James E.; Berg, Kelly C.; Peterson, Carol B.; Wonderlich, Stephen A.; Walsh, B. Timothy

2016-01-01

Objective Existing measures for DSM-IV eating disorder diagnoses have notable limitations, and there are important differences between DSM-IV and DSM-5 feeding and eating disorders. This study developed and validated a new semi-structured interview, the Eating Disorders Assessment for DSM-5 (EDA-5). Method Two studies evaluated the utility of the EDA-5. Study 1 compared the diagnostic validity of the EDA-5 to the Eating Disorder Examination (EDE) and evaluated the test-retest reliability of the new measure. Study 2 compared the diagnostic validity of an EDA-5 electronic application (“app”) to clinician interview and self-report assessments. Results In Study 1, the kappa for EDE and EDA-5 eating disorder diagnoses was 0.74 across all diagnoses (n= 64), with a range of κ=0.65 for Other Specified Feeding or Eating Disorder (OSFED)/Unspecified Feeding or Eating Disorder (USFED) to κ=0.90 for Binge Eating Disorder (BED). The EDA-5 test-retest kappa coefficient was 0.87 across diagnoses. For Study 2, clinical interview versus “app” conditions revealed a kappa of 0.83 for all eating disorder diagnoses (n=71). Across individual diagnostic categories, kappas ranged from 0.56 for OSFED/USFED to 0.94 for BN. Discussion High rates of agreement were found between diagnoses by EDA-5 and the EDE, and EDA-5 and clinical interviews. As this study supports the validity of the EDA-5 to generate DSM-5 eating disorders and the reliability of these diagnoses, the EDA-5 may be an option for the assessment of Anorexia Nervosa, Bulimia Nervosa, and BED. Additional research is needed to evaluate the utility of the EDA-5 in assessing DSM-5 feeding disorders. PMID:25639562

[Clinical interview in psychiatric difficult situations].

PubMed

Lorettu, Liliana; Nivoli, Gian Carlo; Milia, Paolo; Depalmas, Cristiano; Clerici, Massimo; Nivoli, Alessandra M A

2017-01-01

There are here described a number of basic principles underlying an effective clinical interview in psychiatric difficult situations (violent or suicidal patients, victims of serious physical and psychological damages, authors of inadequate or anti-social requests to the therapist). The aim of the present study is to provide the psychiatric operator with useful skills for the optimal management of the interview in difficult situations both at diagnostically and therapeutically level. The methodology was based on examination of the literature and personal experience of the authors. The authors highlighted 18 working hypothesis that may represent beneficial instruments in situations of difficult psychiatric interview. Further studies will deepen under the clinical, actuarial and statistical validity the principles covered in various clinical and crisis situations with difficulty to the interview, in relation also to specific types of patients for a more updated training of the operators in the field of mental health.

Convergence of scores on the interview and questionnaire versions of the Eating Disorder Examination: a meta-analytic review.

PubMed

Berg, Kelly C; Peterson, Carol B; Frazier, Patricia; Crow, Scott J

2011-09-01

Significant discrepancies have been found between interview- and questionnaire-based assessments of psychopathology; however, these studies have typically compared instruments with unmatched item content. The Eating Disorder Examination (EDE), a structured interview, and the questionnaire version of the EDE (EDE-Q) are considered the preeminent assessments of eating disorder symptoms and provide a unique opportunity to examine the concordance of interview- and questionnaire-based instruments with matched item content. The convergence of EDE and EDE-Q scores has been examined previously; however, past studies have been limited by small sample sizes and have not compared the convergence of scores across diagnostic groups. A meta-analysis of 16 studies was conducted to compare the convergence of EDE and EDE-Q scores across studies and diagnostic groups. With regard to the EDE and EDE-Q subscale scores, the overall correlation coefficient effect sizes ranged from .68 to .76. The overall Cohen's d effect sizes ranged from .31 to .62, with participants consistently scoring higher on the questionnaire. For the items measuring behavior frequency, the overall correlation coefficient effect sizes ranged from .37 to .55 for binge eating and .90 to .92 for compensatory behaviors. The overall Cohen's d effect sizes ranged from -0.16 to -0.22, with participants reporting more binge eating on the interview than in the questionnaire in 70% of the studies. These results suggest the interview and questionnaire assess similar constructs but should not be used interchangeably. Additional research is needed to examine the inconsistencies between binge frequency scores on the 2 instruments.

Dissociative disorders among Chinese inpatients diagnosed with schizophrenia.

PubMed

Yu, Junhan; Ross, Colin A; Keyes, Benjamin B; Li, Ying; Dai, Yunfei; Zhang, Tianhong; Wang, Lanlan; Fan, Qing; Xiao, Zeping

2010-01-01

The purpose of this study was to assess the prevalence of dissociative disorders in a sample of Chinese psychiatric inpatients. Participants in the study were 569 consecutively admitted inpatients at Shanghai Mental Health Center, China, of whom 84.9% had a clinical diagnosis of schizophrenia based on the Chinese Classification and Diagnostic Criteria of Mental Disorders, Version 3. All participants completed a self-report measure of dissociation (the Dissociative Experiences Scale), and none had a prior diagnosis of a dissociative disorder. A total of 96 randomly selected participants were interviewed with a structured interview (the Dissociative Disorders Interview Schedule) and a clinical interview. These 96 patients did not differ significantly from the 473 patients who were not interviewed on any demographic measures or who did not complete the self-report dissociation measure. A total of 28 patients (15.3%, after weighting of the data) received a clinical diagnosis of a dissociative disorder based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria. Dissociative identity disorder was diagnosed in 2 patients (0.53%, after weighting). Compared to the patients without a dissociative disorder, patients with dissociative disorders were significantly more likely to report childhood abuse (57.1% vs. 22.1%), but the 2 groups did not differ significantly on any demographic measures. Dissociative disorders were readily identified in an inpatient psychiatric population in China.

DSM-III field trials: I. Initial interrater diagnostic reliability.

PubMed

Spitzer, R L; Forman, J B; Nee, J

1979-06-01

The interrater agreement for major diagnostic categories in studies using DSM-I and DSM-II was usually only fair or poor. In phase one of the DSM-III field trials the overall kappa coefficient of agreement for axis I diagnoses of 281 adult patients was .78 for joint interviews and .66 for diagnoses made after separate interviews; for axis II--personality disorders and specific developmental disorders--the coefficients of agreement were .61 and .54. The interrater reliability of DSM--III is, in general, higher than that previously achieved and may be due to changes in the classification itself, the separation of axis I from axis II conditions, the systematic description of the various disorders, and the inclusion of diagnostic criteria.

Diagnostic change and personality stability following functional restoration treatment in chronic low back pain patients.

PubMed

Vittengl, J R; Clark, L A; Owen-Salters, E; Gatchel, R J

1999-03-01

This study examined personality pathology in a group of patients with chronic low back pain (CLBP) using both diagnostic interviews and dimensional self-report instruments. A group of CLBP patients (N = 125) was assessed before functional restoration treatment and compared with a matched normal comparison group (N = 75). The CLBP group evidenced broad personality pathology in all assessment modes pretreatment relative to the normal comparison sample. In addition, two subsamples of CLBP patients (n = 49 and n = 56) were assessed after treatment. Reductions in personality pathology between pre- and posttreatment assessments were more pronounced for diagnostic interview than dimensional self-report assessments. These results are discussed in the context of personality assessment and CLBP.

The Assessment of Math Learning Difficulties in a Primary Grade-4 Child with High Support Needs: Mixed Methods Approach

ERIC Educational Resources Information Center

Mundia, Lawrence

2012-01-01

This mixed-methods study incorporated elements of survey, case study and action research approaches in investigating an at-risk child. Using an in-take interview, a diagnostic test, an error analysis, and a think-aloud clinical interview, the study identified the child's major presenting difficulties. These included: inability to use the four…

Effects of diagnosis on treatment recommendations in chronic insomnia--a report from the APA/NIMH DSM-IV field trial.

PubMed

Buysse, D J; Reynolds, C F; Kupfer, D J; Thorpy, M J; Bixler, E; Kales, A; Manfredi, R; Vgontzas, A; Stepanski, E; Roth, T; Hauri, P; Stapf, D

1997-07-01

The objective of this study was to determine whether sleep specialists and nonspecialists recommend different treatments for different insomnia diagnoses according to two different diagnostic classifications. Two hundred sixteen patients with chronic insomnia at five sites were each interviewed by two clinicians: one sleep specialist and one nonsleep specialist. All interviewers indicated diagnoses using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV); sleep specialists also indicated diagnoses according to the International Classification for Sleep Disorders (ICSD). Interviewers then indicated how strongly they would recommend each item in a standard list of treatment and diagnostic interventions for each patient. We examined differences in treatment recommendations among the six most common DSM-IV diagnoses assigned by sleep specialists at different sites (n = 192), among the six most common ICSD diagnoses assigned by sleep specialists at different sites (n = 153), and among the six most common DSM-IV diagnoses assigned by nonspecialists at different sites (n = 186). In each analysis, specific treatment and polysomnography recommendations differed significantly for different diagnoses, using either DSM-IV or ICSD criteria. Conversely, different diagnoses were associated with different rank orderings of specific treatment and diagnostic recommendations. Sleep specialist and nonspecialist interviewers each distinguished treatment recommendations among different diagnoses, but in general, nonspecialists more strongly recommended medications and relaxation treatments. Significant site-related differences in treatment recommendations also emerged. Differences in treatment recommendations support the distinction between different DSM-IV and ICSD diagnoses, although they do not provide formal validation. Site-related differences suggest a lack of consensus in how these disorders are conceptualized and treated.

Incorporation of Mobile Application (App) Measures Into the Diagnosis of Smartphone Addiction.

PubMed

Lin, Yu-Hsuan; Lin, Po-Hsien; Chiang, Chih-Lin; Lee, Yang-Han; Yang, Cheryl C H; Kuo, Terry B J; Lin, Sheng-Hsuan

2017-07-01

Global smartphone expansion has brought about unprecedented addictive behaviors. The current diagnosis of smartphone addiction is based solely on information from clinical interview. This study aimed to incorporate application (app)-recorded data into psychiatric criteria for the diagnosis of smartphone addiction and to examine the predictive ability of the app-recorded data for the diagnosis of smartphone addiction. Smartphone use data of 79 college students were recorded by a newly developed app for 1 month between December 1, 2013, and May 31, 2014. For each participant, psychiatrists made a diagnosis for smartphone addiction based on 2 approaches: (1) only diagnostic interview (standard diagnosis) and (2) both diagnostic interview and app-recorded data (app-incorporated diagnosis). The app-incorporated diagnosis was further used to build app-incorporated diagnostic criteria. In addition, the app-recorded data were pooled as a score to predict smartphone addiction diagnosis. When app-incorporated diagnosis was used as a gold standard for 12 candidate criteria, 7 criteria showed significant accuracy (area under receiver operating characteristic curve [AUC] > 0.7) and were constructed as app-incorporated diagnostic criteria, which demonstrated remarkable accuracy (92.4%) for app-incorporated diagnosis. In addition, both frequency and duration of daily smartphone use significantly predicted app-incorporated diagnosis (AUC = 0.70 for frequency; AUC = 0.72 for duration). The combination of duration, frequency, and frequency trend for 1 month can accurately predict smartphone addiction diagnosis (AUC = 0.79 for app-incorporated diagnosis; AUC = 0.71 for standard diagnosis). The app-incorporated diagnosis, combining both psychiatric interview and app-recorded data, demonstrated substantial accuracy for smartphone addiction diagnosis. In addition, the app-recorded data performed as an accurate screening tool for app-incorporated diagnosis. © Copyright 2017 Physicians Postgraduate Press, Inc.

Diagnostic interview study of the prevalence of depression among public employees engaged in long-term relief work in Fukushima.

PubMed

Maeda, Masaharu; Ueda, Yukiko; Nagai, Masato; Fujii, Senta; Oe, Misari

2016-09-01

The Great East Japan Earthquake and in particular, the Fukushima Daiichi Nuclear Power Plant accident, have had a serious psychological impact on not only residents, but also relief workers in Fukushima. Although public employees work in highly stressful situations and play a very important role in long-term relief, their psychiatric features have yet to be clarified. The two aims of this study were to identify the current prevalence rate of depression and post-traumatic stress disorder among public employees working in the disaster area using diagnostic interviews, and to speculate on the psychosocial factors affecting their mental condition. We conducted diagnostic interviews and self-administered questionnaires with 168 public employees working in two coastal towns in Fukushima. Results showed that the current prevalence of depression among public employees is as high as 17.9%, in contrast to the relatively low prevalence of post-traumatic stress disorder (4.8%). Based on the results of self-administered questionnaires and interview contents, frequent exposure to strong complaints or anger from residents and role conflicts were considered the cause of the high prevalence of depression. The present study reveals the serious mental status of public employees working in Fukushima and sheds light on the urgent need to establish an efficient care network to provide adequate psychiatric intervention. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

[Investigation of childhood neuropsychiatric disorders in adults often desirable. Functional disabilities can result in social maladjustment].

PubMed

Nylander, Lena; Holmqvist, Maria; Zettervall, Kerstin

2002-04-11

So-called child neuropsychiatric disorders (ADHD/DAMP, autism spectrum disorders, Tourette's syndrome) are being recognized with increasing frequency in child and adolescent psychiatry. Through follow-up studies, case reports and autobiographical accounts it has become evident that these disorders often persist into adulthood, and the need for diagnostic evaluation of adults is increasing. The Neuropsychiatric Diagnostic Team for Adults in Lund, Sweden, was established in 1998 to meet this need. 228 adults, mostly 18-30 years old, have completed the diagnostic process, resulting in one of the above-mentioned diagnoses in 64%. 80 patients had ADHD/DAMP, 59 had autism spectrum disorders and 7 had Tourette's syndrome. The diagnostic process involves clinical interviews and observation, neuropsychological evaluation and, if possible, a parent interview. So far, the impact on quality of life of a child neuropsychiatric diagnosis received in adulthood is not known. Follow-up studies are needed.

The impact of case definition on attention-deficit/hyperactivity disorder prevalence estimates in community-based samples of school-aged children.

PubMed

McKeown, Robert E; Holbrook, Joseph R; Danielson, Melissa L; Cuffe, Steven P; Wolraich, Mark L; Visser, Susanna N

2015-01-01

To determine the impact of varying attention-deficit/hyperactivity disorder (ADHD) diagnostic criteria, including new DSM-5 criteria, on prevalence estimates. Parent and teacher reports identified high- and low-screen children with ADHD from elementary schools in 2 states that produced a diverse overall sample. The parent interview stage included the Diagnostic Interview Schedule for Children-IV (DISC-IV), and up to 4 additional follow-up interviews. Weighted prevalence estimates, accounting for complex sampling, quantified the impact of varying ADHD criteria using baseline and the final follow-up interview data. At baseline 1,060 caregivers were interviewed; 656 had at least 1 follow-up interview. Teachers and parents reported 6 or more ADHD symptoms for 20.5% (95% CI = 18.1%-23.2%) and 29.8% (CI = 24.5%-35.6%) of children respectively, with criteria for impairment and onset by age 7 years (DSM-IV) reducing these proportions to 16.3% (CI = 14.7%-18.0%) and 17.5% (CI = 13.3%-22.8%); requiring at least 4 teacher-reported symptoms reduced the parent-reported prevalence to 8.9% (CI = 7.4%-10.6%). Revising age of onset to 12 years per DSM-5 increased the 8.9% estimate to 11.3% (CI = 9.5%-13.3%), with a similar increase seen at follow-up: 8.2% with age 7 onset (CI = 5.9%-11.2%) versus 13.0% (CI = 7.6%-21.4%) with onset by age 12. Reducing the number of symptoms required for those aged 17 and older increased the overall estimate to 13.1% (CI = 7.7%-21.5%). These findings quantify the impact on prevalence estimates of varying case definition criteria for ADHD. Further research of impairment ratings and data from multiple informants is required to better inform clinicians conducting diagnostic assessments. DSM-5 changes in age of onset and number of symptoms required for older adolescents appear to increase prevalence estimates, although the full impact is uncertain due to the age of our sample. Published by Elsevier Inc.

Inter-rater reliability of twelve diagnostic systems of schizophrenia.

PubMed

Helmes, E; Landmark, J; Kazarian, S S

1983-05-01

The present and past symptomatology of 31 chronic schizophrenics was rated by four independent judges, two experienced clinical psychiatrists and two psychiatric residents, in a context more representative of actual clinical practice than most research studies. Ratings were made on 64 symptoms derived from 12 diagnostic systems, based on either live or videotaped interviews for present symptomatology and case records for past symptomatology. Inter-rater reliabilities were higher for present than for past symptoms, and in general did not approach those reported for highly trained raters. There were no differences between live and videotaped interviews. Diagnostic systems differed widely in rater agreement. The most consistent across both past and present symptomatology were the systems of Langfeldt, Schneider, and DSM-III, for which the level of reliability was consistent with other studies.

Interview: Interview with Brad Gray for Personalized Medicine.

PubMed

Gray, Brad

2011-05-01

On 29 June 2010 Brad Gray became the President and Chief Executive Officer of the privately held life sciences company NanoString Technologies, WA, USA. Previously the Vice President of Product and Business Development at Genzyme Genetics, the diagnostic services division of Genzyme Corporation, Brad was in charge of developing molecular diagnostics and partnering activities. In December 2010, NanoString announced its securing of an exclusive worldwide license to develop in vitro diagnostic and research products for breast cancer intrinsic subtyping with the PAM50 gene signature. Brad Gray received a BA in Economics and Management from Oxford University, where he studied as a British Marshall Scholar, and an SB in Chemical Engineering from the Massachusetts Institute of Technology. Brad was also a management consultant in the healthcare practice of McKinsey & Company.

Clinical diagnostic and sociocultural dimensions of deliberate self-harm in Mumbai, India.

PubMed

Parkar, Shubhangi R; Dawani, Varsha; Weiss, Mitchell G

2006-04-01

Patients' accounts complement psychiatric assessment of deliberate self-harm (DSH). In this study we examined psychiatric disorders, and sociocultural and cross-cultural features of DSH. SCID diagnostic interviews and a locally adapted EMIC interview were used to study 196 patients after DSH at a general hospital in Mumbai, India. Major depression was the most common diagnosis (38.8%), followed by substance use disorders (16.8%), but 44.4% of patients did not meet criteria for an enduring Axis-I disorder (no diagnosis, V-code, or adjustment disorder). Psychache arising from patient-identified sociocultural contexts and stressors complements, but does not necessarily fulfill, criteria for explanatory psychiatric disorders.

[Situational diagnostic of an evaluation process of professional perfomance].

PubMed

Gonçalves, Vera Lúcia Mira; Leite, Maria Madalena Januário

2004-01-01

The aim of this study was to realize a diagnostic situational about the evaluation process of the nursing team performance of USP Hospital. Based in two guiding questions, it was carried out 9 interviews with nurses of this hospital. These interviews were analyzed according Analyze of Contend. The most frequent themes were: The meaning of evaluation; the feelings; the difficulties and facilities concerning the instrument and the capacitacion. This experience brought about many feelings, as well as aspects that either favor or make the execution of the evaluation difficult, showing the principal points of vulnerability of the process and, therefore, deserving better attention and short-term intervention.

Diagnostic Utility of the ADI-R and DSM-5 in the Assessment of Latino Children and Adolescents

ERIC Educational Resources Information Center

Magaña, Sandy; Vanegas, Sandra B.

2017-01-01

Latino children in the US are systematically underdiagnosed with Autism Spectrum Disorder (ASD); therefore, it is important that recent changes to the diagnostic process do not exacerbate this pattern of under-identification. Previous research has found that the Autism Diagnostic Interview-Revised (ADI-R) algorithm, based on the Diagnostic and…

Methodological and ethical issues related to qualitative telephone interviews on sensitive topics.

PubMed

Mealer, Meredith; Jones Rn, Jacqueline

2014-03-01

To explore the methodological and ethical issues of conducting qualitative telephone interviews about personal or professional trauma with critical care nurses. The most common method for conducting interviews is face-to-face. However, there is evidence to support telephone interviewing on a variety of sensitive topics including post-traumatic stress disorder (PTSD). Qualitative telephone interviews can limit emotional distress because of the comfort experienced through virtual communication. Critical care nurses are at increased risk of developing PTSD due to the cumulative exposure to work-related stress in the intensive care unit. We explored the methodological and ethical issues of conducting qualitative telephone interviews, drawing on our experiences communicating with a group of critical care nurses. Qualitative research interviews with 27 critical care nurses. Fourteen of the nurses met the diagnostic criteria for PTSD; 13 did not and had scores consistent with high levels of resilience. This is a methodology paper on the authors' experiences of interviewing critical care nurses on sensitive topics via the telephone. The authors found that establishing rapport and connections with the participants and the therapeutic use of non-verbal communication were essential, and fostered trust and compassion. The ethical issues of this mode of communication include protecting the privacy and confidentiality associated with the disclosure of sensitive information, and minimising the risk of psychological harm to the researcher and participants. Qualitative telephone interviews are a valuable method of collecting information on sensitive topics. This paper explores a method of interviewing in the workplace. It will help inform interventions to promote healthy adaptation following trauma exposure in the intensive care unit.

Screening for trauma‐related symptoms via a smartphone app: The validity of Smart Assessment on your Mobile in referred police officers

PubMed Central

Bakker, Anne; Schrieken, Bart A.L.; Hoofwijk, Marthe C.; Olff, Miranda

2017-01-01

Abstract To facilitate easily accessible screening for trauma‐related symptoms, a web‐based application called Smart Assessment on your Mobile (SAM) was developed. In this study, we examined whether SAM was able to accurately identify posttraumatic stress disorder (PTSD) and depression in adults. Eighty‐nine referred police officers completed SAM, containing the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM)‐5 (PCL‐5) and the Depression Anxiety and Stress Scale (DASS‐21), on their own device prior to a diagnostic interview where the Clinician‐Administered PTSD Scale for DSM‐5 (CAPS‐5) and Structured Clinical Interview for DSM‐IV (SCID‐I/P) were administered. Results showed a substantial agreement between SAM and the diagnostic interview in the assessment of PTSD and depression. An optimal trade‐off between sensitivity (89%) and specificity (68%) levels was found at a cut‐off score of 31 on the PTSD Checklist for DSM‐5 (area under the curve = 0.845, 95% CI [0.765, 0.925], diagnostic odds ratio = 15.97). This is one of the first studies to support the validity and reliability of a mobile screener following trauma. SAM may facilitate screening for trauma‐related symptoms on a large scale and could be a first step in a stepped‐care model for trauma survivors to help identify individuals who need further diagnostics and care. PMID:28948699

[Diagnostic of ADHD in childhood and adolescence with the K-SADS-PL].

PubMed

Schmidt, Sören; Banaschewski, Tobias; Garbe, Edeltraut; Petermann, Franz; Petermann, Ulrike

2013-01-01

Attention Deficit-/Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric disorders in childhood and adolescence, often accompanied by comorbid disorders. A high standard of diagnostic assessment combined with a demand for valid diagnostic instruments is necessary. The K-SADS-PL is an established semi-structured interview, focusing on the categorical assessment of psychiatric disorders. The aim of the following study was to examine specific characteristics of ADHD symptomatology including functional and behavioral assessment. Therefore correlations between the result in a diagnostic interview (K-SADS-PL) and different ADHD-specific instruments were performed. Groups were formed (exposed vs. unexposed), based on the diagnostic finding in the K-SADS-PL. Group-specific test score differences were calculated and compared by multivariate analyses of covariance. Children with ADHD showed a significantly higher impact of conduct and emotional problems than the unexposed group. Health related quality of life was more impaired in children and families suffering from ADHD which refers to the relevance of family-oriented psychotherapy.

Surgery resident selection and evaluation. A critical incident study.

PubMed

Edwards, J C; Currie, M L; Wade, T P; Kaminski, D L

1993-03-01

This article reports a study of the process of selecting and evaluating general surgery residents. In personnel psychology terms, a job analysis of general surgery was conducted using the Critical Incident Technique (CIT). The researchers collected 235 critical incidents through structured interviews with 10 general surgery faculty members and four senior residents. The researchers then directed the surgeons in a two-step process of sorting the incidents into categories and naming the categories. The final essential categories of behavior to define surgical competence were derived through discussion among the surgeons until a consensus was formed. Those categories are knowledge/self-education, clinical performance, diagnostic skills, surgical skills, communication skills, reliability, integrity, compassion, organization skills, motivation, emotional control, and personal appearance. These categories were then used to develop an interview evaluation form for selection purposes and a performance evaluation form to be used throughout residency training. Thus a continuum of evaluation was established. The categories and critical incidents were also used to structure the interview process, which has demonstrated increased interview validity and reliability in many other studies. A handbook for structuring the interviews faculty members conduct with applicants was written, and an interview training session was held with the faculty. The process of implementation of the structured selection interviews is being documented currently through qualitative research.

A structured interview for the DSM-III personality disorders. A preliminary report.

PubMed

Stangl, D; Pfohl, B; Zimmerman, M; Bowers, W; Corenthal, C

1985-06-01

With few exceptions, published studies fail to indicate that the DSM-III personality disorders can be distinguished from each other with respect to etiology, prognosis, treatment response, or family history. The Structured Interview for the DSM-III Personality Disorders (SIDP) was developed to improve axis II diagnostic reliability, and hence allow validity testing of axis II. Sixty-three subjects were independently rated by two interviewers using the SIDP. The kappa coefficients for interrater agreement reached .70 or higher for histrionic, borderline, and dependent personalities. While it is impossible to separate the validity testing of the SIDP from validity testing of the DSM-III personality criteria themselves, preliminary results from 102 inpatient SIDP interviews suggest some criterion-based validity with respect to standard personality rating scales and some construct validity with respect to the dexamethasone suppression test.

Criterion and concurrent validity of Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID) Spanish version.

PubMed

Ramos-Quiroga, Josep Antoni; Bosch, Rosa; Richarte, Vanesa; Valero, Sergi; Gómez-Barros, Nuria; Nogueira, Mariana; Palomar, Gloria; Corrales, Montse; Sáez-Francàs, Naia; Corominas, Margarida; Real, Alberto; Vidal, Raquel; Chalita, Pablo J; Casas, Miguel

2012-01-01

Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder in adulthood. Its diagnosis requires a retrospective evaluation of ADHD symptoms in childhood, the continuity of these symptoms in adulthood, and a differential diagnosis. For these reasons, diagnosis of ADHD in adults is a complex process which needs effective diagnostic tools. To analyse the criterion validity of the CAADID semi-structured interview, Spanish version, and the concurrent validity compared with other ADHD severity scales. An observational case-control study was conducted on 691 patients with ADHD. They were out-patients treated in a program for adults with ADHD in a hospital. A sensitivity of 98.86%, specificity 67.68%, positive predictive value 90.77% and a negative predictive value 94.87% were observed. Diagnostic precision was 91.46%. The kappa index concordance between the clinical diagnostic interview and the CAADID was 0.88. Good concurrent validity was obtained, the CAADID correlated significantly with WURS scale (r=0.522, P<.01), ADHD Rating Scale (r=0.670, P<.0.1) and CAARS (self-rating version; r=0.656, P<.01 and observer-report r=0.514, P<.01). CAADID is a valid and useful tool for the diagnosis of ADHD in adults for clinical, as well as for research purposes. Copyright © 2012 SEP y SEPB. Published by Elsevier España, S.L. All rights reserved.

Screening for emotional disorders in patients with cancer using the Brief Symptom Inventory (BSI) and the BSI-18 versus a standardized psychiatric interview (the World Health Organization Composite International Diagnostic Interview).

PubMed

Grassi, Luigi; Caruso, Rosangela; Mitchell, Alex J; Sabato, Silvana; Nanni, Maria Giulia

2018-06-01

Given the adverse consequences of psychiatric and psychosocial morbidity on the quality of life for patients with cancer, prompt detection of psychological symptoms is mandatory. The authors examined the properties and accuracy of the Brief Symptom Inventory (the 53-item version [BSI] and the 18-item version [BSI-18]) for the detection of psychiatric morbidity compared with the World Health Organization Composite International Diagnostic Interview (CIDI) for International Classification of Diseases-10th Revision psychiatric diagnoses. A convenience sample of 498 patients with newly diagnosed cancer who were recruited in cancer outpatient services participated in the CIDI interview and in BSI and BSI-18 assessments. The prevalence of psychiatric morbidity was 39.75%. When participants were classified as cases using the BSI standard case rule, agreement with the CIDI was potentially acceptable (sensitivity, 72.7%; specificity, 88.7%). In contrast, the accuracy of the BSI-18 in identifying cases was poor according to the standard case rule, with very low sensitivity (29.3%) (misclassification rate, 28.7%). By using a first alternative case-rule system (a BSI-18 global severity index [GSI] T-score ≥57), sensitivity marginally improved (45%), whereas a second alternative case-rule system (a GSI T-score ≥50) significantly increased sensitivity (77.3%). In receiver operating characteristic curve analysis, a further cutoff GSI T-score ≥48 exhibited good discrimination levels (sensitivity, 82.3%; specificity, 72.4%). There were some differences in GSI cutoff T-scores according to the International Classification of Diseases-10th Revision diagnosis and sex. The BSI appeared to have acceptable diagnostic accuracy compared with a standardized psychiatric interview. For the BSI-18, it is mandatory to use alternative case-rule systems, to identify patients with psychiatric morbidity. Cancer 2018;124:2415-26. © 2018 American Cancer Society. © 2018 American Cancer Society.

Screening young adult cancer survivors for distress with the Distress Thermometer: Comparisons with a structured clinical diagnostic interview.

PubMed

Recklitis, Christopher J; Blackmon, Jaime E; Chang, Grace

2016-01-15

The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population. A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis. The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%). The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303. © 2015 American Cancer Society. © 2015 American Cancer Society.

The exit interview as a proxy measure of malaria case management practice: sensitivity and specificity relative to direct observation.

PubMed

Pulford, Justin; Siba, Peter M; Mueller, Ivo; Hetzel, Manuel W

2014-12-03

This paper aims to assess the sensitivity and specificity of exit interviews as a measure of malaria case management practice as compared to direct observation. The malaria case management of 1654 febrile patients attending 110 health facilities from across Papua New Guinea was directly observed by a trained research officer as part of a repeat cross sectional survey. Patient recall of 5 forms of clinical advice and 5 forms of clinical action were then assessed at service exit and statistical analyses on matched observation/exit interview data conducted. The sensitivity of exit interviews with respect to clinical advice ranged from 36.2% to 96.4% and specificity from 53.5% to 98.6%. With respect to clinical actions, sensitivity of the exit interviews ranged from 83.9% to 98.3% and specificity from 70.6% to 98.1%. The exit interview appears to be a valid measure of objective malaria case management practices such as the completion of a diagnostic test or the provision of antimalarial medication, but may be a less valid measure of low frequency, subjective practices such as the provision of malaria prevention advice.

Telephone audit for monitoring stroke unit facilities: a post hoc analysis from PROSIT study.

PubMed

Candelise, Livia; Gattinoni, Monica; Bersano, Anna

2015-01-01

Although several valid approaches exist to measure the number and the quality of acute stroke units, only few studies tested their reliability. This study is aimed at establishing whether the telephone administration of the PROject of Stroke unIt ITaly (PROSIT) audit questionnaire is reliable compared with direct face-to-face interview. Forty-three medical leaders in charge of in-hospital stroke services were interviewed twice using the same PROSIT questionnaire with 2 different modalities. First, the interviewers approached the medical leaders by telephone. Thereafter, they went to the hospital site and performed a direct face-to-face interview. Six independent couples of trained researchers conducted the audit interviews. The degree of intermodality agreement was measured with kappa statistic. We found a perfect agreement for stroke units identification between the 2 different audit modalities (K = 1.00; standard error [SE], 1.525). The agreement was also very good for stroke dedicated beds (K = 1.00; SE, 1.525) and dedicated personnel (K = 1.00; SE, 1.525), which are the 2 components of stroke unit definition. The agreement was lower for declared in use process of care and availability of diagnostic investigations. The telephone audit can be used for monitoring stroke unit structures. It is more rapid, less expensive, and can repeatedly be used at appropriate intervals. However, a reliable description of the process of care and diagnostic investigations indicators should be obtained by either local site audit visit or prospective stroke register based on individual patient data. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

The Biographical Personality Interview (BPI)--a new approach to the assessment of premorbid personality in psychiatric research. Part II: Psychometric properties.

PubMed

von Zerssen, D; Barthelmes, H; Pössl, J; Black, C; Garzynski, E; Wessel, E; Hecht, H

1998-01-01

The Biographical Personality Interview (BPI) was applied to 179 subjects (158 psychiatric patients and 21 probands from the general population); 100 patients and 20 healthy controls served as a validation sample; the others had been interviewed during the training period or did not meet the inclusion criteria for the validation of the BPI. The acceptance of the interview was high, the inter-rater reliability of the ratings of premorbid personality structures ("types") varied between 0.81 and 0.88 per type. Concurrent validity of the typological constructs as assessed by means of the BPI was inferred from the intercorrelations of type scores and correlations of these scores with questionnaire data and proved to be adequate. Clinical validity of the assessment was indicated by statistically significant differences between diagnostic groups. Problems and further developments of the instrument and its application are discussed.

The Use of Closed-Circuit Television for the Teaching of Psychotherapeutic Interviewing to Medical Students

PubMed Central

Yonge, K. A.

1965-01-01

While closed-circuit television has been used in medical schools in the United States for some 12 years, its use for teaching diagnostic and psychotherapeutic interviewing to medical students has not previously been reported in Canada. The procedure involved a class of 64 students in their second year for a total of 38 hours. Concurrently with the demonstration interviews, the students were supervised in individual practice interviews with patients. The principles of psychotherapy had to be carefully related to the rest of the medical curriculum which essentially is biologically oriented. Three basic principles of health and healing were adopted because they were as applicable psychologically as physically. Evaluation of the program was undertaken by polling the students by means of a questionnaire. The general conclusion was that the use of closed-circuit television for these purposes far surpasses any other technique and has no major drawbacks. PMID:14278028

Domains of psychosocial disability and mental disorders.

PubMed

Ro, Eunyoe; Watson, David; Clark, Lee Anna

2018-06-07

This study examined relations between comprehensive domains of psychosocial disability and mental disorders to determine (1) whether differential patterns of associations exist between psychosocial disability dimensions and commonly diagnosed mental disorders and (2) whether these relations differ between self-reported and interviewer-rated psychosocial disability domains. Self-reported and interviewer-rated psychosocial functioning measures and an interviewer-rated diagnostic assessment tool were administered to 181 psychiatric outpatients. Internalizing disorders showed the strongest and most pervasive associations with psychosocial impairment across both self-reported and interviewer-rated measures, followed by thought disorder; externalizing showed the weakest associations. More specifically, logistic regression analyses indicated that lower well-being factor score significantly increased the odds of distress-disorder diagnoses, and poor basic functioning increased the odds of PTSD. Results clearly showed differences in the magnitude of associations between three dimensions of psychosocial-disability and commonly diagnosed disorders, and that these differences were similar regardless of rater type. © 2018 Wiley Periodicals, Inc.

[SCAN system--semi-structured interview based on diagnostic criteria].

PubMed

Adamowski, Tomasz; Kiejna, Andrzej; Hadryś, Tomasz

2006-01-01

This paper presents the main features of contemporary diagnostic systems which are implemented into the SCAN--modern and semi-structured diagnostic interview. The concepts of further development of the classifications, rationale for operationalized diagnostic criteria and for the divisional approach to mental diagnoses will be in focus. The structure and components of SCAN ver. 2.1 (WHO), i.e. Present State Examination--10th edition, Item Group Checklist, Clinical History Schedule, Glossary of Definitions and computer software with the diagnostic algorithm: I-Shell, as well as rules for a reliable use of diagnostic rating scales, will be discussed within the scope of this paper. The materials and training sets necessary for the learning of proper use of the SCAN, especially training sets for SCAN Training Centers and the Reference Manual--a form of guidebook for SCAN shall be introduced. Finally the paper will present evidence that SCAN is an instrument feasible in different cultural settings. Reliability and validity data of SCAN will also be dealt with indicating that SCAN could be widely used in research studies as well as in everyday clinical practice facilitating more detailed diagnostic approach to a patient.

Validation of diagnoses of distress disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) Supplement

PubMed Central

Green, Jennifer Greif; Avenevoli, Shelli; Gruber, Michael; Kessler, Ronald C.; Lakoma, Matthew; Merikangas, Kathleen R.; Sampson, Nancy A.; Zaslavsky, Alan M.

2012-01-01

Research diagnostic interviews need to discriminate between closely related disorders in order to allow comorbidity among mental disorders to be studied reliably. Yet conventional studies of diagnostic validity generally focus on single disorders and do not examine discriminant validity. The current study examines the validity of fully-structured diagnoses of closely-related distress disorders (generalized anxiety disorder, post-traumatic stress disorder, major depressive episode, and dysthymic disorder) in the lay-administered Composite International Diagnostic Interview Version 3.0 (CIDI) with independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A). The NCS-A is a national survey of DSM-IV mental disorders among 10,148 adolescents. A probability subsample of 347 of these adolescents and their parents were administered blinded follow-up K-SADS interviews. Good concordance (AUC; area under the receiver operating characteristic curve) was found between diagnoses based on the CIDI and the K-SADS for generalized anxiety disorder (AUC = .78), post-traumatic stress disorder (AUC = .79), and major depressive episode/dysthymic disorder (AUC = .86). Further, the CIDI was able to effectively discriminate among different types of distress disorders in the sub-sample of respondents with any distress disorder. PMID:22086845

Validity of the prenatal risk overview for detecting drug use disorders in pregnancy.

PubMed

Harrison, Patricia A; Godecker, Amy; Sidebottom, Abbey

2012-11-01

To validate the Prenatal Risk Overview (PRO) drug use questions against a structured diagnostic interview among pregnant women. Prenatal care patients were administered the PRO at intake and then asked to consent to a research diagnostic interview. Of 1,367 women asked to participate, 1,274 consented and 745 completed the study. Three drug use items comprised one of 13 PRO psychosocial risk domains. The Structured Clinical Interview for DSM-IV (SCID) was used as the validation instrument. To assess criterion validity, the Moderate/High and High Risk classifications were cross-tabulated with SCID Drug Use Disorder diagnoses. In response to the PRO, almost one third of participants (29.4%) reported drug use during the 12 months pre-pregnancy awareness and 11.0% reported use post-pregnancy awareness; 7.0% met SCID diagnostic criteria for Drug Abuse, Drug Dependence, or both, primarily for marijuana use. Drug Use Disorder sensitivity and specificity rates for the PRO Moderate/High Risk classifications were 88.5% and 74.3%, respectively, and for High Risk only, 78.8% and 87.3%. The PRO yielded substantial self-reporting of drug use before and after pregnancy awareness with high sensitivity and specificity for detecting Drug Use Disorders. PRO results can inform decisions about appropriate clinical responses. © 2012 Wiley Periodicals, Inc.

Clinical Use of the Pediatric Attention Disorders Diagnostic Screener for Children at Risk for Attention Deficit Hyperactivity Disorder: Case Illustrations

ERIC Educational Resources Information Center

Keiser, Ashley; Reddy, Linda

2013-01-01

The Pediatric Attention Disorders Diagnostic Screener is a multidimensional, computerized screening tool designed to assess attention and global aspects of executive functioning in children at risk for attention disorders. The screener consists of a semi-structured diagnostic interview, brief parent and teacher rating scales, 3 computer-based…

A Review of Assessment Tools for Diagnosis of Autism Spectrum Disorders: Implications for School Practice

ERIC Educational Resources Information Center

Klose, Laurie McGarry; Plotts, Cynthia; Kozeneski, Nicole; Skinner-Foster, Jacqueline

2012-01-01

This paper provides a review of widely used measures for assessing Autism Spectrum Disorders, including the "Autism Diagnostic Interview-Revised," "Autism Diagnostic Observation Schedule," "Psychoeducational Profile-Third Edition," "Gilliam Autism Rating Scale-Second Edition," and "Childhood Autism…

Diagnosis of Posttraumatic Stress Disorder in Preschool Children

ERIC Educational Resources Information Center

De Young, Alexandra C.; Kenardy, Justin A.; Cobham, Vanessa E.

2011-01-01

This study investigated the existing diagnostic algorithms for posttraumatic stress disorder (PTSD) to determine the most developmentally sensitive and valid approach for diagnosing this disorder in preschoolers. Participants were 130 parents of unintentionally burned children (1-6 years). Diagnostic interviews were conducted with parents to…

Usability characteristics of self-administered computer-assisted interviewing in the emergency department: factors affecting ease of use, efficiency, and entry error.

PubMed

Herrick, D B; Nakhasi, A; Nelson, B; Rice, S; Abbott, P A; Saber Tehrani, A S; Rothman, R E; Lehmann, H P; Newman-Toker, D E

2013-01-01

Self-administered computer-assisted interviewing (SACAI) gathers accurate information from patients and could facilitate Emergency Department (ED) diagnosis. As part of an ongoing research effort whose long-range goal is to develop automated medical interviewing for diagnostic decision support, we explored usability attributes of SACAI in the ED. Cross-sectional study at two urban, academic EDs. Convenience sample recruited daily over six weeks. Adult, non-level I trauma patients were eligible. We collected data on ease of use (self-reported difficulty, researcher documented need for help), efficiency (mean time-per-click on a standardized interview segment), and error (self-report age mismatched with age derived from electronic health records) when using SACAI on three different instruments: Elo TouchSystems ESY15A2 (finger touch), Toshiba M200 (with digitizer pen), and Motion C5 (with digitizer pen). We calculated descriptive statistics and used regression analysis to evaluate the impact of patient and computer factors on time-per-click. 841 participants completed all SACAI questions. Few (<1%) thought using the touch computer to ascertain medical information was difficult. Most (86%) required no assistance. Participants needing help were older (54 ± 19 vs. 40 ± 15 years, p<0.001) and more often lacked internet at home (13.4% vs. 7.3%, p = 0.004). On multivariate analysis, female sex (p<0.001), White (p<0.001) and other (p = 0.05) race (vs. Black race), younger age (p<0.001), internet access at home (p<0.001), high school graduation (p = 0.04), and touch screen entry (vs. digitizer pen) (p = 0.01) were independent predictors of decreased time-per-click. Participant misclick errors were infrequent, but, in our sample, occurred only during interviews using a digitizer pen rather than a finger touch-screen interface (1.9% vs. 0%, p = 0.09). Our results support the facility of interactions between ED patients and SACAI. Demographic factors associated with need for assistance or slower interviews could serve as important triggers to offering human support for SACAI interviews during implementation. Understanding human-computer interactions in real-world clinical settings is essential to implementing automated interviewing as means to a larger long-term goal of enhancing clinical care, diagnostic accuracy, and patient safety.

Usability Characteristics of Sel-Fadministered Computer-Assisted Interviewing in the Emergency Department

PubMed Central

Herrick, D. B.; Nakhasi, A.; Nelson, B.; Rice, S.; Abbott, P. A.; Saber Tehrani, A. S.; Rothman, R. E.; Lehmann, H. P.; Newman-Toker, D. E.

2013-01-01

Objective Self-administered computer-assisted interviewing (SACAI) gathers accurate information from patients and could facilitate Emergency Department (ED) diagnosis. As part of an ongoing research effort whose long-range goal is to develop automated medical interviewing for diagnostic decision support, we explored usability attributes of SACAI in the ED. Methods Cross-sectional study at two urban, academic EDs. Convenience sample recruited daily over six weeks. Adult, non-level I trauma patients were eligible. We collected data on ease of use (self-reported difficulty, researcher documented need for help), efficiency (mean time-per-click on a standardized interview segment), and error (self-report age mismatched with age derived from electronic health records) when using SACAI on three different instruments: Elo TouchSystems ESY15A2 (finger touch), Toshiba M200 (with digitizer pen), and Motion C5 (with digitizer pen). We calculated descriptive statistics and used regression analysis to evaluate the impact of patient and computer factors on time-per-click. Results 841 participants completed all SACAI questions. Few (<1%) thought using the touch computer to ascertain medical information was difficult. Most (86%) required no assistance. Participants needing help were older (54 ± 19 vs. 40 ± 15 years, p<0.001) and more often lacked internet at home (13.4% vs. 7.3%, p = 0.004). On multivariate analysis, female sex (p<0.001), White (p<0.001) and other (p = 0.05) race (vs. Black race), younger age (p<0.001), internet access at home (p<0.001), high school graduation (p = 0.04), and touch screen entry (vs. digitizer pen) (p = 0.01) were independent predictors of decreased time-per-click. Participant misclick errors were infrequent, but, in our sample, occurred only during interviews using a digitizer pen rather than a finger touch-screen interface (1.9% vs. 0%, p = 0.09). Discussion Our results support the facility of interactions between ED patients and SACAI. Demographic factors associated with need for assistance or slower interviews could serve as important triggers to offering human support for SACAI interviews during implementation. Conclusion Understanding human-computer interactions in real-world clinical settings is essential to implementing automated interviewing as means to a larger long-term goal of enhancing clinical care, diagnostic accuracy, and patient safety. PMID:23874364

Reliability and validity of a Chinese version of the Diagnostic Interview for Borderlines-Revised.

PubMed

Wang, Lanlan; Yuan, Chenmei; Qiu, Jianying; Gunderson, John; Zhang, Min; Jiang, Kaida; Leung, Freedom; Zhong, Jie; Xiao, Zeping

2014-09-01

Borderline personality disorder (BPD) is the most studied of the axis II disorders. One of the most widely used diagnostic instruments is the Diagnostic Interview for Borderline Patients-Revised (DIB-R). The aim of this study was to test the reliability and validity of DIB-R for use in the Chinese culture. The reliability and validity of the DIB-R Chinese version were assessed in a sample of 236 outpatients with a probable BPD diagnosis. The Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) was used as a standard. Test-retest reliability was tested six months later with 20 patients, and inter-rater reliability was tested on 32 patients. The Chinese version of the DIB-R showed good internal global consistency (Cronbach's α of 0.916), good test-retest reliability (Pearson correlation of 0.704), good inter-rater reliability (intra-class correlation coefficient of 0.892 and kappa of 0.861). When compared with the DSM-IV diagnosis as measured by the SCID-II, the DIB-R showed relatively good sensitivity (0.768) and specificity (0.891) at the cutoff of 7, moderate diagnostic convergence (kappa of 0.631), as well as good discriminating validity. The Chinese version of the DIB-R has good psychometric properties, which renders it a valuable method for examining the presence, the severity, and component phenotypes of BPD in Chinese samples. © 2013 Wiley Publishing Asia Pty Ltd.

Parent-youth agreement on symptoms and diagnosis: assessment with a diagnostic interview in an adolescent inpatient clinical population.

PubMed

Lauth, Bertrand; Arnkelsson, Guðmundur B; Magnússon, Páll; Skarphéðinsson, Guðmundur Á; Ferrari, Pierre; Pétursson, Hannes

2010-12-01

Diagnostic information on adolescents may be elicited from both youths and their parents, especially for depressive and suicidal symptomatology. The objective of this study was to examine the degree of agreement between parent and adolescent reports of major psychiatric disorders, at the diagnostic and at the symptom level, in a severely affected inpatient clinical population. 64 parent-adolescent pairs were interviewed separately with the semi-structured diagnostic interview Kiddie-SADS-PL. Symptomatology was also assessed with 11 self-report and parent-report scales, all translated, adapted and in most cases validated in Iceland. A total of 25 subscales were included to assess emotional dimensions such as depression or anxiety and cognitive dimensions such as attention deficit or self-concept. Good agreement was found for social phobia and fair agreement for generalized anxiety disorder. Although parent-youth agreement was poor in most cases at the symptoms level, significant correlations indicated consistency for most severity scores, except those related to depressive symptomatology, attention deficit, separation anxiety or conduct disorder. The low agreement between reports of suicidal ideation is in line with results from previous studies and suggests that parents might under- or over-estimate this symptomatology. The combination of data obtained with diagnostic interviews and rating-scales confirmed results from prior empirical work, giving greater weight to parents' reports of observable behavior and to adolescents' reports of subjective experiences, especially depressive symptomatology. Our findings suggest that both parent and child informants are necessary to obtain adequate assessments in adolescents. Further research should explore the correspondence between discrepant diagnoses and external criteria such as parental psychopathology or parent-child relationships and attachment. Psychoanalysis could benefit from cognitive neuroscience and use cognitive assessments as interesting tools. Thus, cognitive assessments can show discrepant results according to parents' or adolescents' reports and can therefore shed light on the parent-child interaction and relational dynamics. Inversely, cognitive neuroscience could benefit from psychoanalysis by taking into account, when interpretating the scores, the relational dynamics and the personal history of the rater. Copyright © 2010 Elsevier Ltd. All rights reserved.

Predictors of parent-child agreement on child anxiety diagnoses on the ADIS-IV-C/P.

PubMed

Hamblin, Rebecca J; Salloum, Alison; Andel, Ross; Nadeau, Joshua M; McBride, Nicole M; Lewin, Adam B; Storch, Eric A

2016-11-30

Diagnostic agreement between parents' and children's reports on children's anxiety problems is notoriously poor; however, very few investigations have examined specific predictors of inter-rater agreement on child anxiety diagnoses. This study examined predictors of categories of parent and child diagnostic endorsement on the Anxiety Disorders Interview Schedule for Children-IV. One hundred eight children (ages 7-13) and their parents completed structured diagnostic interviews for non-OCD/PTSD anxiety diagnoses and paper and pencil measures of functioning and impairment in a variety of domains. Parent-child agreement was statistically significant for social phobia and separation anxiety disorder, but was overall poor for all anxiety diagnoses. Externalizing disorder status, family accommodation frequency, and child rated impairment in various domains differentially predicted informant discrepancies for different anxiety disorders. These data are among the first to suggest variables that may explain parent-child concordance. Copyright © 2016. Published by Elsevier Ireland Ltd.

Experiences of intervertebral motion palpation in osteopathic practice - A qualitative interview study among Swedish osteopaths.

PubMed

Sposato, Niklas S; Bjerså, Kristofer

2017-01-01

Assessment in manual therapy includes quantitative and qualitative procedures, and intervertebral motion palpation (IMP) is one of the core assessment methods in osteopathic practice. The aim of this study was to explore osteopathic practitioners' experiences of clinical decision-making and IMP as a diagnostic tool for planning and evaluation of osteopathic interventions. The study was conducted with semi-structured interviews that included eight informants. Content analysis was used as the analytical procedure. In total, three categories emerged from the analysis: strategic decision-making, diagnostic usability of IMP, and treatment applicability of IMP. The study indicated that IMP was considered relevant and was given particular importance in cases where IMP findings confirmed clinical information attained from other stages in the diagnostic process as a whole. However, IMP findings were experienced as less important if they were not correlated to other findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

The National Comorbidity Survey Adolescent Supplement (NCS-A): I. Background and Measures

PubMed Central

Merikangas, Kathleen R.; Avenevoli, Shelli; Costello, E. Jane; Koretz, Doreen; Kessler, Ronald C.

2009-01-01

Objective This paper presents an overview of the background and measures used in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A). Methods The NCS-A is a national psychiatric epidemiological survey of adolescents ages 13–17. Results The NCS-A was designed to provide the first nationally representative estimates of the prevalence, correlates and patterns of service use for DSM-V mental disorders among US adolescents and to lay the groundwork for follow-up studies of risk-protective factors, consequences, and early expressions of adult mental disorders. The core NCS-A diagnostic interview, the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), is a fully-structured research diagnostic interview designed for use by trained lay interviewers. A multi-construct, multi-method, multi-informant battery was also included to assess risk and protective factors and barriers to service use. Design limitations due to the NCS-A evolving as a supplement to an ongoing survey of mental disorders of US adults include restricted age range of youth, cross-sectional assessment, and lack of full parental/surrogate informant reports on youth mental disorders and correlates. Conclusions Despite these limitations, the NCS-A contains unparalleled information that can be used to generate national estimates of prevalence and correlates of adolescent mental disorders, risk and protective factors, patterns of service use, and barriers to receiving treatment for these disorders. The retrospective NCS-A data on the development of psychopathology can additionally complement data from longitudinal studies based on more geographically restricted samples and serve as a useful baseline for future prospective studies of the onset and progression of mental disorders in adulthood. PMID:19242382

Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study.

PubMed

Dahlin, Marie E; Runeson, Bo

2007-04-12

Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1st and 3rd years. Diagnostic interviews (MINI) were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. 98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available.

Assessing Correlation of Residency Applicants' Interview Dates With Likelihood of Matching.

PubMed

Avasarala, Sameer; Thompson, Elizabeth; Whitehouse, Sarah; Drake, Sean

2018-02-01

This study aimed to determine whether the timing of an interview relative to the recruitment season was associated with being ranked or matched at an academic medical center. Eleven specialties (anesthesiology, diagnostic radiology, emergency medicine, family medicine, general surgery, internal medicine, neurology, neurosurgery, obstetrics-gynecology, orthopedic surgery, and psychiatry) that participated in the National Resident Matching Program were included in the study. Each program's total number of interview days during the October 2014-January 2015 interview season were divided equally into three interview time periods. The Cochran-Armitage trend test was used to evaluate associations among the three interview time periods (early, middle, and late) and interviewee outcomes (ranked or matched at our institution) for all subjects combined for each of the 11 programs and for specialty groups (medical, surgical, and hospital). Of 1034 applicants included in the analyses, 60% were men. Most were graduated from US medical schools (59.8%; a total of 103 applicants obtained first-year training positions through the Match [95.4% combined fill rate]). Twenty-nine interviewed early, 38 in the middle, and 36 in the late period ( P = 0.3877). A total of 864 applicants were ranked by 1 of the 11 residency programs at the study site: 267 in the early period, 319 in the middle, and 278 in the late period ( P = 0.4184). Being ranked in association with specialty classification also showed no significant differences. Interview timing had no relation to the likelihood of a match or being ranked by 1 of the 11 programs studied at our institution. These findings help dispel misconceptions about the importance of the interview date for a successful match.

Borderline or Schizotypal? Differential Psychodynamic Assessment in Severe Personality Disorders.

PubMed

VAN Riel, Laura; Ingenhoven, Theo J M; VAN Dam, Quin D; Polak, Marike G; Vollema, Meinte G; Willems, Anne E; Berghuis, Han; VAN Megen, Harold

2017-03-01

Considerable overlap in symptoms between patients with borderline personality disorder (BPD) and schizotypal personality disorder (STPD) complicates personality diagnostics. Yet very little is known about the level of psychodynamic functioning of both personality disorders. Psychodynamic assessment procedures may specify personality characteristics relevant for differential diagnosis and treatment planning. In this cross-sectional study we explored the differences and similarities in level of personality functioning and psychodynamic features of patients with severe BPD or STPD. In total, 25 patients with BPD and 13 patients with STPD were compared regarding their level of personality functioning (General Assessment of Personality Disorder), current quasipsychotic features (Schizotypal Personality Questionnaire), and psychodynamic functioning [Developmental Profile (DP) interview and Developmental Profile Inventory (DPI) questionnaire]. Both groups of patients showed equally severe impairments in the level of personality functioning and the presence of current quasipsychotic features. As assessed by the DP interview, significant differential psychodynamic patterns were found on the primitive levels of functioning. Moreover, subjects with BPD had significantly higher scores on the adaptive developmental levels. However, the self-questionnaire DPI was not able to elucidate all of these differences. In conclusion, our study found significant differences in psychodynamic functioning between patients with BPD and STPD as assessed with the DP interview. In complicated diagnostic cases, personality assessment by psychodynamic interviewing can enhance subtle but essential differentiation between BPD and STPD.

A Head-to-Head Comparison of the Personality Inventory for DSM-5 (PID-5) With the Personality Diagnostic Questionnaire-4 (PDQ-4) in Predicting the General Level of Personality Pathology Among Community Dwelling Subjects.

PubMed

Fossati, Andrea; Somma, Antonella; Borroni, Serena; Maffei, Cesare; Markon, Kristian E; Krueger, Robert F

2016-02-01

In order to evaluate if measures of DSM-5 Alternative PD Model domains predicted interview-based scores of general personality pathology when compared to self-report measures of DSM-IV Axis II/DSM-5 Section II PD criteria, 300 Italian community adults were administered the Iowa Personality Disorder Screen (IPDS) interview, the Personality Inventory for DSM-5 (PID-5), and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Multiple regression analyses showed that the five PID-5 domain scales collectively explained an adequate rate of the variance of the IPDS interview total score. This result was slightly lower than the amount of variance in the IPDS total score explained by the 10 PDQ-4+ scales. The PID-5 traits scales performed better than the PDQ-4+, although the difference was marginal. Hierarchical regression analyses revealed that the PID-5 domain and trait scales provided a moderate, but significant increase in the prediction of the general level of personality pathology above and beyond the PDQ-4+ scales.

[Development of expert diagnostic system for common respiratory diseases].

PubMed

Xu, Wei-hua; Chen, You-ling; Yan, Zheng

2014-03-01

To develop an internet-based expert diagnostic system for common respiratory diseases. SaaS system was used to build architecture; pattern of forward reasoning was applied for inference engine design; ASP.NET with C# from the tool pack of Microsoft Visual Studio 2005 was used for website-interview medical expert system.The database of the system was constructed with Microsoft SQL Server 2005. The developed expert system contained large data memory and high efficient function of data interview and data analysis for diagnosis of various diseases.The users were able to perform this system to obtain diagnosis for common respiratory diseases via internet. The developed expert system may be used for internet-based diagnosis of various respiratory diseases,particularly in telemedicine setting.

Comparing the Personality Disorder Interview for DSM-IV (PDI-IV) and SCID-II borderline personality disorder scales: an item-response theory analysis.

PubMed

Huprich, Steven K; Paggeot, Amy V; Samuel, Douglas B

2015-01-01

One-hundred sixty-nine psychiatric outpatients and 171 undergraduate students were assessed with the Personality Disorder Interview-IV (PDI-IV; Widiger, Mangine, Corbitt, Ellis, & Thomas, 1995) and the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1997) for borderline personality disorder (BPD). Eighty individuals met PDI-IV BPD criteria, whereas 34 met SCID-II BPD criteria. Dimensional ratings of both measures were highly intercorrelated (rs = .78, .75), and item-level interrater reliability fell in the good to excellent range. An item-response theory analysis was performed to investigate whether properties of the items from each interview could help understand these differences. The limited agreement seemed to be explained by differences in the response options across the two interviews. We found that suicidal behavior was among the most discriminating criteria on both instruments, whereas dissociation and difficulty controlling anger had the 2 lowest alpha parameter values. Finally, those meeting BPD criteria on both interviews had higher levels of anxiety, depression, and more impairments in object relations than those meeting criteria on just the PDI-IV. These findings suggest that the choice of measure has a notable effect on the obtained diagnostic prevalence and the level of BPD severity that is detected.

Using Standardized Diagnostic Instruments to Classify Children with Autism in the Study to Explore Early Development

ERIC Educational Resources Information Center

Wiggins, Lisa D.; Reynolds, Ann; Rice, Catherine E.; Moody, Eric J.; Bernal, Pilar; Blaskey, Lisa; Rosenberg, Steven A.; Lee, Li-Ching; Levy, Susan E.

2015-01-01

The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule…

The Reliability and Validity of the Panic Disorder Self-Report: A New Diagnostic Screening Measure of Panic Disorder

ERIC Educational Resources Information Center

Newman, Michelle G.; Holmes, Marilyn; Zuellig, Andrea R.; Kachin, Kevin E.; Behar, Evelyn

2006-01-01

This study examined the Panic Disorder Self-Report (PDSR), a new self-report diagnostic measure of panic disorder based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994). PDSR diagnoses were compared with structured interview diagnoses of individuals with generalized anxiety…

The Discriminative Ability and Diagnostic Utility of the ADOS-G, ADI-R, and GARS for Children in a Clinical Setting

ERIC Educational Resources Information Center

Mazefsky, Carla A.; Oswald, Donald P.

2006-01-01

Recent years have seen a surge of interest in assessment instruments for diagnosing autism in children. Instruments have generally been developed and evaluated from a research perspective. The Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and Gilliam Autism Rating Scale (GARS) have received…

Time, Lives, and Videotape: Operationalizing Discovery in Scenes of Literacy Sponsorship

ERIC Educational Resources Information Center

Halbritter, Bump; Lindquist, Julie

2012-01-01

We present an approach to operationalizing discovery in literacy research by describing a diagnostic, abductive methodology. This methodology treats products of videotaped interviews and participant-authored footage as narrative data produced in scenes of literacy sponsorship. In describing the operations of our diagnostic approach, we foreground…

Obstetric and Parental Psychiatric Variables as Potential Predictors of Autism Severity

ERIC Educational Resources Information Center

Wallace, Anna E.; Anderson, George M.; Dubrow, Robert

2008-01-01

Associations between obstetric and parental psychiatric variables and subjects' Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) domain scores were examined using linear mixed effects models. Data for the 228 families studied were provided by the Autism Genetic Resource Exchange. Hypertension (P =…

Effects of Experience and Training on Diagnostic Accuracy.

ERIC Educational Resources Information Center

Brammer, Robert

The interview process was studied to uncover the relationship of expertise in psychotherapy to the likelihood of accurate diagnosis. Experience and training affect the number of diagnostic questions clinicians ask as compared to personal, family, social, occupational, and history questions; and this in turn affects the accuracy of the diagnoses…

Epidemiology of pathological gambling in Edmonton.

PubMed

Bland, R C; Newman, S C; Orn, H; Stebelsky, G

1993-03-01

Thirty lifetime pathological gamblers (DSM-III, no exclusion criteria) were identified when 7,214 randomly selected household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule. The lifelong prevalence of pathological gambling was 0.42% (ratio of males to females 3:1). The peak age of onset was 25 to 29 years. Gamblers had high rates of comorbidity with other psychiatric disorders. They were likely to have made suicide attempts (13.3%), to have been convicted of offences (26.7%), to be spouse and child abusers (23.3% and 16.7% respectively) and to have spent long periods unemployed (40%). In addition, 80% had trouble at home or work because of gambling, and 60% borrowed or stole to gamble.

Time and the psychiatric interview: the negotiation of temporal criteria of the depressive disorder.

PubMed

Ziólkowska, Justyna

2014-03-01

In this article, I am concerned with doctors' negotiations of the temporal dimension of the diagnostic criteria of depressive disorders during the first psychiatric interview. The data come from 16 initial psychiatric interviews recorded by doctors in three psychiatric hospitals in Poland. Taking a constructionist view of discourse and psychiatric practices, I shall argue that the discursive practice related to temporal information about patients' illnesses serves in gaining information, which is useful in the medical model of psychiatric diagnosis. The doctors positioned the patients' experiences on the timeline when the illness history was taken and temporal information authenticated the information. Conversely, the patients' current conditions were constructed in a limitless present, which allowed the psychiatrists to remove the relativity.

How and when do expert emergency physicians generate and evaluate diagnostic hypotheses? A qualitative study using head-mounted video cued-recall interviews.

PubMed

Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Ammirati, Christine; Bertrand, Catherine; Dory, Valérie; Charlin, Bernard

2014-12-01

The ability to make a diagnosis is a crucial skill in emergency medicine. Little is known about the way emergency physicians reach a diagnosis. This study aims to identify how and when, during the initial patient examination, emergency physicians generate and evaluate diagnostic hypotheses. We carried out a qualitative research project based on semistructured interviews with emergency physicians. The interviews concerned management of an emergency situation during routine medical practice. They were associated with viewing the video recording of emergency situations filmed in an "own-point-of-view" perspective. The emergency physicians generated an average of 5 diagnostic hypotheses. Most of these hypotheses were generated before meeting the patient or within the first 5 minutes of the meeting. The hypotheses were then rank ordered within the context of a verification procedure based on identifying key information. These tasks were usually accomplished without conscious effort. No hypothesis was completely confirmed or refuted until the results of investigations were available. The generation and rank ordering of diagnostic hypotheses is based on the activation of cognitive processes, enabling expert emergency physicians to process environmental information and link it to past experiences. The physicians seemed to strive to avoid the risk of error by remaining aware of the possibility of alternative hypotheses as long as they did not have the results of investigations. Understanding the diagnostic process used by emergency physicians provides interesting ideas for training residents in a specialty in which the prevalence of reasoning errors leading to incorrect diagnoses is high. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

The quality of assessments for childhood psychopathology within a regional medical center.

PubMed

Sattler, Adam F; Leffler, Jarrod M; Harrison, Nicole L; Bieber, Ewa D; Kosmach, Joseph J; Sim, Leslie A; Whiteside, Stephen P H

2018-05-17

Accurate assessment is essential to implementing effective mental health treatment; however, little research has explored child clinicians' assessment practices in applied settings. The current study thus examines practitioners' use of evidence-based assessment (EBA) instruments (i.e., self-report measures and structured interviews), specificity of identified diagnoses (i.e., use of specific diagnostic labels vs. nonstandardized labels, not otherwise specified [NOS] diagnoses, and adjustment disorder diagnoses), and documentation of Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR, American Psychiatric Association, 2000) criteria. Use of these practices was evaluated via analysis of documentation contained within a regional medical center's medical records. This analysis was limited to 2,499 session notes from patient appointments associated with psychiatric disorders newly diagnosed during 2013. In total, session notes were linked to 694 children aged 7 to 17. Results indicated that EBA use was low overall, although self-report measures were utilized relatively frequently versus structured interviews. Diagnostic specificity was also low overall and clinicians rarely documented full diagnostic criteria; however, EBA use was associated with increased diagnostic specificity. Further, clinicians practicing in psychological, psychiatric, and primary care settings were more likely to use self-report measures as compared to those practicing in an integrated behavioral health social work setting. In addition, structured interviews were most likely to be utilized by clinicians practicing in a psychological services setting. Finally, clinicians were more likely to use self-report measures when the identified primary concern was a mood disorder or attention-deficit/hyperactivity disorder (ADHD). Based on these results, we provide suggestions and references to resources for clinicians seeking to improve the quality of their assessments via implementation of EBA. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The use of the Modified Telephone Interview for Cognitive Status (TICS-M) in the detection of amnestic mild cognitive impairment.

PubMed

Cook, Sarah E; Marsiske, Michael; McCoy, Karin J M

2009-06-01

Many screening tools for detecting cognitive decline require in-person assessment, which is often not cost-effective or feasible for those with physical limitations. The Modified Telephone Interview for Cognitive Status has been used for screening dementia, but little is known about its usefulness in detecting amnestic mild cognitive impairment. Community-dwelling participants (mean age=74.9, mean education = 16.1 years) were administered the Modified Telephone Interview for Cognitive Status during initial screening and subsequently given a multidomain neuropsychological battery. Participants were classified by consensus panel as cognitively normal older adult (noMCI, N=54) or amnestic mild cognitive impairment (N=17) based on neuropsychological performance and Clinical Dementia Rating Scale interview, but independent of Modified Telephone Interview for Cognitive Status score. There was a significant difference between groups in Modified Telephone Interview for Cognitive Status score (t=8.04, P<.01, noMCI range 32-43, mean [SD]=37.4 [2.5], amnestic mild cognitive impairment range 25-37, mean [SD]=31.2 [3.5]). Discriminant function analysis revealed that TICS-M alone correctly classified 85.9% of participants into their respective diagnostic classification (sensitivity=82.4%, specificity=87.0%). Receiver operating characteristics analysis resulted in cutoff score of 34 that optimized sensitivity and specificity of amnestic mild cognitive impairment classification. The Modified Telephone Interview for Cognitive Status is a brief, cost-effective screening measure for identifying those with and without amnestic mild cognitive impairment.

Using the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule with Young Children with Developmental Delay: Evaluating Diagnostic Validity

ERIC Educational Resources Information Center

Gray, Kylie M.; Tonge, Bruce J.; Sweeney, Deborah J.

2008-01-01

Few studies have focused on the validity of the ADI-R and ADOS in the assessment of preschool children with developmental delay. This study aimed to evaluate the diagnostic validity of the ADI-R and the ADOS in young children. Two-hundred and nine children aged 20-55 months participated in the study, 120 of whom received a diagnosis of autism.…

The alcohol use disorder and associated disabilities interview schedule-IV (AUDADIS-IV): reliability of new psychiatric diagnostic modules and risk factors in a general population sample.

PubMed

Ruan, W June; Goldstein, Risë B; Chou, S Patricia; Smith, Sharon M; Saha, Tulshi D; Pickering, Roger P; Dawson, Deborah A; Huang, Boji; Stinson, Frederick S; Grant, Bridget F

2008-01-01

This study presents test-retest reliability statistics and information on internal consistency for new diagnostic modules and risk factors for alcohol, drug, and psychiatric disorders from the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV). Test-retest statistics were derived from a random sample of 1899 adults selected from 34,653 respondents who participated in the 2004-2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Internal consistency of continuous scales was assessed using the entire Wave 2 NESARC. Both test and retest interviews were conducted face-to-face. Test-retest and internal consistency results for diagnoses and symptom scales associated with posttraumatic stress disorder, attention-deficit/hyperactivity disorder, and borderline, narcissistic, and schizotypal personality disorders were predominantly good (kappa>0.63; ICC>0.69; alpha>0.75) and reliability for risk factor measures fell within the good to excellent range (intraclass correlations=0.50-0.94; alpha=0.64-0.90). The high degree of reliability found in this study suggests that new AUDADIS-IV diagnostic measures can be useful tools in research settings. The availability of highly reliable measures of risk factors for alcohol, drug, and psychiatric disorders will contribute to the validity of conclusions drawn from future research in the domains of substance use disorder and psychiatric epidemiology.

Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5.

PubMed

Chmielewski, Michael; Clark, Lee Anna; Bagby, R Michael; Watson, David

2015-08-01

Diagnostic reliability is essential for the science and practice of psychology, in part because reliability is necessary for validity. Recently, the DSM-5 field trials documented lower diagnostic reliability than past field trials and the general research literature, resulting in substantial criticism of the DSM-5 diagnostic criteria. Rather than indicating specific problems with DSM-5, however, the field trials may have revealed long-standing diagnostic issues that have been hidden due to a reliance on audio/video recordings for estimating reliability. We estimated the reliability of DSM-IV diagnoses using both the standard audio-recording method and the test-retest method used in the DSM-5 field trials, in which different clinicians conduct separate interviews. Psychiatric patients (N = 339) were diagnosed using the SCID-I/P; 218 were diagnosed a second time by an independent interviewer. Diagnostic reliability using the audio-recording method (N = 49) was "good" to "excellent" (M κ = .80) and comparable to the DSM-IV field trials estimates. Reliability using the test-retest method (N = 218) was "poor" to "fair" (M κ = .47) and similar to DSM-5 field-trials' estimates. Despite low test-retest diagnostic reliability, self-reported symptoms were highly stable. Moreover, there was no association between change in self-report and change in diagnostic status. These results demonstrate the influence of method on estimates of diagnostic reliability. (c) 2015 APA, all rights reserved).

Agreement between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the proposed DSM-V attention deficit hyperactivity disorder diagnostic criteria: an exploratory study.

PubMed

Ghanizadeh, Ahmad

2013-01-01

There is no empirical literature about the American Psychiatry Association proposed new diagnostic criteria for attention deficit hyperactivity disorder (ADHD). This study examined the agreement between ADHD diagnosis derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and DSM-V diagnostic criteria. It also reports sensitivity, specificity, and agreement for ADHD diagnosis. A clinical sample of 246 children and adolescents were interviewed face to face using both ADHD diagnostic criteria for DSM-V and DSM-IV by interviewing clinician. Comorbid psychiatric disorders were screened using DSM-IV criteria. The rate of ADHD diagnosis using DSM-V was significantly higher than the rate detected by using DSM-IV diagnostic criteria. The sensitivity of DSM-V diagnostic criteria was 100%, while its specificity was 71.1%. The kappa agreement between DSM-IV and DSM-V was 0.75. In addition, positive predictive value was 85.1%. All the four newly added symptoms to ADHD diagnostic criteria are statistically more common in the children with ADHD than those in the comparison group. However, these symptoms are also very common in the children without ADHD. It is expected that the rate of ADHD would increase using the proposed ADHD DSM-V criteria. Moreover, the newly added symptoms have a low specificity for ADHD diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

Comparing the Diagnostic Accuracy of Six Potential Screening Instruments for Bipolar Disorder in Youths Aged 5 to 17 Years.

ERIC Educational Resources Information Center

Youngstrom, Eric A.; Findling, Robert L.; Calabrese, Joseph R.; Gracious, Barbara L.; Demeter, Christine; DelPorto Bedoya, Denise; Price, Megan

2004-01-01

Objective: To compare the diagnostic efficiency of six index tests as predictors of juvenile bipolar disorder in two large outpatient samples, aged 5 to 10 and 11 to 17 years, gathered from 1997 to 2002. Method: DSM-IV diagnosis was based on a semistructured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age…

Toward DSM-V: An Item Response Theory Analysis of the Diagnostic Process for DSM-IV Alcohol Abuse and Dependence in Adolescents

ERIC Educational Resources Information Center

Gelhorn, Heather; Hartman, Christie; Sakai, Joseph; Stallings, Michael; Young, Susan; Rhee, So Hyun; Corley, Robin; Hewitt, John; Hopger, Christian; Crowley, Thomas D.

2008-01-01

Clinical interviews of approximately 5,587 adolescents revealed that DSM-IV diagnostic categories were found to be different in terms of the severity of alcohol use disorders (AUDs). However, a substantial inconsistency and overlap was found in severity of AUDs across categories. The need for an alternative diagnostic algorithm which considers all…

Hypochondriasis Y-BOCS: a study of the psychometric properties of a clinician-administered semi-structured interview to assess hypochondriacal thoughts and behaviours.

PubMed

Greeven, Anja; Spinhoven, Philip; van Balkom, Anton J L M

2009-01-01

This study investigated the psychometric properties of the first clinician-administered semi-structured interview for assessing the severity of hypochondriacal symptoms. The Hypochondriasis Yale-Brown Obsessive-Compulsive Scale (H-YBOCS) consisted of three a priori dimensions: hypochondriacal obsessions, compulsions and avoidance. The 16-item interview was conducted with 112 participants with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, hypochondriasis. We analysed factor analytic structure, reliability, construct validity and sensitivity to change. Factor analysis supported a three-factor model similar to the a priori dimensions. Internal consistency ranged from satisfactory to good. Inter-rater reliability was excellent. The construct validity was low to moderate. The H-YBOCS was sensitive for measuring changes in symptom severity. The H-YBOCS is a (factorially) valid and coherent interview with a high level of agreement across different raters. The relatively low discriminant validity could be due to co-morbid anxiety and depressive disorders. Overall, the H-YBOCS seems to be a promising contribution to the assessment of hypochondriasis. *The hypochondriasis Y-BOCS is a feasible clinician rated interview to assess the severity of hypochondriacal complaints.

An Interview with Medical Diagnostics Scientist Bernhard Weigl

ERIC Educational Resources Information Center

Sullivan, Megan

2010-01-01

Medical diagnostics help us evaluate a range of disorders, such as cancer and infectious diseases. In the United States and other developed countries, doctors have access to advanced equipment and laboratories that provide reliable diagnoses. As a result, when we are sick, we feel confident that we will get the treatment we need. Unfortunately,…

Improving Student Outcomes with mCLASS: Math, a Technology-Enhanced CBM and Diagnostic Interview Assessment

ERIC Educational Resources Information Center

Wang, Ye; Gushta, Matthew

2013-01-01

The No Child Left Behind Act resulted in increased school-level implementation of assessment-based school interventions that aim to improve student performance. Diagnostic assessments are included among these interventions, designed to help teachers use evidence about student performance to modify and differentiate instruction and improve student…

Eating Disorder Diagnostic Scale: Additional Evidence of Reliability and Validity

ERIC Educational Resources Information Center

Stice, Eric; Fisher, Melissa; Martinez, Erin

2004-01-01

The authors conducted 4 studies investigating the reliability and validity of the Eating Disorder Diagnostic Scale (HDDS; E. Stice, C. F. Telch, & S. L. Rizvi, 2000), a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa, and binge eating disorder. Study 1 found that the HDDS showed criterion validity with interview-based…

Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders.

PubMed

Mashamba-Thompson, Tivani P; Jama, Ngcwalisa A; Sartorius, Benn; Drain, Paul K; Thompson, Rowan M

2017-01-08

Key stakeholders' involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients' needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.

Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders

PubMed Central

Mashamba-Thompson, Tivani P.; Jama, Ngcwalisa A.; Sartorius, Benn; Drain, Paul K.; Thompson, Rowan M.

2017-01-01

Introduction: Key stakeholders’ involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. Method: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. Results: 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients’ needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Conclusions: Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics. PMID:28075337

Impact of Health Information Exchange on Emergency Medicine Clinical Decision Making.

PubMed

Gordon, Bradley D; Bernard, Kyle; Salzman, Josh; Whitebird, Robin R

2015-12-01

The objective of the study was to understand the immediate utility of health information exchange (HIE) on emergency department (ED) providers by interviewing them shortly after the information was retrieved. Prior studies of physician perceptions regarding HIE have only been performed outside of the care environment. Trained research assistants interviewed resident physicians, physician assistants and attending physicians using a semi-structured questionnaire within two hours of making a HIE request. The responses were recorded, then transcribed for qualitative analysis. The transcribed interviews were analyzed for emerging qualitative themes. We analyzed 40 interviews obtained from 29 providers. Primary qualitative themes discovered included the following: drivers for requests for outside information; the importance of unexpected information; historical lab values as reference points; providing context when determining whether to admit or discharge a patient; the importance of information in refining disposition; improved confidence of provider; and changes in decisions for diagnostic imaging. ED providers are driven to use HIE when they're missing a known piece of information. This study finds two additional impacts not previously reported. First, providers sometimes find additional unanticipated useful information, supporting a workflow that lowers the threshold to request external information. Second, providers sometimes report utility when no changes to their existing plan are made as their confidence is increased based on external records. Our findings are concordant with previous studies in finding exchanged information is useful to provide context for interpreting lab results, making admission decisions, and prevents repeat diagnostic imaging.

Lack of cortisol response in patients with posttraumatic stress disorder (PTSD) undergoing a diagnostic interview

PubMed Central

Kolassa, Iris-Tatjana; Eckart, Cindy; Ruf, Martina; Neuner, Frank; de Quervain, Dominique JF; Elbert, Thomas

2007-01-01

Background According to DSM-IV, the diagnosis of posttraumatic stress disorder (PTSD) requires the experience of a traumatic event during which the person's response involved intense fear, helplessness, or horror. In order to diagnose PTSD, clinicians must interview the person in depth about his/her previous experiences and determine whether the individual has been traumatized by a specific event or events. However, asking questions about traumatic experiences can be stressful for the traumatized individual and it has been cautioned that subsequent "re-traumatization" could occur. This study investigated the cortisol response in traumatized refugees with PTSD during a detailed and standardized interview about their personal war and torture experiences. Methods Participants were male refugees with severe PTSD who solicited an expert opinion in the Psychological Research Clinic for Refugees of the University of Konstanz. 17 patients were administered the Vivo Checklist of War, Detention, and Torture Events, a standardized interview about traumatic experiences, and 16 subjects were interviewed about absorption behavior. Self-reported measures of affect and arousal, as well as saliva cortisol were collected at four points. Before and after the experimental intervention, subjects performed a Delayed Matching-to-Sample (DMS) task for distraction. They also rated the severity of selected PTSD symptoms, as well as the level of intrusiveness of traumatic memories at that time. Results Cortisol excretion diminished in the course of the interview and showed the same pattern for both groups. No specific response was detectable after the supposed stressor. Correspondingly, ratings of subjective well-being, memories of the most traumatic event(s) and PTSD symptoms did not show any significant difference between groups. Those in the presumed stress condition did not perform worse than persons in the control condition after the stressor. However, both groups performed poorly in the DMS task, which is consistent with memory and concentration problems demonstrated in patients with PTSD. Conclusion A comprehensive diagnostic interview including questions about traumatic events does not trigger an HPA-axis based alarm response or changes in psychological measures, even for persons with severe PTSD, such as survivors of torture. Thus, addressing traumatic experiences within a safe and empathic environment appears to impose no unacceptable additional load to the patient. PMID:17916253

Personality disorders in women with severe premenstrual syndrome.

PubMed

Sassoon, Stephanie A; Colrain, Ian M; Baker, Fiona C

2011-06-01

Premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder, affect up to 18% of women. Both are commonly associated with other mood-related disorders such as major depression, and cause significant life impairment, but their relationship with personality disorders is less clear. After completing the Structured Clinical Interview for DSM-IV-TR disorders, 33 women with severe PMS and 26 asymptomatic women, counterbalanced for menstrual cycle phase, were administered the Structured Interview for DSM-IV Personality Disorders, a diagnostic interview with low transparency, strong inter-rater reliability, and good diagnostic clarity. Women with severe PMS had a higher prevalence of personality disorders (p = 0.003) than asymptomatic women (27% versus 0%), and were more likely to have odd-eccentric, dramatic-erratic, and anxious-fearful personality disorder traits (p < 0.05). Obsessive-compulsive personality disorder (OCPD) was the most common character pathology in the PMS group (n = 6, 18%). OCPD, although not necessarily associated with greater severity of premenstrual symptoms, was related to poorer life functioning in women with PMS. The comorbidity of a personality disorder and severe PMS places an additive burden on general life functioning and may have implications for psychiatric treatment or medication given to those with severe premenstrual symptoms.

Diagnostic agreement between the SCID-II screening questionnaire and the Personality Disorder Examination.

PubMed

Jacobsberg, L; Perry, S; Frances, A

1995-12-01

Instruments to assess personality disorders offer reliability, but at the cost of large amounts of a skilled clinician's time to make assessments. The Structured Clinical Interview for DSM-III Axis II (SCID-II; Spitzer, Williams, Gibbon, & First, 1990), incorporates a self-report screening questionnaire, reducing the number of items needing evaluation by the interviewer. However, false negative responses may cause clinically important areas to be overlooked. To establish the rate of false negative responses, we compared participant self-report on the SCID-II with Axis II diagnostic assessment done by clinicians using the Personality Disorder Examination (Loranger, Susman, Oldham, & Russakoff, 1987). The false negative rate was low for every diagnosis, supporting validity of following up with clinician questioning only those diagnostic elements endorsed in the self-report. Avoidant and dependent personality disorders were accurately self-reported. This, an efficient assessment instrument for personality disorders might combine self-report of those disorders where self-report is reliable, with clinician assessment where needed.

Great expectations: patient perspectives and anticipated utility of non-diagnostic genomic-sequencing results.

PubMed

Hylind, Robyn; Smith, Maureen; Rasmussen-Torvik, Laura; Aufox, Sharon

2018-01-01

The management of secondary findings is a challenge to health-care providers relaying clinical genomic-sequencing results to patients. Understanding patients' expectations from non-diagnostic genomic sequencing could help guide this management. This study interviewed 14 individuals enrolled in the eMERGE (Electronic Medical Records and Genomics) study. Participants in eMERGE consent to undergo non-diagnostic genomic sequencing, receive results, and have results returned to their physicians. The interviews assessed expectations and intended use of results. The majority of interviewees were male (64%) and 43% identified as non-Caucasian. A unique theme identified was that many participants expressed uncertainty about the type of diseases they expected to receive results on, what results they wanted to learn about, and how they intended to use results. Participant uncertainty highlights the complex nature of deciding to undergo genomic testing and a deficiency in genomic knowledge. These results could help improve how genomic sequencing and secondary findings are discussed with patients.

Human radiation studies: Remembering the early years. Oral history of radiologist Earl R. Miller, M.D., August 9 and 17, 1994

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-06-01

Dr. Earl R. Miller was interviewed by representatives of US DOE Office of Human Radiation Research (OHRE). The interview covers Dr. Miller`s involvement with the Manhattan Engineer District, with total body irradiation, and heavy-ion therapy. Dr. Miller`s remembrances include wartime work on radiation exposure, Joe Hamilton, Neutron Therapy research, means of obtaining isotopes, consent forms, infinite laminograms, invention of a baby holder to alleviate exposure of radiological technicians in diagnostic procedures involving infants, and several personages.

Diagnostic Construct Validity of MMPI-2 Restructured Form (MMPI-2-RF) Scale Scores

ERIC Educational Resources Information Center

Sellbom, Martin; Bagby, R. Michael; Kushner, Shauna; Quilty, Lena C.; Ayearst, Lindsay E.

2012-01-01

In the current investigation, the authors examined the diagnostic construct validity of the "Minnesota Multiphasic Personality Inventory-2-Restructured Form" (MMPI-2-RF) in a patient sample. All participants were diagnosed via the "Structured Clinical Interview" for DSM-IV Axis I Disorders (SCID-I/P). The data set used in this…

The Diagnosis of Autism and Autism Spectrum Disorder in Low- and Middle-Income Countries: Experience from Jamaica

ERIC Educational Resources Information Center

Samms-Vaughan, Maureen; Rahbar, Mohammad H.; Dickerson, Aisha S.; Loveland, Katherine A.; Hessabi, Manouchehr; Pearson, Deborah A.; Bressler, Jan; Shakespeare-Pellington, Sydonnie; Grove, Megan L.; Coore-Desai, Charlene; Reece, Jody; Boerwinkle, Eric

2017-01-01

The administration requirements of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised, widely used in high-income countries, make them less feasible for diagnosis of autism spectrum disorder in low- and middle-income countries. The flexible administration requirements of the Childhood Autism Rating Scale have…

Development and Evaluation of the Diagnostic Power for a Computer-Based Two-Tier Assessment

ERIC Educational Resources Information Center

Lin, Jing-Wen

2016-01-01

This study adopted a quasi-experimental design with follow-up interview to develop a computer-based two-tier assessment (CBA) regarding the science topic of electric circuits and to evaluate the diagnostic power of the assessment. Three assessment formats (i.e., paper-and-pencil, static computer-based, and dynamic computer-based tests) using…

Classifying Autism Spectrum Disorders by ADI-R: Subtypes or Severity Gradient?

ERIC Educational Resources Information Center

Cholemkery, Hannah; Medda, Juliane; Lempp, Thomas; Freitag, Christine M.

2016-01-01

To reduce phenotypic heterogeneity of Autism spectrum disorders (ASD) and add to the current diagnostic discussion this study aimed at identifying clinically meaningful ASD subgroups. Cluster analyses were used to describe empirically derived groups based on the Autism Diagnostic Interview-revised (ADI-R) in a large sample of n = 463 individuals…

Brief Report: Autism in Individuals with Down Syndrome

ERIC Educational Resources Information Center

Starr, Elizabeth M.; Berument, Sibel Kazak; Tomlins, Megan; Papanikolaou, Katerina; Rutter, Michael

2005-01-01

As an off-shoot of a study examining the reliability and validity of an adapted version of the Pre-Linguistic Autism Diagnostic Observation Schedule (A-PL-ADOS), 13 individuals with Down syndrome with IQs ranging between 24 and 48 were administered the Autism Diagnostic Interview-Revised (ADI-R) and the A-PL-ADOS, which are well-validated…

National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses with Clinical Reassessments

ERIC Educational Resources Information Center

Kessler, Ronald C.; Avenevoli, Shelli; Green, Jennifer; Gruber, Michael J.; Guyer, Margaret; He, Yulei; Jin, Robert; Kaufman, Joan; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen R.

2009-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses that was based on the World Health Organization's Composite International Diagnostic Interview (CIDI) and implemented in the National comorbidity survey replication adolescent supplement is found to have good individual-level concordance with diagnosis based on blinded…

The Predictive Validity of the PTSD Checklist in a Nonclinical Sample of Combat-Exposed National Guard Troops

ERIC Educational Resources Information Center

Arbisi, Paul A.; Kaler, Matthew E.; Kehle-Forbes, Shannon M.; Erbes, Christopher R.; Polusny, Melissa A.; Thuras, Paul

2012-01-01

After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the "Diagnostic and Statistical…

Profiles of Receptive and Expressive Language Abilities in Boys with Comorbid Fragile X Syndrome and Autism

ERIC Educational Resources Information Center

McDuffie, Andrea; Kover, Sara; Abbeduto, Leonard; Lewis, Pamela; Brown, Ted

2012-01-01

The authors examined receptive and expressive language profiles for a group of verbal male children and adolescents who had fragile X syndrome along with varying degrees of autism symptoms. A categorical approach for assigning autism diagnostic classification, based on the combined use of the Autism Diagnostic Interview--Revised and the Autism…

How Useful Is the Social Communication Questionnaire in Toddlers at Risk of Autism Spectrum Disorder?

ERIC Educational Resources Information Center

Oosterling, Iris; Rommelse, Nanda; De Jonge, Maretha; Van Der Gaag, Rutger Jan; Swinkels, Sophie; Roos, Sascha; Visser, Janne; Buitelaar, Jan

2010-01-01

Background: The Social Communication Questionnaire (SCQ) is a screening instrument with established validity against the Autism Diagnostic Interview-Revised (ADI-R) in children aged 4 years and older. Indices of diagnostic accuracy have been shown to be strong in school-aged samples; however, relatively little is known about the performance of the…

[Early detection of autism in children. Review of literature].

PubMed

Pisula, E

1997-01-01

The difficulties with early detection of autistic disorder in children are discussed. DSM-IV diagnostic criteria are presented. Usefulness of clinical interview and clinical experiment in diagnosing autistic disorder are analyzed.

Preschoolers’ Observed Temperament and Psychiatric Disorders Assessed with a Parent Diagnostic Interview

PubMed Central

Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Dyson, Margaret; Olino, Thomas M.; Durbin, C. Emily; Klein, Daniel N.

2011-01-01

Evidence supports the role of temperament in the origins of psychiatric disorders. However, there are few data on associations between temperament and psychiatric disorders in early childhood. A community sample of 541 three-year old preschoolers participated in a laboratory temperament assessment, and caregivers were administered a structured diagnostic interview on preschool psychopathology. In bivariate analyses, temperamental dysphoria and low exuberance were associated with depression; fear, low exuberance, and low sociability were associated with anxiety disorders; and disinhibition and dysphoria were associated with oppositional defiant disorder. Although there were no bivariate associations between temperament and attention-deficit/hyperactivity disorder, disinhibition emerged as a unique predictor in multivariate analyses. Findings indicate that the pattern of relations between temperament and psychopathology in older youth and adults is evident as early as age 3. PMID:21391025

Diagnosing depression after stroke.

PubMed

Black, K J

1995-07-01

Neurobehavioral sequelae of strokes can limit a patient's ability to describe or express emotion, can cause him to give "yes" answers to the clinician who expects them, or can directly cause apathy or crying spells. Also, anosognosia for depressive signs can cause the patient to deny depressive signs that are objectively observable. These diagnostic confounders have not been adequately assessed in previous research on poststroke depression; thus many studies are of doubtful validity, as shown by studies of the dexamethasone suppression test for melancholia in stroke patients. Future studies on depression after stroke must prospectively rule out fluent aphasia, motor aprosody, and amnesia before relying on diagnostic information from the psychiatric interview, and the interview should always be supplemented by direct observation of vegetative signs and other behavior. With this extended information, major depression can and should be diagnosed using accepted symptom and duration criteria.

The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): Reliability of New Psychiatric Diagnostic Modules and Risk Factors in a General Population Sample

PubMed Central

Ruan, W. June; Goldstein, Risë B.; Chou, S. Patricia; Smith, Sharon M.; Saha, Tulshi D.; Pickering, Roger P.; Dawson, Deborah A.; Huang, Boji; Stinson, Frederick S.; Grant, Bridget F.

2008-01-01

This study presents test-retest reliability statistics and information on internal consistency for new diagnostic modules and risk factor of alcohol, drug, and psychiatric disorders the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV). Test-retest statistics were derived from a random sample of 1,899 adults selected from 34,653 respondents who participated in the 2004–2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Internal consistency of continuous scales was assessed using the entire Wave 2 NESARC. Both test and retest interviews were conducted face-to-face. Test-retest and internal consistency results for diagnoses and symptom scales associated with posttraumatic stress disorder, attention-deficit/hyperactivity disorder, and borderline, narcissistic, and schizotypal personality disorders were predominantly good (kappa > 0.63; ICC > 0.69; alpha > 0.75) and reliability for risk factor measures fell within the good to excellent range (intraclass correlations = 0.50–0.94; alpha = 0.64–0.90). The high degree of reliability found in this study suggests that new AUDADIS-IV diagnostic measures can be useful tools in research settings. The availability of highly reliable measures of risk factors of alcohol, drug, and psychiatric disorders will contribute to the validity of conclusions drawn from future research in the domains of substance use disorder and psychiatric epidemiology. PMID:17706375

WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results.

PubMed

Ustün, B; Compton, W; Mager, D; Babor, T; Baiyewu, O; Chatterji, S; Cottler, L; Göğüş, A; Mavreas, V; Peters, L; Pull, C; Saunders, J; Smeets, R; Stipec, M R; Vrasti, R; Hasin, D; Room, R; Van den Brink, W; Regier, D; Blaine, J; Grant, B F; Sartorius, N

1997-09-25

The WHO Study on the reliability and validity of the alcohol and drug use disorder instruments in an international study which has taken place in centres in ten countries, aiming to test the reliability and validity of three diagnostic instruments for alcohol and drug use disorders: the Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and a special version of the Alcohol Use Disorder and Associated Disabilities Interview schedule-alcohol/drug-revised (AUDADIS-ADR). The purpose of the reliability and validity (R&V) study is to further develop the alcohol and drug sections of these instruments so that a range of substance-related diagnoses can be made in a systematic, consistent, and reliable way. The study focuses on new criteria proposed in the tenth revision of the International Classification of Diseases (ICD-10) and the fourth revision of the diagnostic and statistical manual of mental disorders (DSM-IV) for dependence, harmful use and abuse categories for alcohol and psychoactive substance use disorders. A systematic study including a scientifically rigorous measure of reliability (i.e. 1 week test-retest reliability) and validity (i.e. comparison between clinical and non-clinical measures) has been undertaken. Results have yielded useful information on reliability and validity of these instruments at diagnosis, criteria and question level. Overall the diagnostic concordance coefficients (kappa, kappa) were very good for dependence disorders (0.7-0.9), but were somewhat lower for the abuse and harmful use categories. The comparisons among instruments and independent clinical evaluations and debriefing interviews gave important information about possible sources of unreliability, and provided useful clues on the applicability and consistency of nosological concepts across cultures.

Eating Behaviors and Obesity in African American and Caucasian Women

DTIC Science & Technology

2010-08-16

Disorder Diagnostic Scale [23] is a 22-item scale that is useful as a screening tool for Anorexia Nervosa , Bulimia Nervosa , and Binge Eating Disorder...Agreement between eating disorder diagnoses from the Eating Disorder Diagnostic Scale and those by clinical interview is high: 99% for Anorexia , 96...Diagnostic Scale revealed that only 24% of the total sample met criteria for Bulimia Nervosa or Binge Eating Disordered behavior (sub- or threshold

The self-report Dissociative Disorders Interview Schedule: A preliminary report.

PubMed

Ross, Colin A; Browning, Elena

2017-01-01

A self-report version of the Dissociative Disorders Interview Schedule (SR-DDIS) was administered to 100 inpatients in a hospital-based trauma program. All participants had previously completed the interviewer-administered version of the DDIS. When we compared the overall results on the DDIS and SR-DDIS for the 100 inpatients, the findings were very consistent for both symptom clusters and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), diagnoses. The agreement rate between the 2 versions for DSM-5 diagnoses was fair to substantial using Cohen's kappa, with agreement being substantial for 4 out of the 7 diagnoses made by the DDIS. It appears likely that the SR-DDIS can be used instead of the DDIS, at least in clinical populations, with no clinically or conceptually significant differences between the results obtained with the 2 versions.

Utilizing interview and self-report assessment of the Five-Factor Model to examine convergence with the alternative model for personality disorders.

PubMed

Helle, Ashley C; Trull, Timothy J; Widiger, Thomas A; Mullins-Sweatt, Stephanie N

2017-07-01

An alternative model for personality disorders is included in Section III (Emerging Models and Measures) of Diagnostic and Statistical Manual of Mental Disorders, (5th ed.; DSM-5). The DSM-5 dimensional trait model is an extension of the Five-Factor Model (FFM; American Psychiatric Association, 2013). The Personality Inventory for DSM-5 (PID-5) assesses the 5 domains and 25 traits in the alternative model. The current study expands on recent research to examine the relationship of the PID-5 with an interview measure of the FFM. The Structured Interview for the Five Factor Model of Personality (SIFFM) assesses the 5 bipolar domains and 30 facets of the FFM. Research has indicated that the SIFFM captures maladaptive aspects of personality (as well as adaptive). The SIFFM, NEO PI-R, and PID-5 were administered to participants to examine their respective convergent and discriminant validity. Results provide evidence for the convergence of the 2 models using self-report and interview measures of the FFM. Clinical implications and future directions are discussed, particularly a call for the development of a structured interview for the assessment of the DSM-5 dimensional trait model. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Results of the psychiatric, select-out evaluation of US astronaut applications

NASA Technical Reports Server (NTRS)

Faulk, D. M.; Santy, P. A.; Holland, A. W.; Marsh, R.

1992-01-01

The psychiatric exclusion criteria for astronauts are based on NASA Medical Psychiatric Standards for space flight. Until recently, there were no standardized methods to evaluate disqualifying psychopathology in astronaut applicants. Method: One hundred and six astronaut applicants who had passed the intitial screening were evaluated for Axis 1 and Axis 2 DSM-3-R diagnoses using the NASA structured psychiatric interview. The interview consisted of three parts: (1) an unstructured portion for obtaining biographical and historical information, (2) the schedule for effective disorders-lifetime version (SASDL), specially modified to include all disqualifying Axis 1 mental disorders; and, (3) the personality assessment schedule (PAS) also modified to evaluate for Axis 2 disorders. Results: Nine of 106 candidates (8.5 percent) met diagnostic criteria for six Axis 1 disorders (including V code) or Axis 2 disorders. Two of these disorders were disqualifying for the applicants. 'Near' diagnoses (where applicants met at least 50 percent of the listed criteria) were assessed to demonstrate that clinicians using the interview were able to overcome applicants' reluctance to report symptomatomatology. Conclusion: The use of the NASA structured interview was effective in identifying past and present psychopathology in a group of highly motivated astronaut applicants. This was the first time a structured psychiatric interview had been used in such a setting for this purpose.

Dissociative Disorders Among Chinese Inpatients Diagnosed With Schizophrenia

PubMed Central

Yu, Junhan; Ross, Colin A.; Keyes, Benjamin B.; Li, Ying; Dai, Yunfei; Zhang, Tianhong; Wang, Lanlan; Fan, Qing; Xiao, Zeping

2010-01-01

The purpose of the study was to assess the prevalence of dissociative disorders in a sample of Chinese psychiatric inpatients. Participants in the study consisted of 569 consecutively admitted inpatients at Shanghai Mental Health Center, China, of whom 84.9% had a clinical diagnosis of schizophrenia based on the Chinese Classification and Diagnostic Criteria for Mental Disorders, Version 3 (CCMD-3). All participants completed a self-report measure of dissociation, the Dissociative Experiences Scale (DES) and none had a prior diagnosis of a dissociative disorder. Ninety-six randomly selected participants were interviewed with a structured interview, the Dissociative Disorders Interview Schedule (DDIS) and a clinical interview. These 96 patients did not differ significantly from the 473 patients who were not interviewed on any demographic measures or on the self-report measure dissociation. A total of 28 (15.3%, after weighting of the data) patients received a clinical diagnosis of a dissociative disorder based on DSM-IV-TR criteria. Dissociative identity disorder was diagnosed in 2 (0.53%, after weighting) patients. Compared to the patients without a dissociative disorder, patients with dissociative disorders were significantly more likely to report childhood abuse (57.1% versus 22.1%), but the two groups did not differ significantly on any demographic measures. Dissociative disorders were readily identified in an inpatient psychiatric population in China. PMID:20603768

The heritability of avoidant and dependent personality disorder assessed by personal interview and questionnaire.

PubMed

Gjerde, L C; Czajkowski, N; Røysamb, E; Orstavik, R E; Knudsen, G P; Ostby, K; Torgersen, S; Myers, J; Kendler, K S; Reichborn-Kjennerud, T

2012-12-01

Personality disorders (PDs) have been shown to be modestly heritable. Accurate heritability estimates are, however, dependent on reliable measurement methods, as measurement error deflates heritability. The aim of this study was to estimate the heritability of DSM-IV avoidant and dependent personality disorder, by including two measures of the PDs at two time points. Data were obtained from a population-based cohort of young adult Norwegian twins, of whom 8045 had completed a self-report questionnaire assessing PD traits. 2794 of these twins subsequently underwent a structured diagnostic interview for DSM-IV PDs. Questionnaire items predicting interview results were selected by multiple regression, and measurement models of the PDs were fitted in Mx. The heritabilities of the PD factors were 0.64 for avoidant PD and 0.66 for dependent PD. No evidence of common environment, that is, environmental factors that are shared between twins and make them similar, was found. Genetic and environmental contributions to avoidant and dependent PD seemed to be the same across sexes. The combination of both a questionnaire- and an interview assessment of avoidant and dependent PD results in substantially higher heritabilities than previously found using single-occasion interviews only. © 2012 John Wiley & Sons A/S.

Assessment of personality-related levels of functioning: a pilot study of clinical assessment of the DSM-5 level of personality functioning based on a semi-structured interview.

PubMed

Thylstrup, Birgitte; Simonsen, Sebastian; Nemery, Caroline; Simonsen, Erik; Noll, Jane Fjernestad; Myatt, Mikkel Wanting; Hesse, Morten

2016-08-25

The personality disorder categories in the Diagnostic and Statistical Manual of Mental Disorders IV have been extensively criticized, and there is a growing consensus that personality pathology should be represented dimensionally rather than categorically. The aim of this pilot study was to test the Clinical Assessment of the Level of Personality Functioning Scale, a semi-structured clinical interview, designed to assess the Level of Personality Functioning Scale of the DSM-5 (Section III) by applying strategies similar to what characterizes assessments in clinical practice. The inter-rater reliability of the assessment of the four domains and the total impairment in the Level of Personality Functioning Scale were measured in a patient sample that varied in terms of severity and type of pathology. Ratings were done independently by the interviewer and two experts who watched a videotaped Clinical Assessment of the Level of Personality Functioning Scale interview. Inter-rater reliability coefficients varied between domains and were not sufficient for clinical practice, but may support the use of the interview to assess the dimensions of personality functioning for research purposes. While designed to measure the Level of Personality Functioning Scale with a high degree of similarity to clinical practice, the Clinical Assessment of the Level of Personality Functioning Scale had weak reliabilities and a rating based on a single interview should not be considered a stand-alone assessment of areas of functioning for a given patient.

Process-orientated psychoanalytic work in initial interviews and the importance of the opening scene.

PubMed

Wegner, Peter

2014-06-01

From the very first moment of the initial interview to the end of a long course of psychoanalysis, the unconscious exchange between analysand and analyst, and the analysis of the relationship between transference and countertransference, are at the heart of psychoanalytic work. Drawing on initial interviews with a psychosomatically and depressively ill student, a psychoanalytic understanding of initial encounters is worked out. The opening scene of the first interview already condenses the central psychopathology - a clinging to the primary object because it was never securely experienced as present by the patient. The author outlines the development of some psychoanalytic theories concerning the initial interview and demonstrates their specific importance as background knowledge for the clinical situation in the following domains: the 'diagnostic position', the 'therapeutic position', the 'opening scene', the 'countertransference' and the 'analyst's free-floating introspectiveness'. More recent investigations refer to 'process qualities' of the analytic relationship, such as 'synchronization' and 'self-efficacy'. The latter seeks to describe after how much time between the interview sessions constructive or destructive inner processes gain ground in the patient and what significance this may have for the decision about the treatment that follows. All these factors combined can lead to establishing a differential process-orientated indication that also takes account of the fact that being confronted with the fear of unconscious processes of exchange is specific to the psychoanalytic profession. Copyright © 2014 Institute of Psychoanalysis.

Trouble with ataxia: A longitudinal qualitative study of the diagnosis and medical management of a group of rare, progressive neurological conditions

PubMed Central

Ealing, John; Greenfield, Julie; Kingston, Helen; Sanders, Caroline; Payne, Katherine

2013-01-01

Objectives: An exploratory investigation of diagnosis and management in progressive ataxias: rare neurological conditions usually affecting balance, mobility and speech. Methods: A longitudinal qualitative study into the experiences of people with ataxia and neurologists. Thematic analysis and follow-up interviews were used to determine diagnosis and management issues over time. Results: People with ataxia recruited via two hospital departments and Ataxia UK were interviewed at baseline (n = 38) and 12-month follow-up (n = 31). Eight consultant neurologists were interviewed once. Patient accounts were diverse, but many expressed frustration at having an incurable condition and dissatisfaction with service outcomes. At follow-up, there was variation in their contact and satisfaction with helping agencies. Service issues regarding continuity of care and the primary/secondary care interface were evident. Neurologists’ accounts also varied. One-half reported that there is nothing that can be done, and one-half favoured specialist referral to increase the likelihood of finding an underlying aetiology within budget constraints. Conclusions: Diagnostic uncertainties existing at baseline remained for patients at follow-up interviews, although some had learned to deal with the uncertainties brought by the diagnosis of a largely untreatable condition. Care pathways only seemed to operate in the case of defined conditions, such as Friedreich’s Ataxia, the most commonly inherited cause. The findings point to a need to develop the evidence base to inform the relative utility of diagnostic procedures in the context of finite resources for patient care and support. PMID:26770684

Patient experiences of colonoscopy, barium enema and CT colonography: a qualitative study.

PubMed

Von Wagner, C; Knight, K; Halligan, S; Atkin, W; Lilford, R; Morton, D; Wardle, J

2009-01-01

Previous studies of patient experience with bowel screening tests, in particular CT colonography (CTC), have superimposed global rating scales and not explored individual experience in detail. To redress this, we performed qualitative interviews in order to characterize patient expectations and experiences in depth. Following ethical permission, 16 patients undergoing CTC, 18 undergoing colonoscopy and 15 undergoing barium enema agreed to a semi-structured interview by a health psychologist. Interviews were recorded, responses transcribed and themes extracted with the aim of assimilating individual experiences to facilitate subsequent development and interpretation of quantitative surveys of overall satisfaction with each diagnostic test. Transcript analysis identified three principal themes: physical sensations, social interactions and information provision. Physical sensations differed for each test but were surprisingly well tolerated overall. Social interactions with staff were perceived as very important in colouring the whole experience, particularly in controlling the feelings of embarrassment, which was critical for all procedures. Information provision was also an important determinant of experience. Verbal feedback was most common during colonoscopy and invariably reassuring. However, patients undergoing CTC received little visual or verbal feedback and were often confused regarding the test outcome. Barium enema had no specific advantage over other tests. Qualitative interviews provided important perspectives on patient experience. Our data demonstrated that models describing the quality of medical encounters are applicable to single diagnostic episodes. Staff interactions and information provision were particularly important. We found advantages specific to both CTC and colonoscopy but none for barium enema. CTC could benefit greatly from improved information provision following examination.

Twelve-month and lifetime health service use in Te Rau Hinengaro: The New Zealand Mental Health Survey.

PubMed

Oakley Browne, Mark A; Wells, J Elisabeth; McGee, Magnus A

2006-10-01

To estimate the 12 month and lifetime use of health services for mental health problems. A nationwide face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are 12 month and lifetime health service use for mental health and substance use problems. Of the population, 13.4% had a visit for a mental health reason in the 12 months before interview. Of all 12 month cases of mental disorder, 38.9% had a mental health visit to a health or non-health-care provider in the past 12 months. Of these 12 month cases, 16.4% had contact with a mental health specialist, 28.3% with a general medical provider, 4.8% within the human services sector and 6.9% with a complementary or alternative medicine practitioner. Most people with lifetime disorders eventually made contact if their disorder continued. However, the percentages seeking help at the age of onset were small for most disorders and several disorders had large percentages who never sought help. The median duration of delay until contact varies from 1 year for major depressive disorder to 38 years for specific phobias. A significant unmet need for treatment for people with mental disorder exists in the New Zealand community, as in other comparable countries.

"Recovery" from the diagnosis of autism - and then?

PubMed

Olsson, Martina Barnevik; Westerlund, Joakim; Lundström, Sebastian; Giacobini, MaiBritt; Fernell, Elisabeth; Gillberg, Christopher

2015-01-01

The aim of this study was to follow up the 17 children, from a total group of 208 children with autism spectrum disorder (ASD), who "recovered from autism". They had been clinically diagnosed with ASD at or under the age of 4 years. For 2 years thereafter they received intervention based on applied behavior analysis. These 17 children were all of average or borderline intellectual functioning. On the 2-year follow-up assessment, they no longer met criteria for ASD. At about 10 years of age they were targeted for a new follow-up. Parents were given a semistructured interview regarding the child's daily functioning, school situation, and need of support, and were interviewed using the Vineland Adaptive Behavior Scales (VABS) and the Autism - Tics, Attention-deficit/hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC) telephone interview. The vast majority of the children had moderate-to-severe problems with attention/activity regulation, speech and language, behavior, and/or social interaction. A majority of the children had declined in their VABS scores. Most of the 14 children whose parents were A-TAC-interviewed had problems within many behavioral A-TAC domains, and four (29%) had symptom levels corresponding to a clinical diagnosis of ASD, AD/HD, or both. Another seven children (50%) had pronounced subthreshold indicators of ASD, AD/HD, or both. Children diagnosed at 2-4 years of age as suffering from ASD and who, after appropriate intervention for 2 years, no longer met diagnostic criteria for the disorder, clearly needed to be followed up longer. About 3-4 years later, they still had major problems diagnosable under the umbrella term of ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). They continued to be in need of support, educationally, from a neurodevelopmental and a medical point of view. According to parent interview data, a substantial minority of these children again met diagnostic criteria for ASD.

Radiology resident recruitment: A study of the impact of web-based information and interview day activities.

PubMed

Deloney, Linda A; Perrot, L J; Lensing, Shelly Y; Jambhekar, Kedar

2014-07-01

Residency recruitment is a critical and expensive process. A program's Web site may improve recruitment, but little is known about how applicants use program sites or what constitutes optimal content. The importance of an interview day and interactions with a program's residents has been described, but candidate preferences for various activities and schedules have not been widely reported. We investigated contemporary use and perceived utility of information provided on radiology program Web sites, as well as preferences for the interview day experience. Using an anonymous cross-sectional survey, we studied 111 candidates who were interviewed between November 1, 2012 and January 19, 2013 for a diagnostic radiology residency position at our institution. Participation in this institutional review board-approved study was entirely voluntary, and no identifying information was collected. Responses were sealed and not analyzed until after the match. A total of 70 candidates returned a completed survey (63% response rate). Optimal content considered necessary for a "complete" Web site was identified. The most important factor in deciding where to apply was geographical connection to a program. "AuntMinnie" was the most popular source of program information on social media. Candidates overwhelmingly preferred one-on-one faculty interviews but had no preference between a Saturday and weekday schedule. The ideal interview experience should include a "meet and greet" with residents off campus and a personal interview with the program director. The overall "feel" or "personality" of the program was critical to a candidate's rank order decision. Our findings offer insight into what factors make programs appealing to radiology applicants. This information will be useful to medical educators engaged in career counseling and recruitment. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Positive and negative life events and personality traits in predicting course of depression and anxiety.

PubMed

Spinhoven, P; Elzinga, B M; Hovens, J G F M; Roelofs, K; van Oppen, P; Zitman, F G; Penninx, B W J H

2011-12-01

To examine the prognostic value of personality dimensions and negative and positive life events for diagnostic and symptom course trajectories in depressive and anxiety disorder. A total of 1209 subjects (18-65 years) with depressive and/or anxiety disorder were recruited in primary and specialized mental health care. Personality dimensions at baseline were assessed with the NEO-FFI and incidence and date of life events retrospectively with a structured interview at 2-year follow-up. DSM-IV-based diagnostic interviews as well as life chart assessments allowed course assessment at both the diagnostic and symptom trajectory level over 2 years. Life events were significantly related to diagnostic and symptom course trajectories of depression and anxiety also after correcting for sociodemographic and clinical characteristics. Only negative life events prospectively predicted longer time to remission of depressive disorder. Prospective associations of neuroticism and extraversion with prognosis of anxiety and depression were greatly reduced after correcting for baseline severity and duration of index disorder. Personality traits did not moderate the effect of life events on 2-year course indicators. Negative life events have an independent effect on diagnostic and symptom course trajectories of depression and to a lesser extent anxiety unconfounded by sociodemographic, clinical, and personality characteristics. © 2011 John Wiley & Sons A/S.

ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation

ERIC Educational Resources Information Center

Louwerse, A.; Eussen, M. L. J. M.; Van der Ende, J.; de Nijs, P. F. A.; Van Gool, A. R.; Dekker, L. P.; Verheij, C.; Verheij, F.; Verhulst, F. C.; Greaves-Lord, K.

2015-01-01

The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were…

Autism Spectrum Phenotype in Males and Females with Fragile X Full Mutation and Premutation

ERIC Educational Resources Information Center

Clifford, Sally; Dissanayake, Cheryl; Bui, Quang M.; Huggins, Richard; Taylor, Annette K.; Loesch, Danuta Z.

2007-01-01

The behavioural phenotype of autism was assessed in individuals with full mutation and premutation fragile X syndrome (FXS) using the Autism Diagnostic Observation Scale-Generic (ADOS-G) and the Autism Diagnostic Interview (ADI-R). The participants, aged 5-80 years, comprised 33 males and 31 females with full mutation, 7 males and 43 females with…

A Genome-Wide Association Study of Autism Incorporating Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule, and Social Responsiveness Scale

ERIC Educational Resources Information Center

Connolly, John J.; Glessner, Joseph T.; Hakonarson, Hakon

2013-01-01

Efforts to understand the causes of autism spectrum disorders (ASDs) have been hampered by genetic complexity and heterogeneity among individuals. One strategy for reducing complexity is to target endophenotypes, simpler biologically based measures that may involve fewer genes and constitute a more homogenous sample. A genome-wide association…

Autism Spectrum Disorder in Children and Adolescents with Fragile X Syndrome: Within-Syndrome Differences and Age-Related Changes

ERIC Educational Resources Information Center

McDuffie, Andrea; Abbeduto, Leonard; Lewis, Pamela; Kover, Sara; Kim, Jee-Seon; Weber, Ann; Brown, W. Ted

2010-01-01

The Autism Diagnostic Interview-Revised (ADI-R) was used to examine diagnostic profiles and age-related changes in autism symptoms for a group of verbal children and adolescents who had fragile X syndrome, with and without autism. After controlling for nonverbal IQ, we found statistically significant between-group differences for lifetime and…

Reliability and validity of a semi-structured DSM-based diagnostic interview module for the assessment of Attention Deficit Hyperactivity Disorder in adult psychiatric outpatients.

PubMed

Gorlin, Eugenia I; Dalrymple, Kristy; Chelminski, Iwona; Zimmerman, Mark

2016-08-30

Despite growing recognition that the symptoms and functional impairments of Attention Deficit/Hyperactivity Disorder (ADHD) persist into adulthood, only a few psychometrically sound diagnostic measures have been developed for the assessment of ADHD in adults, and none have been validated for use in a broad treatment-seeking psychiatric sample. The current study presents the reliability and validity of a semi-structured DSM-based diagnostic interview module for ADHD, which was administered to 1194 adults presenting to an outpatient psychiatric practice. The module showed excellent internal consistency and interrater reliability, good convergent and discriminant validity (as indexed by relatively high correlations with self-report measures of ADHD and ADHD-related constructs and little or no correlation with other, non-ADHD symptom domains), and good construct validity (as indexed by significantly higher rates of psychosocial impairment and self-reported family history of ADHD in individuals who meet criteria for an ADHD diagnosis). This instrument is thus a reliable and valid diagnostic tool for the detection of ADHD in adults presenting for psychiatric evaluation and treatment. Published by Elsevier Ireland Ltd.

3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-defined Delirium

PubMed Central

Marcantonio, Edward R.; Ngo, Long H.; O’Connor, Margaret; Jones, Richard N.; Crane, Paul K.; Metzger, Eran D.; Inouye, Sharon K.

2015-01-01

Background Delirium is common, morbid, and costly, yet remains often unrecognized in most clinical settings. The Confusion Assessment Method (CAM) is the most widely used diagnostic algorithm, and operationalizing its features would represent a substantial advance for clinical care. Objective To derive the 3D-CAM, a new 3-minute diagnostic assessment for CAM-defined delirium, and to validate it against a clinical reference standard. Design Diagnostic test study Setting 4 general medicine units in an academic medical center Participants 201 inpatients aged ≥ 75 years old Measurements We identified 20 items that best operationalized the 4 CAM diagnostic features to create the 3D-CAM. For prospective validation, 3D-CAM assessments were administered by trained research assistants. Independently, clinicians performed an extensive assessment that included patient interviews, family interviews, and review of the medical record. These data were considered by an expert panel to determine the presence or absence of delirium and dementia (reference standard). We compared the 3D-CAM delirium determination to the reference standard in all patients and in subgroups with and without dementia. Results The 201 participants in the prospective validation study had mean age (SD) of 84 (5.5) years, and 27% had dementia. The expert panel identified delirium in 21%. Median administration time for 3D-CAM was 3 minutes (inter-quartile range: 2–5 minutes). The sensitivity [95% CI] of 3D-CAM was 95% [84%, 99%] and the specificity was 94% [90%, 97%]. The 3D-CAM performed well in patients both with dementia (sensitivity=96% [82%, 100%], specificity=86% [67%, 96%]) and without dementia (sensitivity=93% [66%, 100%], specificity=96% [91%,99%]). Limitations Limited to single center, cross-sectional, and medicine patients only Conclusion The 3D-CAM operationalizes the CAM algorithm using a 3-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium. PMID:25329203

Study protocol of the internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE), Korea, 2015–2019

PubMed Central

Jeong, Hyunsuk; Jo, Sun-Jin; Lee, Seung-Yup; Kim, Eunjin; Son, Hye Jung; Han, Hyun-ho; Lee, Hae Kook; Kweon, Yong-Sil; Bhang, Soo-young; Choi, Jung-Seok; Kim, Bung-Nyun; Gentile, Douglas A; Potenza, Marc N

2017-01-01

Introduction In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine internet gaming disorder (IGD) diagnostic criteria as a condition warranting further empirical and clinical research. The aim of this study is to clarify the natural and clinical courses of IGD proposed DSM-5 in adolescents and to evaluate its risk and protective factors. Methods and analysis The Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence (iCURE) study is an ongoing multidisciplinary, prospective, longitudinal cohort study conducted in 21 schools in Korea. Participant recruitment commenced in March 2015 with the goal of registering 3000 adolescents. The baseline assessment included surveys on emotional, social and environmental characteristics. A parent or guardian completed questionnaires and a structured psychiatric comorbidity diagnostic interview regarding their children. Adolescents with the Internet Game Use-Elicited Symptom Screen total scores of 6 or higher were asked to participate in the clinical diagnostic interview. Two subcohorts of adolescents were constructed: a representative subcohort and a clinical evaluation subcohort. The representative subcohort comprises a randomly selected 10% of the iCURE to investigate the clinical course of IGD based on clinical diagnosis and to estimate the false negative rate. The clinical evaluation subcohort comprised participants meeting three or more of the nine IGD criteria, determined by clinical diagnostic interview, to show the clinical course of IGD. Follow-up data will be collected annually for the 3 years following the baseline assessments. The primary endpoint is 2-year incidence, remission and recurrence rates of IGD. Cross-sectional and longitudinal associations between exposures and outcomes as well as mediation factors will be evaluated. Ethics and dissemination This study is approved by the Institutional Review Board of the Catholic University of Korea. Results will be published in peer-reviewed journals. Trial registration number ClinicalTrials.gov (identifier: NCT02415322). PMID:28982839

Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in French emergency departments.

PubMed

N'Diaye, Dieynaba S; Schwarzinger, Michaël; Obach, Dorothée; Poissy, Julien; Matheron, Sophie; Casalino, Enrique; Yazdanpanah, Yazdan

2014-11-19

Tétanos Quick Stick® (TQS) is a test for tetanus immunity screening for wounded patients in emergency departments (EDs), but represents additional costs compared with a medical interview on vaccination history. The study objective was to assess the effectiveness and cost of the TQS in French EDs. We performed a model-based analysis that simulates screening of tetanus immunity and risk of tetanus based on prophylaxis administration. Strategies compared were: i) diagnosis of tetanus immunity by "TQS"; ii) "Medical Interview" (current practice). The study population was 1,658,000 French adults seeking ED care for a wound in 2012. Model parameters were estimated based on French national surveillance data, and published literature. Outcome measures were number of tetanus cases, life years gained and costs (2012 €) from a societal perspective. Use of TQS had negligible impact on health outcomes (0.02 tetanus cases/year in France vs. 0.41 for "Medical Interview"), but resulted in a decrease in annual costs of €2,203,000 (-42%). Base case and sub-group analysis showed that with the same effectiveness, the average cost per patient was: €13 with "Medical Interview" vs. €11.7 with TQS for the overall cohort; €28.9 with "Medical Interview" vs. €21 with "TQS" for tetanus-prone wounds; €15 with "Medical Interview" vs. €14.1 with "TQS" for patients aged ≥65 years; and €6.2 with "Medical Interview" vs. €7.8 with "TQS" for non-tetanus-prone wounds. Use of TQS is as effective and less costly than "Medical Interview" when applied in ED to wounded patients with tetanus-prone wounds or aged ≥65 years. However, it is more expensive in patients with non-tetanus-prone wounds.

Familial diagnostic experiences in paediatric oncology.

PubMed

Evans, N T; Wakefield, C E; McLoone, J K; Cohn, R J

2015-01-06

Diagnostic delays may not have significant prognostic implications in paediatric oncology, but psychological impacts remain understudied. Interviews exploring diagnostic experiences were conducted with childhood cancer survivors (n=19), parents (n=78) and siblings (n=15). Median diagnostic time was 3 weeks. Participants described a mixture of rapid diagnoses (28.9%), plus delayed appraisal intervals (that is, parent- or patient-associated diagnostic delays; 40.0%) and diagnostic intervals (that is, healthcare-associated delays; 46.7%). Families experiencing delays described guilt and anger and deleterious impacts on the family-clinician relationship. Some believed delays impacted on treatment and prognosis. The effect of the diagnostic experience can be considerable.

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

PubMed Central

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J.; Kessler, Ronald C.; Merikangas, Kathleen R.; Sampson, Nancy A.; Zaslavsky, Alan M.

2012-01-01

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 Supplement (NCS-A), a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the US. 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 (AUC = .81–.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. PMID:21495110

Treatment decisions on antidepressants in nursing homes: a qualitative study.

PubMed

Iden, Kristina Riis; Hjørleifsson, Stefan; Ruths, Sabine

2011-12-01

To explore decision-making on treatment with antidepressants among doctors and nurses in nursing homes. A qualitative study based on interviews with three focus groups comprising eight physicians engaged full time, eight physicians engaged part time, and eight registered nurses, respectively. The interview guide comprised questions on initiating, evaluating, and withdrawing treatment with antidepressants. The interviews were audio-recorded, transcribed, and analysed by systematic text condensation. The first theme was the diagnostic process. The informants expressed difficulty in differentiating between depression and sorrow resulting from loss in old age. Further, the doctors reported that they relied on nurses' observations and rarely carried out systematic diagnostic work and follow-up of patients with depression. The second theme was treatment. Antidepressants were usually the only type of treatment provided, and patients were kept on medication even though staff felt uncertain whether this was effective. The third theme was who really determines the treatment. Registered nurses reported that unskilled and auxiliary nursing staff requested drug treatment, and doctors felt some pressure from the nurses to prescribe antidepressants. This study suggests that the quality of diagnosis and treatment for depression in nursing homes needs to be improved in Norway. Doctors should be more available and take responsibility and leadership in medical decisions.

Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia.

PubMed

Fadzil, Ariff; Balakrishnan, Kartini; Razali, Rosdinom; Sidi, Hatta; Malapan, Thinakaran; Japaraj, Robert Peter; Midin, Marhani; Nik Jaafar, Nik Ruzyanei; Das, Srijit; Manaf, Mohd Rizal Abdul

2013-04-01

Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics. A cross-sectional survey design was used. A total of 175 antenatal mothers participated. Their socio-demographic and obstetric histories were recorded. The Hospital Anxiety and Depression Scale (HADS) and Mini International Neuropsychiatric Interview (M.I.N.I.) were used. The prevalence of anxiety and depression disorders among antenatal mothers using diagnostic clinical interview were 9.1% and 8.6%, respectively. Factors associated with antenatal anxiety were marital status (being unmarried), positive history of mental illness, gestational age (<20 weeks), unplanned pregnancy and depressive comorbidity. However, only gestational age of less than 20 weeks and depressive disorder remained significant factors in the multivariate analysis. The prevalence rate of antenatal depression detected by HADS screening was comparable to the rate from diagnostic interview, but there was a slight overestimation for antenatal anxiety. Nonetheless, HADS as a screening tool offers a practical solution for detecting these two conditions in a busy antenatal clinic or a large epidemiological survey. In view of the deleterious effects of antenatal anxiety and depression on mothers and children, these two conditions should be screened and managed appropriately. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

A comparison of the nature and correlates of panic attacks in the context of Panic Disorder and Social Anxiety Disorder.

PubMed

Brown, Lily A; LeBeau, Richard; Liao, Betty; Niles, Andrea N; Glenn, Daniel; Craske, Michelle G

2016-01-30

Panic attacks occurring outside of Panic Disorder are not well-understood despite their inclusion as a diagnostic specifier in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). This study compares panic attacks in the context of Panic Disorder compared to social anxiety in terms of their symptom frequency, severity, and clinical correlates. Participants (n=404) were interviewed using the Anxiety Disorders Interview Schedule (ADIS-IV-L; Brown et al., 1994), from which we analyzed interviewer ratings of panic attacks and panic attack symptoms, as well as other demographic and clinical characteristics. Panic attacks in the context of Panic Disorder were characterized by a greater number and severity of symptoms compared to panic attacks in the context of Social Anxiety Disorder, and were associated with a history of traumatization, inpatient psychiatric treatment, and benzodiazepine use. Social anxiety panic attacks were associated with reduced physical health concerns. Cognitive panic attack symptoms were more prevalent in Panic Disorder and were associated with a variety of poor clinical correlates. Panic attacks in the context of Panic Disorder are more severe than those in social anxiety, and this may be driven by cognitive disturbances during those attacks. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Gender and socio-cultural determinants of delay to diagnosis of TB in Bangladesh, India and Malawi.

PubMed

Gosoniu, G D; Ganapathy, S; Kemp, J; Auer, C; Somma, D; Karim, F; Weiss, M G

2008-07-01

Tuberculosis (TB) control programmes in Bangladesh, India and Malawi. To compare the interval from symptom onset to diagnosis of TB for men and women, and to assess socio-cultural and gender-related features of illness explaining diagnostic delay. Semi-structured Explanatory Model Interview Catalogue (EMIC) interviews were administered to 100 or more patients at each site, assessing categories of distress, perceived causes and help seeking. Based on time from initial symptoms to diagnosis of TB, patients were classified with problem delay (>90 days), timely diagnosis (< or =30 days) or moderate delay. EMIC interview data were analysed to explain problem delay. The median interval from symptom onset to diagnosis was longest in India and shortest in Malawi. With adjustment for confounding, female sex (Bangladesh), and status of married woman (India) and housewife (Malawi) were associated with problem delay. Prominent non-specific symptoms--chest pain (Bangladesh) and breathlessness (Malawi)--were also significant. Cough in India, widely associated with TB, was associated with timely diagnosis. Sanitation as a perceived cause linked to poor urban conditions was associated with delayed diagnosis in India. Specific prior help seeking with circuitous referral patterns was identified. The study identified gender- and illness-related features of diagnostic delay. Further research distinguishing patient and provider delay is needed.

Interrater reliability of the DSM-III diagnoses in two Norwegian studies on psychiatric and super obese patients.

PubMed

Larsen, F; Vaglum, S

1986-01-01

Two Norwegian psychiatrists classified independently according to DSM-III, 45 patients drawn at random from two populations: one of psychiatric patients (N = 161) and one of super obese surgical patients (N = 71). They interviewed the patients and listened to each other's audio-taped interviews afterwards. In the total group, on axis I the overall agreement was 78 percent (kappa = 0.74). On axis II, the overall agreement was 81 percent (kappa = 0.68). The study shows that by using the DSM-III, two Norwegian psychiatrists obtained good diagnostic reliability.

Beyond Describing Affect: Reconceptualizing Emotions in Depression

ERIC Educational Resources Information Center

Horner, Michelle S.

2009-01-01

Several research that examine emotions as a way to diagnose and treat pediatric depression are discussed. The growing research into this field may one day elevate emotion to be included in the standard diagnostic and clinical interview.

Utility of the 3Di Short Version for the Diagnostic Assessment of Autism Spectrum Disorder and Compatibility with DSM-5.

PubMed

Slappendel, Geerte; Mandy, William; van der Ende, Jan; Verhulst, Frank C; van der Sijde, Ad; Duvekot, Jorieke; Skuse, David; Greaves-Lord, Kirstin

2016-05-01

The Developmental Diagnostic Dimensional Interview-short version (3Di-sv) provides a brief standardized parental interview for diagnosing autism spectrum disorder (ASD). This study explored its validity, and compatibility with DSM-5 ASD. 3Di-sv classifications showed good sensitivity but low specificity when compared to ADOS-2-confirmed clinical diagnosis. Confirmatory factor analyses found a better fit against a DSM-5 model than a DSM-IV-TR model of ASD. Exploration of the content validity of the 3Di-sv for the DSM-5 revealed some construct underrepresentation, therefore we obtained data from a panel of 3Di-trained clinicians from ASD-specialized centers to recommend items to fill these gaps. Taken together, the 3Di-sv provides a solid basis to create a similar instrument suitable for DSM-5. Concrete recommendations are provided to improve DSM-5 compatibility.

Diagnosis and hypnotic treatment of an unusual case of hysterical amnesia.

PubMed

Iglesias, Alex; Iglesias, Adam

2009-10-01

This article reports on the use of hypnosis to facilitate the diagnostic process and the treatment of an unusual case of adult psychogenic amnesia. An Iraqi citizen living in the U.S. developed an atypical case of Dissociative Amnesia, Systematized type, post-automotive collision. The amnesia presented with features encompassing complete loss of the patient's native language. Dissociation theory as a conceptualization of hysterical reactions was employed as the basis in the formulation of this case. The differential diagnosis was facilitated by the Hypnotic Diagnostic Interview for Hysterical Disorders (HDIHD) Adult Form, an interview tool specifically designed for cases such as this. Treatment consisted exclusively of ego strengthening and time projection approaches in hypnosis. It was hypothesized that, as the coping capacities became more viable, the dissociative symptoms would remiss. After 6 weekly visits the patient regained complete command of his native language. Follow-up at 6 months indicated that the patient remained devoid of symptoms.

A diagnostic and statistical manual of mental disorders history of premenstrual dysphoric disorder.

PubMed

Zachar, Peter; Kendler, Kenneth S

2014-04-01

The proposals to include a menstruation-related mood disorder in the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R), and DSM-IV led to intense public and behind-the-scenes controversy. Although the controversies surrounding the DSM-5 revision were greater in number than the controversies of the earlier revisions, the DSM-5 proposal to include a menstruation-related mood disorder was not among them. Premenstrual dysphoric disorder was made an official disorder in the DSM-5 with no significant protest. To understand the factors that led to this change, we interviewed those psychiatrists and psychologists who were most involved in the DSM-IV revision. On the basis of these interviews, we offer a list of empirical and nonempirical considerations that led to the DSM-IV compromise and explore how key alterations in these considerations led to a different outcome for the DSM-5.

‘Schizophrenia is a dirty word’: service users’ experiences of receiving a diagnosis of schizophrenia

PubMed Central

Howe, Lorna; Tickle, Anna; Brown, Ian

2014-01-01

Aims and method To explore service users’ experiences of receiving a diagnosis of schizophrenia and the stigma associated with the diagnostic label. Seven participants were interviewed about their perceptions of these experiences. Interviews were analysed using interpretative phenomenological analysis. Results Five superordinate themes resulted from the analysis: (1) avoidance of the diagnosis of schizophrenia; (2) stigma and diagnostic labels; (3) lack of understanding of schizophrenia; (4) managing stigma to maintain normality; (5) being ‘schizophrenic’. These, together with their subthemes, highlighted avoidance of the term schizophrenia by participants and use of alternative terms by professionals, which limited opportunities for understanding the label and challenging associated stigma. Participants strived to maintain normality despite potential stigma. Clinical implications There is a need to address the process of giving a diagnosis as a phenomenon of consequence within its own terms. Implications relate to how professionals deliver and discuss the diagnosis of schizophrenia. PMID:25237536

Teaching history-taking: where are we?

PubMed Central

Nardone, D. A.; Reuler, J. B.; Girard, D. E.

1980-01-01

Knowledge in history-taking has increased rapidly over the last twenty years. Currently the principles to be taught include "conduct," "content," and "diagnostic reasoning." However, inattentiveness of medical schools, reluctance of busy faculty to be involved, and increasing enrollments have resulted in difficulties in teaching these skills. Studies have shown a beneficial short-term effect of teaching these materials on interview performance but it is unknown whether this effect is long-lasting. The methods for instruction include the bedside and videotape models utilizing the concept of the fifteen-minute interview technique, programmed instruction, patient instructors, and direct student feedback. Future research should focus on identifying strategies in diagnostic reasoning, developing graduated competency criteria for trainees at different levels of their education, refining methods to evaluate large numbers of students, measuring outcomes of effective training such as compliance, and comparing costs and effectiveness of various methods. In addition, there remains the need to establish an association of course directors. PMID:7405275

Sources of self-efficacy in an undergraduate introductory astronomy course for non-science majors

NASA Astrophysics Data System (ADS)

Carter, Brooke L.

The role of the astronomy laboratory on non-science major student self-efficacy is investigated through combining quantitative and qualitative methodologies. The Astronomy Diagnostic Test 2.0 is distributed to an introductory astronomy laboratory for non-science major class in the Spring of 2005. The ADT 2.0 is used to draw comparisons between interview subjects and the remaining class. Eight subjects were interviewed three times throughout the semester in order to determine the important contributing factors to the subjects' self-efficacy beliefs. Results of the quantitative data suggest that the interview participants' general science self-efficacy did not significantly increase over the course of the semester. Results of the quantitative data suggest the most important contributor to the subjects' self-efficacy in the laboratory is verbal persuasion. The results of this limited study suggest that the astronomy laboratory experience is a strong contributor to student self-efficacy beliefs.

A structured interview for the assessment of the Five-Factor Model of personality: facet-level relations to the axis II personality disorders.

PubMed

Trull, T J; Widiger, T A; Burr, R

2001-04-01

The Structured Interview for the Five-Factor Model (SIFFM; Trull & Widiger, 1997) is an 120-item semistructured interview that assesses both adaptive and maladaptive features of the personality traits included in the five-factor model of personality, or "Big Five." In this article, we evaluate the ability of SIFFM scores to predict personality disorder symptomatology in a sample of 232 adults (46 outpatients and 186 nonclinical college students). Personality disorder symptoms were assessed using the Personality Diagnostic Questionnaire-Revised (PDQ-R; Hyler & Rider, 1987). Results indicated that many of the predicted associations between lower-order personality traits and personality disorders were supported. Further, many of these associations held even after controlling for comorbid personality disorder symptoms. These findings may help inform conceptualizations of the personality disorders, as well as etiological theories and treatment.

Structured interview versus self-report test vantages for the assessment of personality pathology in cocaine dependence.

PubMed

Marlowe, D B; Husband, S D; Bonieskie, L M; Kirby, K C; Platt, J J

1997-01-01

The study compared structured interview (SCID-II) and self-report test (MCMI-II) vantages for the detection and characterization of personality pathology among 144 urban, poor, cocaine-addicted individuals seeking outpatient treatment. Diagnostic agreement was inadequate for most disorders, and the instruments at best shared only modest common variance. Positive predictive power was poor for all MCMI-II scales, though negative predictive power was good to excellent. This lends support for the use of the MCMI-II as a screening measure to rule out Axis II disorders; however, confirmation of positive diagnoses will require follow-up interview assessment. Future development of self-report personality inventories for substance abusers should focus on controlling for the acute dysphoric effects of drug use and related dysfunction, expanding attention to Cluster B content domains, and incorporating more objective criteria for assessing paranoia and "odd/eccentric" traits.

Psychiatric diagnoses in a group of astronaut applicants

NASA Technical Reports Server (NTRS)

Santy, Patricia A.; Faulk, Dean M.; Holland, Al W.

1991-01-01

Between 1959 and 1987, the psychiatric evaluation of astronaut candidates evolved from a 30-h intensive examination evaluating applicants for psychopathology, and studying their performance under stress, to a 2-h clinical interview whose structure and contents were determined by the individual examiner. Evaluations done during these years applied both psychiatric (or, 'select-out') criteria and psychological (or, 'select-in') criteria. In an attempt to more rigorously define the psychiatric, 'select-out' component, a standardized, semistructured clinical interview was developed to identify the presence or history of psychiatric disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed. ('DSM-III'). A total of 117 astronaut applicants underwent this clinical interview as part of a comprehensive medical evaluation during a recent astronaut selection. Of the 117 applicants, 9 (7.7 percent) met DSM-III criteria for a variety of Axis I and Axis II diagnoses, including V-code diagnoses.

Interviewing Children Versus Tossing Coins: Accurately Assessing the Diagnosticity of Children’s Disclosures of Abuse

PubMed Central

LYON, THOMAS D.; AHERN, ELIZABETH C.; SCURICH, NICHOLAS

2014-01-01

We describe a Bayesian approach to evaluating children’s abuse disclosures and review research demonstrating that children’s disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children’s age. We discuss how some commentators understate the probative value of children’s disclosures by: confusing the probability of abuse given disclosure with the probability of disclosure given abuse, assuming that children formally questioned about sexual abuse have a low prior probability of sexual abuse, misstating the probative value of abuse disclosure, and confusing the distinction between disclosure and nondisclosure with the distinction between true and false disclosures. We review interviewing methods that increase the probative value of disclosures, including interview instructions, narrative practice, noncontingent reinforcement, and questions about perpetrator/caregiver statements and children’s reactions to the alleged abuse. PMID:22339423

Psychopathology 8 1/2 years post parasuicide.

PubMed

Curran, S; Fitzgerald, M; Greene, V T

1999-01-01

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8 1/2 years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five and died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

The convergent and concurrent validity of trait-based prototype assessment of personality disorder categories in homeless persons.

PubMed

Samuel, Douglas B; Connolly, Adrian J; Ball, Samuel A

2012-09-01

The DSM-5 proposal indicates that personality disorders (PDs) be defined as collections of maladaptive traits but does not provide a specific diagnostic method. However, researchers have previously suggested that PD constructs can be assessed by comparing individuals' trait profiles with those prototypic of PDs and evidence from the five-factor model (FFM) suggests that these prototype matching scores converge moderately with traditional PD instruments. The current study investigates the convergence of FFM PD prototypes with interview-assigned PD diagnoses in a sample of 99 homeless individuals. This sample had very high rates of PDs, which extends previous research on samples with more modest prevalence rates. Results indicated that diagnostic agreement between these methods was generally low but consistent with the agreement previously observed between explicit PD measures. Furthermore, trait-based and diagnostic interview scores evinced similar relationships with clinically important indicators such as abuse history and past suicide attempts. These findings demonstrate the validity of prototype methods and suggest their consideration for assessing trait-defined PD types within DSM-5.

Biopharmaceutical industry perspectives on the business prospects for personalized medicine.

PubMed

Milne, Christopher-Paul; Zuckerman, Rachael

2011-09-01

Personalized medicine is entering its second decade, yet the role it will play in addressing the biopharmaceutical industry's productivity gap and the rising cost of healthcare is still a matter of speculation. So what does the biopharmaceutical industry itself say about the business prospects for personalized medicine? The authors conducted interviews with 20 science and business experts from 13 companies to find out. In this article, particular attention is paid to drug-diagnostic codevelopment, so-called companion diagnostics. The results of the interviews are discussed in light of perspectives from various stakeholders available from the literature in the public domain. In brief, biopharmaceutical acknowledges the many difficulties that plague this path to product development with particular concern for knowledge gaps in the scientific base, the timing of studies during development, as well as the regulatory, reimbursement and commercial hurdles that can thwart approval, launch and market uptake. Nonetheless, personalized medicine in general and companion diagnostics in particular are believed to be an increasingly sustainable business proposition with expectations for rapid market growth in the near term.

Screening for Posttraumatic Stress Disorder among Somali ex-combatants: A validation study

PubMed Central

Odenwald, Michael; Lingenfelder, Birke; Schauer, Maggie; Neuner, Frank; Rockstroh, Brigitte; Hinkel, Harald; Elbert, Thomas

2007-01-01

Background In Somalia, a large number of active and former combatants are affected by psychological problems such as Posttraumatic Stress Disorder (PTSD). This disorder impairs their ability to re-integrate into civilian life. However, many screening instruments for Posttraumatic Stress Disorder used in post-conflict settings have limited validity. Here we report on development and validation of a screening tool for PTSD in Somali language with a sample of ex-combatants. Methods We adapted the Posttraumatic Diagnostic Scale (PDS) to reflect linguistic and cultural differences within the Somali community so that local interviewers could be trained to administer the scale. For validation purposes, a randomly selected group of 135 Somali ex-combatants was screened by trained local interviewers; 64 of them were then re-assessed by trained clinical psychologists using the Composite International Diagnostic Interview (CIDI) and the Self-Report Questionnaire (SRQ-20). Results The screening instrument showed good internal consistency (Cronbach's α = .86), convergent validity with the CIDI (sensitivity = .90; specificity = .90) as well as concurrent validity: positive cases showed higher SRQ-20 scores, higher prevalence of psychotic symptoms, and higher levels of intake of the local stimulant drug khat. Compared to a single cut-off score, the multi-criteria scoring, in keeping with the DSM-IV, produced more diagnostic specificity. Conclusion The results provide evidence that our screening instrument is a reliable and valid method to detect PTSD among Somali ex-combatants. A future Disarmament, Demobilization and Reintegration Program in Somalia is recommended to screen for PTSD in order to identify ex-combatants with special psycho-social needs. PMID:17822562

PFAPA syndrome and Behçet's disease: a comparison of two medical entities based on the clinical interviews performed by three different specialists.

PubMed

Cantarini, Luca; Vitale, Antonio; Bersani, Giulia; Nieves, Laura Martin; Cattalini, Marco; Lopalco, Giuseppe; Caso, Francesco; Costa, Luisa; Iannone, Florenzo; Lapadula, Giovanni; Galeazzi, Mauro; Ceribelli, Angela; Brunetta, Enrico; Selmi, Carlo; Rigante, Donato

2016-02-01

The pediatric syndrome characterized by periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) and adult Behçet's disease share some clinical manifestations and are both polygenic autoinflammatory disorders with interleukin-1β showing to play a pivotal role. However, the diagnosis is mostly clinical and we hypothesize that specific criteria may be addressed differently by different physicians. To determine the diagnostic variability, we compared the answers of 80 patients with a definite diagnosis of Behçet's disease (age 42.1 ± 13.7 years) obtained by separate telephone interviews conducted by a rheumatologist, a pediatrician, and an internist working largely in the field of autoinflammatory disorders. Questions were related to the age of symptom onset, the occurrence of recurrent fevers during childhood, and the association with oral aphthosis, cervical adenitis and/or pharyngitis, previous treatments, possible growth impairment, the time lapse between PFAPA-like symptoms and the onset of Behçet's disease, and the occurrence of Behçet-related manifestation during childhood. The rheumatologist identified 30 % of patients with Behçet's disease fulfilling PFAPA syndrome diagnostic criteria, compared to the pediatrician and the internist identifying 10 and 7.5 %, respectively. Most of the patients suffered from recurrent oral aphthosis in childhood also without fever (50, 39, and 48 % with each interviewer), yet no patient fulfilled the Behçet's disease diagnostic criteria. Our data suggest that physician awareness and expertise are central to the diagnosis of autoinflammatory disorders through an accurate collection of the medical history.

The Screening Accuracy of the Parent and Teacher-Reported Social Responsiveness Scale (SRS): Comparison with the 3Di and ADOS

ERIC Educational Resources Information Center

Duvekot, Jorieke; van der Ende, Jan; Verhulst, Frank C.; Greaves-Lord, Kirstin

2015-01-01

The screening accuracy of the parent and teacher-reported Social Responsiveness Scale (SRS) was compared with an autism spectrum disorder (ASD) classification according to (1) the Developmental, Dimensional, and Diagnostic Interview (3Di), (2) the Autism Diagnostic Observation Schedule (ADOS), (3) both the 3Di and ADOS, in 186 children referred to…

Prevalence Rates of Attention Deficit/Hyperactivity Disorder in a School Sample of Venezuelan Children

ERIC Educational Resources Information Center

Montiel, Cecilia; Pena, Joaquin A.; Montiel-Barbero, Isabel; Polanczyk, Guilherme

2008-01-01

A total of 1,535 4-12 year-old children were screened with the Conners' rating scales, followed by diagnostic confirmation by the diagnostic interview schedule for children-IV-parent version. The prevalence of ADHD was estimated to be 10.03%, and only 3.9% of children had received medication for the treatment of ADHD symptoms. Prevalence rates and…

Validity of the Children's Social Behavior Questionnaire (CSBQ) in Children with Intellectual Disability: Comparing the CSBQ with ADI-R, ADOS, and Clinical DSM-IV-TR Classification

ERIC Educational Resources Information Center

de Bildt, Annelies; Mulder, Erik J.; Hoekstra, Pieter J.; van Lang, Natasja D. J.; Minderaa, Ruud B.; Hartman, Catharina A.

2009-01-01

The Children's Social Behavior Questionnaire (CSBQ) was compared with the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), and clinical classification in children with mild and moderate intellectual disability (ID), to investigate its criterion related validity. The contribution of the CSBQ to a…

Morbidity of "DSM-IV" Axis I Disorders in Patients with Noncardiac Chest Pain: Psychiatric Morbidity Linked with Increased Pain and Health Care Utilization

ERIC Educational Resources Information Center

White, Kamila S.; Raffa, Susan D.; Jakle, Katherine R.; Stoddard, Jill A.; Barlow, David H.; Brown, Timothy A.; Covino, Nicholas A.; Ullman, Edward; Gervino, Ernest V.

2008-01-01

The present study examined current and lifetime psychiatric morbidity, chest pain, and health care utilization in 229 patients with noncardiac chest pain (NCCP), angina-like pain in the absence of cardiac etiology. Diagnostic interview findings based on the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.; "DSM-IV"; American…

Can a Diagnosis of Asperger Syndrome Be Made in Very Young Children with Suspected Autism Spectrum Disorder?

ERIC Educational Resources Information Center

McConachie, Helen; Le Couteur, Ann; Honey, Emma

2005-01-01

Of a cohort of 104 children with Autism, PDD-NOS or specific language disorder, recruited at age 2-3 years of age, only three appeared to meet diagnostic assessment criteria for Asperger syndrome (AS). The children were followed up at 4-5 years, and assessments at both time points included the Autism Diagnostic Interview (ADI-R), the Autism…

Inter-informant agreement and prevalence estimates for mood syndromes: direct interview vs. family history method.

PubMed

Vandeleur, C L; Rothen, S; Lustenberger, Y; Glaus, J; Castelao, E; Preisig, M

2015-01-15

The use of the family history method is recommended in family studies as a type of proxy interview of non-participating relatives. However, using different sources of information can result in bias as direct interviews may provide a higher likelihood of assigning diagnoses than family history reports. The aims of the present study were to: (1) compare diagnoses for threshold and subthreshold mood syndromes from interviews to those relying on information from relatives; (2) test the appropriateness of lowering the diagnostic threshold and combining multiple reports from the family history method to obtain comparable prevalence estimates to the interviews; (3) identify factors that influence the likelihood of agreement and reporting of disorders by informants. Within a family study, 1621 informant-index subject pairs were identified. DSM-5 diagnoses from direct interviews of index subjects were compared to those derived from family history information provided by their first-degree relatives. (1) Inter-informant agreement was acceptable for Mania, but low for all other mood syndromes. (2) Except for Mania and subthreshold depression, the family history method provided significantly lower prevalence estimates. The gap improved for all other syndromes after lowering the threshold of the family history method. (3) Individuals who had a history of depression themselves were more likely to report depression in their relatives. Low proportion of affected individuals for manic syndromes and lack of independence of data. The higher likelihood of reporting disorders by affected informants entails the risk of overestimation of the size of familial aggregation of depression. Copyright © 2014 Elsevier B.V. All rights reserved.

Validating new summary indices for the Childhood Trauma Interview: associations with first onsets of major depressive disorder and anxiety disorders.

PubMed

Vrshek-Schallhorn, Suzanne; Wolitzky-Taylor, Kate; Doane, Leah D; Epstein, Alyssa; Sumner, Jennifer A; Mineka, Susan; Zinbarg, Richard E; Craske, Michelle G; Isaia, Ashley; Hammen, Constance; Adam, Emma K

2014-09-01

Childhood and adolescent adversity is of great interest in relation to risk for psychopathology, and interview measures of adversity are thought to be more reliable and valid than their questionnaire counterparts. One interview measure, the Childhood Trauma Interview (CTI; Fink et al., 1995), has been positively evaluated relative to similar measures, but there are some psychometric limitations to an existing scoring approach that limit the full potential of this measure. We propose several new summary indices for the CTI that permit examination of different types of adversity and different developmental periods. Our approach creates several summary indices: one sums the severity scores of adversities endorsed; another utilizes the number of minor and major (moderate to severe) adversities. The new indices were examined in association with first onsets of major depressive disorder (MDD) and anxiety disorders across a 5-year period using annual clinical diagnostic interviews (Structured Clinical Interview for DSM-IV-TR). Summary scores derived with the previously used approach were also examined for comparison. Data on 332 participants came from the Youth Emotion Project, a longitudinal study of risk for emotional disorders. Results support the predictive validity of the proposed summary scoring methods and indicate that several forms of major (but typically not minor) adversity are significantly associated with first onsets of MDD and anxiety disorders. Finally, multivariate regression models show that, in many instances, the new indices contributed significant unique variance predicting disorder onsets over and above the previously used summary indices. PsycINFO Database Record (c) 2014 APA, all rights reserved.

42 CFR 414.65 - Payment for telehealth services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... professional service via an interactive telecommunications system is made according to the following... psychotherapy, psychiatric diagnostic interview examination, pharmacologic management, end-stage renal disease... intervention services furnished via an interactive telecommunications system is equal to the current fee...

Operationalization of diagnostic criteria of DSM-5 somatic symptom disorders.

PubMed

Xiong, Nana; Zhang, Yaoyin; Wei, Jing; Leonhart, Rainer; Fritzsche, Kurt; Mewes, Ricarda; Hong, Xia; Cao, Jinya; Li, Tao; Jiang, Jing; Zhao, Xudong; Zhang, Lan; Schaefert, Rainer

2017-11-07

The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients. This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical "interview about cognitive, affective, and behavioral features associated with somatic complaints" was used to operationalize the SSD criteria B. For comparison, DSM-IV somatoform disorders were assessed with the Mini International Neuropsychiatric Interview plus. Cohen's к scores were given to illustrate the agreement of the diagnoses. A three-structure model of the interview, within which items were classified as respectively assessing the cognitive (B1), affective (B2), and behavioral (B3) features, was examined. According to percentages of screening-positive persons and the receiver operator characteristic (ROC) analysis, a cut-off point of 2 was recommended for each subscale of the interview. With the operationalization, the frequency of DSM-5 SSD was estimated as 36.5% in our sample, and that of DSM-IV somatoform disorders was 8.2%. The agreement between them was small (Cohen's к = 0.152). Comparisons of sociodemographic features of SSD patients with different severity levels (mild, moderate, severe) showed that mild SSD patients were better-off in terms of financial and employment status, and that the severity subtypes were congruent with the level of depression, anxiety, quality of life impairment, and the frequency of doctor visits. The operationalization of the diagnosis and severity specifications of SSD was valid, but the diagnostic agreement between DSM-5 SSD and DSM-IV somatoform disorders was small. The interpretation the SSD criteria should be made cautiously, so that the diagnosis would not became over-inclusive.

Measuring anxiety in depressed patients: A comparison of the Hamilton anxiety rating scale and the DSM-5 Anxious Distress Specifier Interview.

PubMed

Zimmerman, Mark; Martin, Jacob; Clark, Heather; McGonigal, Patrick; Harris, Lauren; Holst, Carolina Guzman

2017-10-01

DSM-5 included criteria for an anxious distress specifier for major depressive disorder (MDD). In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project we examined whether a measure of the specifier, the DSM-5 Anxious Distress Specifier Interview (DADSI), was as valid as the Hamilton Anxiety Scale (HAMA) as a measure of the severity of anxiety in depressed patients. Two hundred three psychiatric patients with MDD were interviewed by trained diagnostic raters who administered the Structured Clinical Interview for DSM-IV (SCID) supplemented with questions to rate the DADSI, HAMA, and Hamilton Depression Rating Scale (HAMD). The patients completed self-report measures of depression, anxiety, and irritability. Sensitivity to change was examined in 30 patients. The DADSI and HAMA were significantly correlated (r = 0.60, p < 0.001). Both the DADSI and HAMA were more highly correlated with measures of anxiety than with measures of the other symptom domains. The HAMD was significantly more highly correlated with the HAMA than with the DADSI. For each anxiety disorder, patients with the disorder scored significantly higher on both the DADSI and HAMA than did patients with no current anxiety disorder. A large effect size of treatment was found for both measures (DADSI: d = 1.48; HAMA: d = 1.37). Both the DADSI and HAMA were valid measures of anxiety severity in depressed patients, though the HAMA was more highly confounded with measures of depression than the DADSI. The DADSI is briefer than the HAMA, and may be more feasible to use in clinical practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trajectories of Substance Use Disorder in Youth After Detention: A 12-Year Longitudinal Study

PubMed Central

Welty, Leah J.; Hershfield, Jennifer A.; Abram, Karen M.; Han, Hongyun; Byck, Gayle R.; Teplin, Linda A.

2016-01-01

Objective Identify trajectories of substance use disorders (SUDs) in youth during the 12 years after detention, and how gender, race/ethnicity, and age at baseline predict trajectories. Method As part of the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois, 1995–1998, participants were re-interviewed in the community or correctional facilities up to 9 times over 12 years. Independent interviewers assessed SUDs using the Diagnostic Interview Schedule for Children 2.3 (baseline) and the Diagnostic Interview Schedule IV (follow-ups). Primary outcome was a mutually exclusive 5-category typology of disorder: no SUD, alcohol alone, marijuana alone, comorbid alcohol and marijuana, or “other” illicit (“hard”) drug. We estimated trajectories using growth mixture models with a 3-category ordinal variable derived from the typology. Results During the 12-year follow-up, 19.6% of youth did not have an SUD. The remaining 81.4% were in 3 trajectory classes. Class 1 (24.5%), a bell-shaped trajectory, peaked 5 years after baseline when 42.7% had an SUD and 12.5% had comorbid/“other” illicit drug disorders. Class 2 (41.3%) had higher prevalence of SUD at baseline (73.8%). Although prevalence decreased over time, 23.5% had an SUD 12 years later. Class 3 (14.6%), the most serious and persistent trajectory, had the highest prevalence of comorbid/“other” illicit drug disorders—52.1% at baseline and 17.4% 12 years later. Males, Hispanics, non-Hispanic whites, and youth who were older at baseline (detention) had the worst outcomes. Conclusion Gender, race/ethnicity, and age at detention predict trajectories of SUDs in delinquent youth. Findings provide an empirical basis for child psychiatry to address health disparities and improve prevention. PMID:28117060

Psychometric Evaluation of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID).

PubMed

Duncan, Laura; Georgiades, Kathy; Wang, Li; Van Lieshout, Ryan J; MacMillan, Harriet L; Ferro, Mark A; Lipman, Ellen L; Szatmari, Peter; Bennett, Kathryn; Kata, Anna; Janus, Magdalena; Boyle, Michael H

2017-12-04

The goals of the study were to examine test-retest reliability, informant agreement and convergent and discriminant validity of nine DSM-IV-TR psychiatric disorders classified by parent and youth versions of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Using samples drawn from the general population and child mental health outpatient clinics, 283 youth aged 9 to 18 years and their parents separately completed the MINI-KID with trained lay interviewers on two occasions 7 to 14 days apart. Test-retest reliability estimates based on kappa (κ) went from 0.33 to 0.79 across disorders, samples and informants. Parent-youth agreement on disorders was low (average κ = 0.20). Confirmatory factor analysis provided evidence supporting convergent and discriminant validity. The MINI-KID disorder classifications yielded estimates of test-retest reliability and validity comparable to other standardized diagnostic interviews in both general population and clinic samples. These findings, in addition to the brevity and low administration cost, make the MINI-KID a good candidate for use in epidemiological research and clinical practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

How Do Students Misunderstand Number Representations?

ERIC Educational Resources Information Center

Herman, Geoffrey L.; Zilles, Craig; Loui, Michael C.

2011-01-01

We used both student interviews and diagnostic testing to reveal students' misconceptions about number representations in computing systems. This article reveals that students who have passed an undergraduate level computer organization course still possess surprising misconceptions about positional notations, two's complement representation, and…

Antisocial personality disorder is on a continuum with psychopathy.

PubMed

Coid, Jeremy; Ullrich, Simone

2010-01-01

Antisocial personality disorder (ASPD) and psychopathy are different diagnostic constructs. It is unclear whether they are separate clinical syndromes or whether psychopathy is a severe form of ASPD. A representative sample of 496 prisoners in England and Wales was interviewed in the second phase of a survey carried out in 1997 using the Schedules for Clinical Assessment in Neuropsychiatry, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis II personality disorders, and the Psychopathy Checklist-Revised. Among those 18 years and older (n = 470), 211 (44.9%) received a diagnosis of ASPD, of whom 67 (31.8%) were classified as psychopaths, indicated by Psychopathy Checklist-Revised scores of 25 and above. Symptoms of ASPD and psychopathy both demonstrated low diagnostic contrast when comparing subgroups of ASPD above and below the cutoff for psychopathy. There were no differences in demography, Axis I comorbidity, and treatment-seeking behavior. Psychopathic individuals with ASPD demonstrated comorbid schizoid and narcissistic personality disorder, more severe conduct disorder and adult antisocial symptoms, and more violent convictions. Psychopathy and ASPD are not separate diagnostic entities, but psychopathic ASPD is a more severe form than ASPD alone with greater risk of violence. Dimensional scores of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition personality disorders (other than ASPD) may be helpful in identifying this specific subgroup. Copyright 2010 Elsevier Inc. All rights reserved.

Rapid and Accurate Behavioral Health Diagnostic Screening: Initial Validation Study of a Web-Based, Self-Report Tool (the SAGE-SR)

PubMed Central

Purcell, Susan E; Rhea, Karen; Maier, Philip; First, Michael; Zweede, Lisa; Sinisterra, Manuela; Nunn, M Brad; Austin, Marie-Paule; Brodey, Inger S

2018-01-01

Background The Structured Clinical Interview for DSM (SCID) is considered the gold standard assessment for accurate, reliable psychiatric diagnoses; however, because of its length, complexity, and training required, the SCID is rarely used outside of research. Objective This paper aims to describe the development and initial validation of a Web-based, self-report screening instrument (the Screening Assessment for Guiding Evaluation-Self-Report, SAGE-SR) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the SCID-5-Clinician Version (CV) intended to make accurate, broad-based behavioral health diagnostic screening more accessible within clinical care. Methods First, study staff drafted approximately 1200 self-report items representing individual granular symptoms in the diagnostic criteria for the 8 primary SCID-CV modules. An expert panel iteratively reviewed, critiqued, and revised items. The resulting items were iteratively administered and revised through 3 rounds of cognitive interviewing with community mental health center participants. In the first 2 rounds, the SCID was also administered to participants to directly compare their Likert self-report and SCID responses. A second expert panel evaluated the final pool of items from cognitive interviewing and criteria in the DSM-5 to construct the SAGE-SR, a computerized adaptive instrument that uses branching logic from a screener section to administer appropriate follow-up questions to refine the differential diagnoses. The SAGE-SR was administered to healthy controls and outpatient mental health clinic clients to assess test duration and test-retest reliability. Cutoff scores for screening into follow-up diagnostic sections and criteria for inclusion of diagnoses in the differential diagnosis were evaluated. Results The expert panel reduced the initial 1200 test items to 664 items that panel members agreed collectively represented the SCID items from the 8 targeted modules and DSM criteria for the covered diagnoses. These 664 items were iteratively submitted to 3 rounds of cognitive interviewing with 50 community mental health center participants; the expert panel reviewed session summaries and agreed on a final set of 661 clear and concise self-report items representing the desired criteria in the DSM-5. The SAGE-SR constructed from this item pool took an average of 14 min to complete in a nonclinical sample versus 24 min in a clinical sample. Responses to individual items can be combined to generate DSM criteria endorsements and differential diagnoses, as well as provide indices of individual symptom severity. Preliminary measures of test-retest reliability in a small, nonclinical sample were promising, with good to excellent reliability for screener items in 11 of 13 diagnostic screening modules (intraclass correlation coefficient [ICC] or kappa coefficients ranging from .60 to .90), with mania achieving fair test-retest reliability (ICC=.50) and other substance use endorsed too infrequently for analysis. Conclusions The SAGE-SR is a computerized adaptive self-report instrument designed to provide rigorous differential diagnostic information to clinicians. PMID:29572204

The Clinical Ethnographic Interview: A user-friendly guide to the cultural formulation of distress and help seeking

PubMed Central

Arnault, Denise Saint; Shimabukuro, Shizuka

2013-01-01

Transcultural nursing, psychiatry, and medical anthropology have theorized that practitioners and researchers need more flexible instruments to gather culturally relevant illness experience, meaning, and help seeking. The state of the science is sufficiently developed to allow standardized yet ethnographically sound protocols for assessment. However, vigorous calls for culturally adapted assessment models have yielded little real change in routine practice. This paper describes the conversion of the Diagnostic and Statistical Manual IV, Appendix I Outline for Cultural Formulation into a user-friendly Clinical Ethnographic Interview (CEI), and provides clinical examples of its use in a sample of highly distressed Japanese women. PMID:22194348

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

PubMed

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J; Kessler, Ronald C; Merikangas, Kathleen R; Sampson, Nancy A; Zaslavsky, Alan M

2011-06-01

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.

A Single-Case Study of Resiliency After Extreme Incest in an Old Order Amish Family.

PubMed

McGuigan, William M; Stephenson, Sarah J

2015-01-01

This exploratory research brief presents a single case study of the resiliency of "Mary B." She grew up in an Old Order Amish family where isolation, secrecy, and patriarchy masked repeated sexual assaults by her older brothers that began at age 7. By the age of 20, Mary alleged she had been raped on more than 200 separate occasions by members of her Amish family. After years of pleading with her mother and church officials to intervene, she sought therapy outside the Amish community. This led to three of her brothers being incarcerated. Her family disowned her and she was banned from the Amish community, leaving with an 8th grade education and little more than the clothes she was wearing. In less than 2 years, Mary had moved to a new town, completed her GED, obtained a car and driving license, maintained a small home, and worked as a certified nursing assistant. She consented to tape recorded interviews and completed several quantitative diagnostic measures. Scores on the diagnostic measures placed her within the normal range on self-esteem, competency, depression, stress, social support, and life skills. Analysis of interviews revealed Mary rebounded from her past by reframing her experiences. Themes identified within the interviews supported 6 of the 7 types of resiliencies (insight, independence, initiative, relationships, humor, and morality) outlined in the therapeutic Challenge Model.

Health Disparities in Drug- and Alcohol-Use Disorders: A 12-Year Longitudinal Study of Youths After Detention

PubMed Central

Welty, Leah J.; Harrison, Anna J.; Abram, Karen M.; Olson, Nichole D.; Aaby, David A.; McCoy, Kathleen P.; Washburn, Jason J.

2016-01-01

Objectives. To examine sex and racial/ethnic differences in the prevalence of 9 substance-use disorders (SUDs)—alcohol, marijuana, cocaine, hallucinogen or PCP, opiate, amphetamine, inhalant, sedative, and unspecified drug— in youths during the 12 years after detention. Methods. We used data from the Northwestern Juvenile Project, a prospective longitudinal study of 1829 youths randomly sampled from detention in Chicago, Illinois, starting in 1995 and reinterviewed up to 9 times in the community or correctional facilities through 2011. Independent interviewers assessed SUDs with Diagnostic Interview Schedule for Children 2.3 (baseline) and Diagnostic Interview Schedule version IV (follow-ups). Results. By median age 28 years, 91.3% of males and 78.5% of females had ever had an SUD. At most follow-ups, males had greater odds of alcohol- and marijuana-use disorders. Drug-use disorders were most prevalent among non-Hispanic Whites, followed by Hispanics, then African Americans (e.g., compared with African Americans, non-Hispanic Whites had 32.1 times the odds of cocaine-use disorder [95% confidence interval = 13.8, 74.7]). Conclusions. After detention, SUDs differed markedly by sex, race/ethnicity, and substance abused, and, contrary to stereotypes, did not disproportionately affect African Americans. Services to treat substance abuse—during incarceration and after release—would reach many people in need, and address health disparities in a highly vulnerable population. PMID:26985602

Health Disparities in Drug- and Alcohol-Use Disorders: A 12-Year Longitudinal Study of Youths After Detention.

PubMed

Welty, Leah J; Harrison, Anna J; Abram, Karen M; Olson, Nichole D; Aaby, David A; McCoy, Kathleen P; Washburn, Jason J; Teplin, Linda A

2016-05-01

To examine sex and racial/ethnic differences in the prevalence of 9 substance-use disorders (SUDs)--alcohol, marijuana, cocaine, hallucinogen or PCP, opiate, amphetamine, inhalant, sedative, and unspecified drug--in youths during the 12 years after detention. We used data from the Northwestern Juvenile Project, a prospective longitudinal study of 1829 youths randomly sampled from detention in Chicago, Illinois, starting in 1995 and reinterviewed up to 9 times in the community or correctional facilities through 2011. Independent interviewers assessed SUDs with Diagnostic Interview Schedule for Children 2.3 (baseline) and Diagnostic Interview Schedule version IV (follow-ups). By median age 28 years, 91.3% of males and 78.5% of females had ever had an SUD. At most follow-ups, males had greater odds of alcohol- and marijuana-use disorders. Drug-use disorders were most prevalent among non-Hispanic Whites, followed by Hispanics, then African Americans (e.g., compared with African Americans, non-Hispanic Whites had 32.1 times the odds of cocaine-use disorder [95% confidence interval = 13.8, 74.7]). After detention, SUDs differed markedly by sex, race/ethnicity, and substance abused, and, contrary to stereotypes, did not disproportionately affect African Americans. Services to treat substance abuse--during incarceration and after release--would reach many people in need, and address health disparities in a highly vulnerable population.

The Joint Structure of DSM–IV Axis I and Axis II Disorders

PubMed Central

Røysamb, Espen; Tambs, Kristian; Ørstavik, Ragnhild E.; Torgersen, Svenn; Kendler, Kenneth S.; Neale, Michael C.; Aggen, Steven H.; Reichborn-Kjennerud, Ted

2011-01-01

The Diagnostic and Statistical Manual (4th ed. [DSM–IV]; American Psychiatric Association, 1994) distinction between clinical disorders on Axis I and personality disorders on Axis II has become increasingly controversial. Although substantial comorbidity between axes has been demonstrated, the structure of the liability factors underlying these two groups of disorders is poorly understood. The aim of this study was to determine the latent factor structure of a broad set of common Axis I disorders and all Axis II personality disorders and thereby to identify clusters of disorders and account for comorbidity within and between axes. Data were collected in Norway, through a population-based interview study (N = 2,794 young adult twins). Axis I and Axis II disorders were assessed with the Composite International Diagnostic Interview (CIDI) and the Structured Interview for DSM–IV Personality (SIDP–IV), respectively. Exploratory and confirmatory factor analyses were used to investigate the underlying structure of 25 disorders. A four-factor model fit the data well, suggesting a distinction between clinical and personality disorders as well as a distinction between broad groups of internalizing and externalizing disorders. The location of some disorders was not consistent with the DSM–IV classification; antisocial personality disorder belonged primarily to the Axis I externalizing spectrum, dysthymia appeared as a personality disorder, and borderline personality disorder appeared in an interspectral position. The findings have implications for a meta-structure for the DSM. PMID:21319931

The "Shopping" Behavior of Parents of Mentally Retarded Children: The Professional Person's Role

ERIC Educational Resources Information Center

Anderson, Kathryn A.

1971-01-01

Discussed is the role of the professional in preventing or stopping diagnostic and therapeutic shopping (repeated visits to the same or different professionals without resolution of a resolvable problem), with emphasis on the initial informing interview. (KW)

Adolescent Sociopaths. Revised.

ERIC Educational Resources Information Center

Chapple, Eliot D.

Presented is the final report of a research project on the programed training and placement of nonpsychotic disturbed adolescents. Eleven chapters cover topics which include the following: psychiatry and the sociopaths and psychopaths; boys dealt with in the project; development of the programed interaction diagnostic interview; disturbances to…

Expert and self-assessment of lifetime symptoms and diagnosis of major depressive disorder in large-scale genetic studies in the general population: comparison of a clinical interview and a self-administered checklist.

PubMed

Martin, Jessica; Streit, Fabian; Treutlein, Jens; Lang, Maren; Frank, Josef; Forstner, Andreas J; Degenhardt, Franziska; Witt, Stephanie H; Schulze, Thomas G; Cichon, Sven; Nöthen, Markus M; Rietschel, Marcella; Strohmaier, Jana

2017-10-01

Major depression disorder (MDD) is a complex neuropsychiatric disorder and an increasing number of genetic risk variants are being identified. Investigation of their influence in the general population requires accurate and efficient assessment of depressive symptoms. Here, clinical interviews conducted by clinicians are the gold standard. We investigated whether valid and reliable clinical phenotypes can be obtained efficiently using self-administered instruments. Lifetime depressive symptoms and lifetime MDD diagnosis were assessed in 464 population-based individuals using a clinical interview and a structured, self-administered checklist. Analyses were carried out of the following: (i) intraclass correlations (ICC) between checklist and interview; (ii) sensitivity/specificity of the checklist; and (iii) the association of interview and checklist with a positive family history of MDD (FH-MDD+). The correspondence of the self-administered checklist with the clinical interview was good for most depressive symptoms (ICC=0.60-0.80) and moderate for MDD diagnosis (ICC=0.45). With the consecutive inclusion of MDD diagnostic criteria, sensitivity decreased from 0.67 to 0.46, whereas specificity remained high (0.95). For checklist and interview, strong associations were found between FH-MDD+ and most depressive symptoms and MDD diagnosis (all odds ratio≥1.83). The self-administered checklist showed high reliability for both the assessment of lifetime depressive symptoms and screening for individuals with no lifetime diagnosis of MDD. However, attention is warranted when the aim is to identify MDD cases. The positive association between depressive symptomatology and FH-MDD+ indicates the usefulness of both instruments to assess patients in genetic studies. Our data suggest that the more time-efficient and cost-efficient self-administered instruments also allow for the assessment of depressive symptoms accurate enough to investigate the influence of MDD genetic risk variants in the general population.

Expert and self-assessment of lifetime symptoms and diagnosis of major depressive disorder in large-scale genetic studies in the general population: comparison of a clinical interview and a self-administered checklist

PubMed Central

Martin, Jessica; Streit, Fabian; Treutlein, Jens; Lang, Maren; Frank, Josef; Forstner, Andreas J.; Degenhardt, Franziska; Witt, Stephanie H.; Schulze, Thomas G.; Cichon, Sven; Nöthen, Markus M.; Rietschel, Marcella

2017-01-01

Major depression disorder (MDD) is a complex neuropsychiatric disorder and an increasing number of genetic risk variants are being identified. Investigation of their influence in the general population requires accurate and efficient assessment of depressive symptoms. Here, clinical interviews conducted by clinicians are the gold standard. We investigated whether valid and reliable clinical phenotypes can be obtained efficiently using self-administered instruments. Lifetime depressive symptoms and lifetime MDD diagnosis were assessed in 464 population-based individuals using a clinical interview and a structured, self-administered checklist. Analyses were carried out of the following: (i) intraclass correlations (ICC) between checklist and interview; (ii) sensitivity/specificity of the checklist; and (iii) the association of interview and checklist with a positive family history of MDD (FH-MDD+). The correspondence of the self-administered checklist with the clinical interview was good for most depressive symptoms (ICC=0.60–0.80) and moderate for MDD diagnosis (ICC=0.45). With the consecutive inclusion of MDD diagnostic criteria, sensitivity decreased from 0.67 to 0.46, whereas specificity remained high (0.95). For checklist and interview, strong associations were found between FH-MDD+ and most depressive symptoms and MDD diagnosis (all odds ratio≥1.83). The self-administered checklist showed high reliability for both the assessment of lifetime depressive symptoms and screening for individuals with no lifetime diagnosis of MDD. However, attention is warranted when the aim is to identify MDD cases. The positive association between depressive symptomatology and FH-MDD+ indicates the usefulness of both instruments to assess patients in genetic studies. Our data suggest that the more time-efficient and cost-efficient self-administered instruments also allow for the assessment of depressive symptoms accurate enough to investigate the influence of MDD genetic risk variants in the general population. PMID:28731911

Reliability of the Structured Clinical Interview for DSM-5 Sleep Disorders Module.

PubMed

Taylor, Daniel J; Wilkerson, Allison K; Pruiksma, Kristi E; Williams, Jacob M; Ruggero, Camilo J; Hale, Willie; Mintz, Jim; Organek, Katherine Marczyk; Nicholson, Karin L; Litz, Brett T; Young-McCaughan, Stacey; Dondanville, Katherine A; Borah, Elisa V; Brundige, Antoinette; Peterson, Alan L

2018-03-15

To develop and demonstrate interrater reliability for a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Sleep Disorders (SCISD). The SCISD was designed to be a brief, reliable, and valid interview assessment of adult sleep disorders as defined by the DSM-5. A sample of 106 postdeployment active-duty military members seeking cognitive behavioral therapy for insomnia in a randomized clinical trial were assessed with the SCISD prior to treatment to determine eligibility. Audio recordings of these interviews were double-scored for interrater reliability. The interview is 8 pages long, includes 20 to 51 questions, and takes 10 to 20 minutes to administer. Of the nine major disorders included in the SCISD, six had prevalence rates high enough (ie, n ≥ 5) to include in analyses. Cohen kappa coefficient (κ) was used to assess interrater reliability for insomnia, hypersomnolence, obstructive sleep apnea hypopnea (OSAH), circadian rhythm sleep-wake, nightmare, and restless legs syndrome disorders. There was excellent interrater reliability for insomnia (1.0) and restless legs syndrome (0.83); very good reliability for nightmare disorder (0.78) and OSAH (0.73); and good reliability for hypersomnolence (0.50) and circadian rhythm sleep-wake disorders (0.50). The SCISD is a brief, structured clinical interview that is easy for clinicians to learn and use. The SCISD showed moderate to excellent interrater reliability for six of the major sleep disorders in the DSM-5 among active duty military seeking cognitive behavioral therapy for insomnia in a randomized clinical trial. Replication and extension studies are needed. Registry: ClinicalTrials.gov; Title: Comparing Internet and In-Person Brief Cognitive Behavioral Therapy of Insomnia; Identifier: NCT01549899; URL: https://clinicaltrials.gov/ct2/show/NCT01549899. © 2018 American Academy of Sleep Medicine.

The Rest of the Story: A Qualitative Study of Complementing Standardized Assessment Data with Informal Interviews with Older Patients and Families.

PubMed

Lafortune, Claire; Elliott, Jacobi; Egan, Mary Y; Stolee, Paul

2017-04-01

While standardized health assessments capture valuable information on patients' demographic and diagnostic characteristics, health conditions, and physical and mental functioning, they may not capture information of most relevance to individual patients and their families. Given that patients and their informal caregivers are the experts on that patient's unique context, it is important to ensure they are able to convey all relevant personal information to formal healthcare providers so that high-quality, patient-centered care may be delivered. This study aims to identify information that older patients and families consider important but that might not be included in standardized assessments. Transcripts were analyzed from 29 interviews relating to eight patients with hip fractures from three sites (large urban, smaller urban, rural) in two provinces in Canada. These interviews were conducted as part of a larger ethnographic study. Each transcript was analyzed by two researchers using content analysis. Results were reviewed in two focus group interviews with older adults and family caregivers. Identified themes were compared with items from two standardized assessments used in healthcare settings. Three broad themes emerged from the qualitative analysis that were not covered in the standardized assessments: informal caregiver and family considerations, insider healthcare knowledge, and patients' healthcare attitudes and experiences. The importance of these themes was confirmed through focus group interviews. Focus group participants also emphasized the importance of conducting assessments in a patient-centered way and the importance of open-ended questions. A less structured interview approach may yield information that would otherwise be missed in standardized assessments. Combining both sources could yield better-informed healthcare planning and quality-improvement efforts.

A qualitative study on community pharmacists' decision-making process when making a diagnosis.

PubMed

Sinopoulou, Vassiliki; Summerfield, Paul; Rutter, Paul

2017-12-01

Self-care policies are increasingly directing patients to seek advice from community pharmacists. This means pharmacists need to have sound diagnostic decision-making skills to enable them to recognise a variety of conditions. The aim of this study was to investigate the process by which pharmacists manage patient signs and symptoms and to explore their use of decision-making for diagnostic purposes. Data were collected through semi-structured, face-to-face interviews with community pharmacists working in England, between August 2013 and November 2014. Pharmacists were asked to share their experiences on how they performed patient consultations, and more specifically how they would approach a hypothetical headache scenario. As part of the interview, their sources of knowledge and experience were also explored. Framework analysis was used to identify themes and subthemes. Eight interviews were conducted with pharmacists who had a wide range of working practice, from 1 year through to 40 years of experience. The pharmacists' main motivations during consultations were product selection and risk minimisation. Their questioning approach and decision-making relied heavily on mnemonic methods. This led to poor quality information gathering-although pharmacists acknowledged they needed to "delve deeper" but were often unable to articulate how or why. Some pharmacists exhibited elements of clinical reasoning in their consultations, but this seemed, mostly, to be unconscious and subsequently applied inappropriately. Overall, pharmacists exhibited poor decision-making ability, and often decisions were based on personal belief and experiences rather than evidence. Community pharmacists relied heavily on mnemonic methods to manage patients' signs and symptoms with diagnosis-based decision-making being seldom employed. These findings suggest practicing pharmacists should receive more diagnostic training. © 2017 John Wiley & Sons, Ltd.

Parents' descriptions of young children's dissociative reactions after trauma.

PubMed

Cintron, Gabriela; Salloum, Alison; Blair-Andrews, Zoe; Storch, Eric A

2017-10-09

There is limited research on the phenomenology of how young children who have been exposed to trauma express the intrusive symptom of dissociative reactions. The current qualitative study utilized interviews from a semi-structured diagnostic clinical interview with 74 caregivers of young children (ages 3 to 7) who were exposed to trauma to identify parents' descriptions of their children's dissociative reactions during a clinical interview. Based on results from the interview, 45.9% of the children had dissociative reactions (8.5% had flashbacks and 41.9% had dissociative episodes). Interviews were transcribed to identify themes of dissociative reactions in young children. Common themes to flashbacks and dissociative episodes included being triggered, being psychologically in their own world (e.g., spaced out and shut down), and displaying visible signs (e.g., crying and screaming). For flashbacks, caregivers reported that it seemed as if the child was re-experiencing the trauma (e.g., yelling specific words and having body responses). For dissociative episodes, caregivers noted that the child not only seemed psychologically somewhere else (e.g., distant and not there) but also would be physically positioned somewhere else (e.g., sitting and not responding). Caregivers also expressed their own reactions to the child's dissociative episode due to not understanding what was occurring, and trying to interrupt the occurrences (e.g., calling out to the child). Themes, descriptions, and phrases to describe dissociative reactions in young children after trauma can be used to help parents and professionals more accurately identify occurrences of dissociative reactions.

Residents' perceptions of their own sadness--a qualitative study in Norwegian nursing homes.

PubMed

Iden, Kristina Riis; Ruths, Sabine; Hjørleifsson, Stefan

2015-03-08

Mood symptoms are highly prevalent among frail old people residing in nursing homes. Systematic diagnostics of depression is scarce, and treatment is not always in accordance with best evidence. The distinction between non-pathological sadness and depression may be challenging, and we know little of the older peoples' perspectives. The aim of this qualitative interview study was to explore residents' perceptions of their own sadness. We performed individual, semi-structured interviews with twelve older people residing in nursing homes with no dementia. The interview guide comprised questions on what made the informants sad and what prevented sadness. We recorded, transcribed verbatim and analysed the interviews using systematic text condensation. The interviews revealed three main themes. I. Decay and loss of agency. The informants perceived their sadness to be caused by loss of health and functional ability, reliance on long-term care, dysfunctional technical aids and poor care. II. Loneliness in the middle of the crowd. Loss of family and friends, and lack of conversations with staff members and fellow patients were also sources of sadness. III. Relating and identity. The informants kept sadness at bay through: acceptance and re-orientation to their current life situation, maintaining narratives about their identity and belonging, and religiosity. Nursing home nurses and doctors should identify and respond to sadness that is a rational response to manageable causes. Further, identifying and supporting residents' resources and coping strategies is a salutogenetic approach that may alleviate sadness.

Study protocol of the internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE), Korea, 2015-2019.

PubMed

Jeong, Hyunsuk; Yim, Hyeon Woo; Jo, Sun-Jin; Lee, Seung-Yup; Kim, Eunjin; Son, Hye Jung; Han, Hyun-Ho; Lee, Hae Kook; Kweon, Yong-Sil; Bhang, Soo-Young; Choi, Jung-Seok; Kim, Bung-Nyun; Gentile, Douglas A; Potenza, Marc N

2017-10-05

In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine internet gaming disorder (IGD) diagnostic criteria as a condition warranting further empirical and clinical research. The aim of this study is to clarify the natural and clinical courses of IGD proposed DSM-5 in adolescents and to evaluate its risk and protective factors. The Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence (iCURE) study is an ongoing multidisciplinary, prospective, longitudinal cohort study conducted in 21 schools in Korea. Participant recruitment commenced in March 2015 with the goal of registering 3000 adolescents. The baseline assessment included surveys on emotional, social and environmental characteristics. A parent or guardian completed questionnaires and a structured psychiatric comorbidity diagnostic interview regarding their children. Adolescents with the Internet Game Use-Elicited Symptom Screen total scores of 6 or higher were asked to participate in the clinical diagnostic interview. Two subcohorts of adolescents were constructed: a representative subcohort and a clinical evaluation subcohort. The representative subcohort comprises a randomly selected 10% of the iCURE to investigate the clinical course of IGD based on clinical diagnosis and to estimate the false negative rate. The clinical evaluation subcohort comprised participants meeting three or more of the nine IGD criteria, determined by clinical diagnostic interview, to show the clinical course of IGD. Follow-up data will be collected annually for the 3 years following the baseline assessments. The primary endpoint is 2-year incidence, remission and recurrence rates of IGD. Cross-sectional and longitudinal associations between exposures and outcomes as well as mediation factors will be evaluated. This study is approved by the Institutional Review Board of the Catholic University of Korea. Results will be published in peer-reviewed journals. ClinicalTrials.gov (identifier: NCT02415322). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Clinical Components of Borderline Personality Disorder and Personality Functioning.

PubMed

Ferrer, Marc; Andión, Óscar; Calvo, Natalia; Hörz, Susanne; Fischer-Kern, Melitta; Kapusta, Nestor D; Schneider, Gudrun; Clarkin, John F; Doering, Stephan

2018-01-01

Impairment in personality functioning (PF) represents a salient criterion of the DSM-5 alternative diagnostic model for personality disorders (AMPD). The main goal of this study is to analyze the relationship of the borderline personality disorder (BPD) clinical components derived from the DSM-5 categorical diagnostic model (affective dysregulation, behavioral dysregulation, and disturbed relatedness) with personality organization (PO), i.e., PF, assessed by the Structured Interview of Personality Organization (STIPO). STIPO and the Structured Clinical Interviews for DSM-IV (SCID-I and -II) were administered to 206 BPD patients. The relationship between PO and BPD components were studied using Spearman correlations and independent linear regression analyses. Significant positive correlations were observed between STIPO scores and several DSM-5 BPD criteria and comorbid psychiatric disorders. STIPO dimensions mainly correlated with disturbed relatedness and, to a lesser extent, affective dysregulation components. Each BPD clinical component was associated with specific STIPO dimensions. Both diagnostic models, DSM-5 BPD criteria and PO, are not only related but complementary concepts. The results of this study particularly recommend STIPO for the assessment of relational functioning, which is a major domain of the Personality Functioning Scale Levels of the DSM-5 AMPD. © 2018 S. Karger AG, Basel.

Novel clustering of items from the Autism Diagnostic Interview-Revised to define phenotypes within autism spectrum disorders

PubMed Central

Hu, Valerie W.; Steinberg, Mara E.

2009-01-01

Heterogeneity in phenotypic presentation of ASD has been cited as one explanation for the difficulty in pinpointing specific genes involved in autism. Recent studies have attempted to reduce the “noise” in genetic and other biological data by reducing the phenotypic heterogeneity of the sample population. The current study employs multiple clustering algorithms on 123 item scores from the Autism Diagnostic Interview-Revised (ADI-R) diagnostic instrument of nearly 2000 autistic individuals to identify subgroups of autistic probands with clinically relevant behavioral phenotypes in order to isolate more homogeneous groups of subjects for gene expression analyses. Our combined cluster analyses suggest optimal division of the autistic probands into 4 phenotypic clusters based on similarity of symptom severity across the 123 selected item scores. One cluster is characterized by severe language deficits, while another exhibits milder symptoms across the domains. A third group possesses a higher frequency of savant skills while the fourth group exhibited intermediate severity across all domains. Grouping autistic individuals by multivariate cluster analysis of ADI-R scores reveals meaningful phenotypes of subgroups within the autistic spectrum which we show, in a related (accompanying) study, to be associated with distinct gene expression profiles. PMID:19455643

The politics of methodology in 'post-medical geography': mental health research and the interview.

PubMed

Parr, H

1998-12-01

This paper argues that emerging 'post-medical geographies' require attention to the methodological in order to fully appreciate how different geographical knowledges are produced and contextualized within the politics of research relationships. 'Geographies of mental health and illness' are focused upon in order to argue that the 'peopling' of health research should also be accompanied by debate about what sorts of methodologies we employ in accessing these minds/bodies and voices. The research interview is a primary focus here. A critique of psychoanalytic approaches to geographical research argues that such 'models' of interpretation and management can mean that participants or research 'subjects' can be framed in almost diagnostic categories of behaviour. Empirical examples of mental health research in Nottingham are used to argue that more flexible approaches which pay attention to perceived dualisms (such as 'sanity' and 'insanity'), negotiation, embodiment, socio-spatial contexts and content within the interview situation may aid in understanding the politics which encompass geographical health research.

Short-interval test-retest interrater reliability of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) in outpatients.

PubMed

Dreessen, L; Arntz, A

1998-01-01

The short-interval test-retest interrater reliability of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) was studied in a psychotherapy outpatient group whose main complaint was mostly an Axis I anxiety disorder. Using a test-retest approach to assess interrater reliability, three sources of variance were taken into account (rater variance in the elicitation and interpretation of information and patient variance across interviews). Base rate requirements were established before calculating reliability coefficients. On the whole, interrater agreement on the SCID-II was found to be satisfactory, except for the histrionic personality traits. This is the first study that has estimated short-interval test-retest interrater reliability of the SCID-II in outpatients, and also the first that has studied single SCID-II traits and dimensional diagnoses. The results found support the use of the SCID-II as a diagnostic instrument for clinical and research purposes.

Assessment of personality functioning: validity of the operationalized psychodynamic diagnosis axis IV (structure).

PubMed

Doering, Stephan; Burgmer, Markus; Heuft, Gereon; Menke, Dina; Bäumer, Brigitta; Lübking, Margit; Feldmann, Marcus; Schneider, Gudrun

2014-01-01

The assessment of personality functioning has recently become a focus of psychiatric diagnostics. The interview-based Operationalized Psychodynamic Diagnosis (OPD-2) provides a 'structure axis' for the assessment of personality functioning. One hundred twenty-four psychiatric patients were diagnosed by means of the Structured Clinical Interviews for DSM-IV (SCID-I and SCID-II), underwent OPD-2 interviews, and completed 9 questionnaires. The OPD-2 structure axis shows good interrater reliability (intraclass correlation = 0.793). Correlations between the OPD-2 structure axis domains and a priori selected questionnaire scales were of medium size and significant. Patients with a personality disorder (PD) showed significantly worse personality functioning than those without. In cluster B PD, personality functioning was more severely impaired than in cluster C PD. The OPD-2 structure axis shows good reliability as well as concurrent and discriminant validity and can be recommended for clinical use and research purposes. © 2013 S. Karger AG, Basel.

Utility of the International Classification of Functioning, Disability and Health (ICF) for educational psychologists’ work

PubMed Central

Aljunied, Mariam; Frederickson, Norah

2014-01-01

Despite embracing a bio-psycho-social perspective, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists’ work with children who have Autism Spectrum Disorders (ASD). Mothers of 40 children with ASD aged eight to 12 years were interviewed using a structured protocol based on the ICF framework. The Diagnostic Interview for Social and Communication Disorder (DISCO) was completed with a subset of 19 mothers. Internal consistency and inter-rater reliability of the interview assessments were found to be acceptable and there was evidence for concurrent and discriminant validity. Despite some limitations, initial support for the utility of the ICF model suggests its potential value across educational, health and care fields. Further consideration of its relevance to educational psychologists in new areas of multi-agency working is warranted. PMID:26157197

The incremental validity of borderline personality disorder relative to major depressive disorder for suicidal ideation and deliberate self-harm in adolescents.

PubMed

Sharp, Carla; Green, Kelly L; Yaroslavsky, Ilya; Venta, Amanda; Zanarini, Mary C; Pettit, Jeremy

2012-12-01

Few studies have examined the relation between suicide-related behaviors and Borderline Personality Disorder (BPD) in adolescent samples. The current study investigated the incremental validity of BPD relative to Major Depressive Disorder (MDD) for suicide-related behaviors in a psychiatric sample of adolescents at the cross-sectional level of analysis. The sample included N = 156 consecutive admissions (55.1% female; M age = 15.47; SD = 1.41), to the adolescent treatment program of an inpatient treatment facility. Of the sample 19.2% (n = 30) met criteria for BPD on the Child Interview for DSM-IV Borderline Personality Disorder and 39.1% (n = 61) met criteria for MDD on the Computerized Diagnostic Interview Schedule for Children-IV. Results showed that BPD conferred additional risk for suicidal ideation and deliberate self-harm. Our findings support the clinical impression that BPD should be evaluated in inpatient samples of adolescents either through intake interviews or more structured assessments.

Risk factors for depression in elderly people: a prospective study.

PubMed

Green, B H; Copeland, J R; Dewey, M E; Sharma, V; Saunders, P A; Davidson, I A; Sullivan, C; McWilliam, C

1992-09-01

In 1982-1983 a random sample of 1486 people aged 65 years and above was generated from general practitioner lists; 1070 were interviewed in the community using the Geriatric Mental State and a Social History questionnaire. The cohort was followed up by interview 3 years later. At year 3 the diagnostic computer program AGECAT diagnosed 44 incident cases of depression. Information from the depressed group's initial and further interviews was compared with a control group (which excluded cases of affective or organic mental illness). Univariate analysis yielded three factors that were significantly associated with the development of depression 3 years later: a lack of satisfaction with life; feelings of loneliness; and smoking. Multivariate analysis confirmed their independent effects and revealed 2 further factors attaining significance: female gender and a trigger factor, bereavement of a close figure within 6 months of the third-year diagnosis. Some other factors traditionally associated with depression, such as poor housing, marital status and living alone, failed to attain significance as risk factors.

Educational Research in an Introductory Astronomy Course.

ERIC Educational Resources Information Center

Hemenway, Mary Kay; Straits, William J.; Wilke, R. Russell; Hufnagel, Beth

2002-01-01

Used classroom observations, personal interviews, and pre-instruction/post-instruction administration of the Texas Attitude Survey and the Astronomy Diagnostic Test to evaluate hands-on instructional innovations in a college astronomy course. Modified instruction based on student concerns; scores for the second course showed significant…

Reliability and Validity of Prototype Diagnosis for Adolescent Psychopathology.

PubMed

Haggerty, Greg; Zodan, Jennifer; Mehra, Ashwin; Zubair, Ayyan; Ghosh, Krishnendu; Siefert, Caleb J; Sinclair, Samuel J; DeFife, Jared

2016-04-01

The current study investigated the interrater reliability and validity of prototype ratings of 5 common adolescent psychiatric disorders: attention-deficit/hyperactivity disorder, conduct disorder, major depressive disorder, generalized anxiety disorder, and posttraumatic stress disorder. One hundred fifty-seven adolescent inpatient participants consented to participate in this study. We compared ratings from 2 inpatient clinicians, blinded to each other's ratings and patient measures, after their separate initial diagnostic interview to assess interrater reliability. Prototype ratings completed by clinicians after their initial diagnostic interview with adolescent inpatients and outpatients were compared with patient-reported behavior problems and parents' report of their child's behavioral problems. Prototype ratings demonstrated good interrater reliability. Clinicians' prototype ratings showed predicted relationships with patient-reported behavior problems and parent-reported behavior problems. Prototype matching seems to be a possible alternative for psychiatric diagnosis. Prototype ratings showed good interrater reliability based on clinicians unique experiences with the patient (as opposed to video-/audio-recorded material) with no training.

Diagnostic Reasoning across the Medical Education Continuum.

PubMed

Smith, C Scott; Hill, William; Francovich, Chris; Morris, Magdalena; Robbins, Bruce; Robins, Lynne; Turner, Andrew

2014-07-15

We aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. We performed semi-structured interviews of premedical students, first year medical students, third year medical students, second year internal medicine residents, and experienced faculty (ten each) as they diagnosed three common causes of dyspnea. A second observer recorded emotional tone. All interviews were digitally recorded and blinded transcripts were created. Propositional analysis and concept mapping were performed. Grounded theory was used to identify salient categories and transcripts were scored with these categories. Transcripts were then unblinded. Systematic differences in propositional structure, number of concept connections, distribution of grounded theory categories, episodic and semantic memories, and emotional tone were identified. Summary concept maps were created and grounded theory concepts were explored for each learning level. We identified three major findings: (1) The "apprentice effect" in novices (high stress and low narrative competence); (2) logistic concept growth in intermediates; and (3) a cognitive state transition (between analytical and intuitive approaches) in experts. These findings warrant further study and comparison.

Fifteen years after a ferry disaster: clinical interviews and survivors’ self-assessment of their experience

PubMed Central

Arnberg, Filip K.; Hultman, Christina M.; Michel, Per-Olof; Lundin, Tom

2013-01-01

Background Disasters yield increased rates of psychological disorders decades later. Other consequences, however, have received little attention in the past. Objective We aimed to examine diagnostic status and survivors’ views on disaster-related consequences and social support. Methods A mixed-methods approach was used with 22 survivors (of 49 eligible) 15 years after a ferry disaster. Data collection included audiotaped interviews with open-ended questions and diagnostic assessment of Axis-I disorders. Results The post-disaster incidence was 54% (12/22) for Axis-I disorders, and 45% (10/22) for full or subsyndromal posttraumatic stress disorder. Thematic analysis revealed that survivor perception of the long-term consequences included positive (character change) and negative aspects (being ascribed a survivor identity). Participants’ sought social support for several years, yet many felt hindered by experiential dissimilarity and distress of significant others. Conclusions Axis-I disorders were prevalent, but not salient to survivors’ perceptions in the long-term. Post-disaster interventions need to attend to common barriers to support. PMID:24106579

Comparison of treated and untreated major depressive disorder in a nationwide sample of Korean adults.

PubMed

Park, Subin; Cho, Maeng Je; Bae, Jae Nam; Chang, Sung Man; Jeon, Hong Jin; Hahm, Bong-Jin; Son, Jung-Woo; Kim, Shin Gyeom; Bae, Ahn; Hong, Jin Pyo

2012-06-01

We examined factors associated with lifetime treatment of major depressive disorder (MDD) in a nationwide sample of Korean adults. Of the 6,510 subjects aged 18-64 years who participated in the Korean Epidemiologic Catchment Area study, 362 (5.6%) with a lifetime diagnosis of MDD were analyzed. Diagnostic assessments were based on the Korean version of the Composite International Diagnostic Interview administered by lay interviewers. Of the 362 respondents with a lifetime diagnosis of MDD, 117 (32.3%) had been treated for psychiatric problems. Treated individuals with MDD were more likely to have chronic episode(s), more symptoms of depression, insomnia, and suicidal ideation, and were less likely to have feelings of guilt. In addition, treated individuals were more likely to have comorbid anxiety disorders, especially obsessive-compulsive disorder, post-traumatic stress disorder, and generalized anxiety disorder. Treatment-seeking by individuals with MDD is affected by socio-cultural factors such as misconception and stigma of mental illness, as well as severity of depression and comorbid conditions.

How academic psychiatry can better prepare students for their future patients. Part I: the failure to recognize depression and risk for suicide in primary care; problem identification, responsibility, and solutions.

PubMed

Lake, C Raymond

2008-01-01

The author, after a review of the relevant literature, found that depression and the risk for suicide remain unacceptably underrecognized in primary care (PC). The negative consequences are substantial for patients and their physicians. Suicide prevention in PC begins with the recognition of depression because suicide occurs largely during depression. In this article (Part I), the author suggests causes, responsibilities, and solutions for that failure. He also addresses the role of academic psychiatry's traditional curriculum. The comprehensive, initial diagnostic interview that is typically taught to medical students in psychiatry may decrease recognition in PC care because of the time required to complete it. In Part II, the author offers guidelines to develop a weekly interview course with an instrument targeting abbreviated diagnostic screening for only the most critical psychiatric problems such as depression and the risk for suicide.

No lower cognitive functioning in older adults with attention-deficit/hyperactivity disorder.

PubMed

Semeijn, E J; Korten, N C M; Comijs, H C; Michielsen, M; Deeg, D J H; Beekman, A T F; Kooij, J J S

2015-09-01

Research illustrates cognitive deficits in children and younger adults with attention-deficit/hyperactivity disorder (ADHD). Few studies have focused on the cognitive functioning in older adults. This study investigates the association between ADHD and cognitive functioning in older adults. Data were collected in a cross-sectional side study of the Longitudinal Aging Study Amsterdam (LASA). A diagnostic interview to diagnose ADHD was administered among a subsample (N = 231, age 60-94). ADHD symptoms and diagnosis were assessed with the Diagnostic Interview for ADHD in Adults (DIVA) 2.0. Cognitive functioning was assessed with tests in the domains of executive functioning, information processing speed, memory, and attention/working memory. Regression analyses indicate that ADHD diagnosis and ADHD severity were only negatively associated with cognitive functioning in the attention/working memory domain. When adjusting for depression, these associations were no longer significant. The study shows that ADHD in older adults is associated with lower cognitive functioning in the attention/working memory domain. However, this was partly explained by depressive symptoms.

Genetic and environmental structure of DSM-IV criteria for Antisocial Personality Disorder: a twin study

PubMed Central

Rosenström, Tom; Ystrom, Eivind; Torvik, Fartein Ask; Czajkowski, Nikolai Olavi; Gillespie, Nathan A.; Aggen, Steven H.; Krueger, Robert F.; Kendler, Kenneth S; Reichborn-Kjennerud, Ted

2017-01-01

Results from previous studies on DSM-IV and DSM-5 Antisocial Personality Disorder (ASPD) have suggested that the construct is etiologically multidimensional. To our knowledge, however, the structure of genetic and environmental influences in ASPD has not been examined using an appropriate range of biometric models and diagnostic interviews. The 7 ASPD criteria (section A) were assessed in a population-based sample of 2794 Norwegian twins by a structured interview for DSM-IV personality disorders. Exploratory analyses were conducted at the phenotypic level. Multivariate biometric models, including both independent and common pathways, were compared. A single phenotypic factor was found, and the best-fitting biometric model was a single-factor common pathway model, with common-factor heritability of 51% (95% CI = 40–67%). In other words, both genetic and environmental correlations between the ASPD criteria could be accounted for by a single common latent variable. The findings support the validity of ASPD as a unidimensional diagnostic construct. PMID:28108863

Genetic and Environmental Structure of DSM-IV Criteria for Antisocial Personality Disorder: A Twin Study.

PubMed

Rosenström, Tom; Ystrom, Eivind; Torvik, Fartein Ask; Czajkowski, Nikolai Olavi; Gillespie, Nathan A; Aggen, Steven H; Krueger, Robert F; Kendler, Kenneth S; Reichborn-Kjennerud, Ted

2017-05-01

Results from previous studies on DSM-IV and DSM-5 Antisocial Personality Disorder (ASPD) have suggested that the construct is etiologically multidimensional. To our knowledge, however, the structure of genetic and environmental influences in ASPD has not been examined using an appropriate range of biometric models and diagnostic interviews. The 7 ASPD criteria (section A) were assessed in a population-based sample of 2794 Norwegian twins by a structured interview for DSM-IV personality disorders. Exploratory analyses were conducted at the phenotypic level. Multivariate biometric models, including both independent and common pathways, were compared. A single phenotypic factor was found, and the best-fitting biometric model was a single-factor common pathway model, with common-factor heritability of 51% (95% CI 40-67%). In other words, both genetic and environmental correlations between the ASPD criteria could be accounted for by a single common latent variable. The findings support the validity of ASPD as a unidimensional diagnostic construct.

Pediatric restless legs syndrome: analysis of symptom descriptions and drawings.

PubMed

Picchietti, Daniel L; Arbuckle, Robert A; Abetz, Linda; Durmer, Jeffrey S; Ivanenko, Anna; Owens, Judith A; Croenlein, Jens; Allen, Richard P; Walters, Arthur S

2011-11-01

The specific aims of this study were to collect and analyze detailed symptom descriptions from patients with pediatric restless legs syndrome, ages 6 to 17 years, as well as assess symptom impact and the usefulness of drawings. Trained qualitative interviewers conducted face-to-face audio-recorded interviews of children and adolescents who met criteria for definite restless legs syndrome. Thirty-three patients in 3 age groups used 16 different categories of descriptors for restless legs sensations, with a mean of 3 or more categories used per patient in each age group. "Need to move/kick," "pain/hurts," "uncomfortable/cannot get comfortable," and "like bugs or ants/crawling" were the most common descriptors. Two-thirds reported daytime sensations, and nearly half had arm involvement. They described impact on sleep, cognitive function, and affect. Drawings provided useful diagnostic information. These detailed empirical data will be useful in clinical practice, as well as in the development of formal diagnostic tools and severity measures.

[The state of outpatient psychotherapy in Germany].

PubMed

Zepf, Siegfried; Mengele, Ute; Hartmann, Sebastian

2003-01-01

This paper presents the results of a study of the state of adult outpatient psychotherapy in Germany after the PTG came into force. 1042 psychotherapists were questioned on certain issues. One result was that patients have to wait 4.6 months for psychotherapy and that every second patient asking for a diagnostic interview and possible treatment was refused. Of those who were given a diagnostic interview 35 % were not taken into treatment, although disturbances were diagnosed--such as tinnitus, pain, organic disturbances with psychic complications, suicidal tendencies, anorexia nervosa, addiction, psychosomatic illnesses, personality disorders, psychotic disorders--would normally demand psychotherapeutic treatment. Furthermore only 56 % of those patients who Löcherbach et al. considered needing and wanting psychotherapeutic treatment were actually in a G IV psychotherapy. Apart from this the possibility of getting psychotherapy as well as the kind of psychotherapy proved to be dependent on the kind of medical insurance. Different payments by the insurance companies caused longer waiting times for patients and determined the choice of psychotherapy by the psychotherapists.

Anxiety disorders and onset of cardiovascular disease: the differential impact of panic, phobias and worry.

PubMed

Batelaan, Neeltje M; ten Have, Margreet; van Balkom, Anton J L M; Tuithof, Marlous; de Graaf, Ron

2014-03-01

Anxiety has been linked to onset of cardiovascular disease. This study examines the differential impact of types of anxiety (panic, phobia and worry) on 3-year onset of non-fatal cardiovascular disease (CVD). By investigating anxiety disorders as opposed to anxiety symptoms and by using a reliable diagnostic instrument to assess anxiety, limitations of previous studies are considered. 5149 persons at risk for CVD were interviewed using the Composite International Diagnostic Interview. The panic-type included panic disorder and panic attacks; the phobic-type included agoraphobia and social phobia, and the worry-type included generalized anxiety disorder. CVD was self-reported and required treatment or monitoring by a doctor. Analyses were adjusted for sociodemographics, behavioral variables, and comorbid somatic and psychiatric disorders. During follow-up, 62 persons (1.2%) developed CVD. Baseline generalized anxiety disorder was strongly associated with onset of CVD (adjusted OR: 3.39). Further research should replicate findings and focus on biological underpinnings of this association. Copyright © 2014 Elsevier Ltd. All rights reserved.

Diagnosis and Treatment of Eating Disorders.

ERIC Educational Resources Information Center

Neuman, Patricia; And Others

This paper was designed to provide professional counselors with a comprehensive but concise method of accurately evaluting, interviewing, and planning for treatment of eating disorder clients. The paper is organized in five sections. The first section, Diagnosis, compares, contrasts, and offers clear explanations of the diagnostic criteria for…

Sex Differences and Depression in Puerto Rico.

ERIC Educational Resources Information Center

Canino, Glorisa J.; And Others

1987-01-01

Examined sex differences in rates of depressive disorders and depressive symptomatology, as measured by the Diagnostic Interview Schedule, for an island-wide probability sample of Puerto Rico. Found depression significantly more prevalent among women than men. Discusses risk factors from a sex-role and cultural perspective. (Author/KS)

Psychiatric Comorbidity in Gender Dysphoric Adolescents

ERIC Educational Resources Information Center

de Vries, Annelou L. C.; Doreleijers, Theo A. H.; Steensma, Thomas D.; Cohen-Kettenis, Peggy T.

2011-01-01

Background: This study examined psychiatric comorbidity in adolescents with a gender identity disorder (GID). We focused on its relation to gender, type of GID diagnosis and eligibility for medical interventions (puberty suppression and cross-sex hormones). Methods: To ascertain DSM-IV diagnoses, the Diagnostic Interview Schedule for Children…

College Students' Gambling Behavior: When Does It Become Harmful?

ERIC Educational Resources Information Center

Weinstock, Jeremiah; Whelan, James P.; Meyers, Andrew

2008-01-01

Objective: The authors investigated behavioral indicators of pathological gambling in a college student sample. Participants and Methods: The authors administered a diagnostic interview for pathological gambling to 159 college students, who also completed a demographic questionnaire, and a self-report measure of psychological distress. Results:…

Clinical Interviewing with Older Adults

ERIC Educational Resources Information Center

Mohlman, Jan; Sirota, Karen Gainer; Papp, Laszlo A.; Staples, Alison M.; King, Arlene; Gorenstein, Ethan E.

2012-01-01

Over the next few decades the older adult population will increase dramatically, and prevalence rates of psychiatric disorders are also expected to increase in the elderly cohort. These demographic projections highlight the need for diagnostic instruments and methods that are specifically tailored to older adults. The current paper discusses the…

Parent-Reported Predictors of Adolescent Panic Attacks.

ERIC Educational Resources Information Center

Hayward, Chris; Wilson, Kimberly A.; Lagle, Kristy; Killen, Joel D.; Taylor, C. Barr

2004-01-01

Objective: To identify parent-reported risk factors for adolescent panic attacks. Method: Structured diagnostic interviews were obtained from 770 parents of participants in a school-based risk factor study for adolescent panic. Parent-reported risk factors assessed included characteristics of the child (negative affect, separation anxiety disorder…

Prevalence of "DSM-IV" Major Depression among Spanish University Students

ERIC Educational Resources Information Center

Vazquez, Fernando L.; Blanco, Vanessa

2008-01-01

Objective: The authors' purpose in this study was to estimate prevalence and correlates of "Diagnostic and Statistical Manual of Mental Disorders," 4th edition ("DSM-IV"), major depressive episodes (MDEs) among Spanish university students. Participants and Methods: In October and November 2004, interviewers administered a…

Diagnostic overshadowing and other challenges involved in the diagnostic process of patients with mental illness who present in emergency departments with physical symptoms--a qualitative study.

PubMed

Shefer, Guy; Henderson, Claire; Howard, Louise M; Murray, Joanna; Thornicroft, Graham

2014-01-01

We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of 'diagnostic overshadowing'--the misattribution of physical symptoms to mental illness--and other challenges involved in the diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.

Diagnostic accuracy for major depression in multiple sclerosis using self-report questionnaires.

PubMed

Fischer, Anja; Fischer, Marcus; Nicholls, Robert A; Lau, Stephanie; Poettgen, Jana; Patas, Kostas; Heesen, Christoph; Gold, Stefan M

2015-09-01

Multiple sclerosis and major depressive disorder frequently co-occur but depression often remains undiagnosed in this population. Self-rated depression questionnaires are a good option where clinician-based standardized diagnostics are not feasible. However, there is a paucity of data on diagnostic accuracy of self-report measures for depression in multiple sclerosis (MS). Moreover, head-to-head comparisons of common questionnaires are largely lacking. This could be particularly relevant for high-risk patients with depressive symptoms. Here, we compare the diagnostic accuracy of the Beck Depression Inventory (BDI) and 30-item version of the Inventory of Depressive Symptomatology Self-Rated (IDS-SR30) for major depressive disorder (MSS) against diagnosis by a structured clinical interview. Patients reporting depressive symptoms completed the BDI, the IDS-SR30 and underwent diagnostic assessment (Mini International Neuropsychiatric Interview, M.I.N.I.). Receiver-Operating Characteristic analyses were performed, providing error estimates and false-positive/negative rates of suggested thresholds. Data from n = 31 MS patients were available. BDI and IDS-SR30 total score were significantly correlated (r = 0.82). The IDS-SR30total score, cognitive subscore, and BDI showed excellent to good accuracy (area under the curve (AUC) 0.86, 0.91, and 0.85, respectively). Both the IDS-SR30 and the BDI are useful to quantify depressive symptoms showing good sensitivity and specificity. The IDS-SR30 cognitive subscale may be useful as a screening tool and to quantify affective/cognitive depressive symptomatology.

Longitudinal diagnostic efficiency of DSM-IV criteria for obsessive-compulsive personality disorder: a 2-year prospective study.

PubMed

Grilo, C M; Skodol, A E; Gunderson, J G; Sanislow, C A; Stout, R L; Shea, M T; Morey, L C; Zanarini, M C; Bender, D S; Yen, S; McGlashan, T H

2004-07-01

To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for obsessive-compulsive personality disorder (OCPD). At baseline, criteria and diagnoses were determined using diagnostic interviews, and blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, using the independent OCPD diagnosis at follow-up as the standard. Longitudinal diagnostic efficiencies for the OCPD criteria varied; findings suggested the overall predictive utility of 'preoccupied with details', 'rigid and stubborn', and 'reluctant to delegate'. These findings suggest the predictive validity of three cognitive-interpersonal OCPD criteria.

Evaluating the accessibility and utility of HIV-related point-of-care diagnostics for maternal health in rural South Africa: a study protocol

PubMed Central

Mashamba-Thompson, T P; Drain, P K; Sartorius, B

2016-01-01

Introduction Poor healthcare access is a major barrier to receiving antenatal care and a cause of high maternal mortality in South Africa (SA). ‘Point-of-care’ (POC) diagnostics is a powerful emerging healthcare approach to improve healthcare access. This study focuses on evaluating the accessibility and utility of POC diagnostics for maternal health in rural SA primary healthcare (PHC) clinics in order to generate a model framework of implementation of POC diagnostics in rural South African clinics. Method and analyses We will use several research methods, including a systematic review, quasi-experiments, survey, key informant interviews and audits. We will conduct a systematic review and experimental study to determine the impact of POC diagnostics on maternal health. We will perform a cross-sectional case study of 100 randomly selected rural primary healthcare clinics in KwaZulu-Natal to measure the context and patterns of POC diagnostics access and usage by maternal health providers and patients. We will conduct interviews with relevant key stakeholders to determine the reasons for POC deficiencies regarding accessibility and utility of HIV-related POC diagnostics for maternal health. We will also conduct a vertical audit to investigate all the quality aspects of POC diagnostic services including diagnostic accuracy in a select number of clinics. On the basis of information gathered, we will propose a model framework for improved implementation of POC diagnostics in rural South African public healthcare clinics. Statistical (Stata-13) and thematic (NVIVO) data analysis will be used in this study. Ethics and dissemination The study protocol was approved by the Ethics Committee of the University of KwaZulu-Natal (BE 484/14) and the KwaZulu-Natal Department of Health based on the Helsinki Declaration (HRKM 40/15). Findings of this study will be disseminated electronically and in print. They will be presented to conferences related to HIV/AIDS, diagnostics, maternal health and strengthening of health systems. PMID:27354074

Rapid and Accurate Behavioral Health Diagnostic Screening: Initial Validation Study of a Web-Based, Self-Report Tool (the SAGE-SR).

PubMed

Brodey, Benjamin; Purcell, Susan E; Rhea, Karen; Maier, Philip; First, Michael; Zweede, Lisa; Sinisterra, Manuela; Nunn, M Brad; Austin, Marie-Paule; Brodey, Inger S

2018-03-23

The Structured Clinical Interview for DSM (SCID) is considered the gold standard assessment for accurate, reliable psychiatric diagnoses; however, because of its length, complexity, and training required, the SCID is rarely used outside of research. This paper aims to describe the development and initial validation of a Web-based, self-report screening instrument (the Screening Assessment for Guiding Evaluation-Self-Report, SAGE-SR) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the SCID-5-Clinician Version (CV) intended to make accurate, broad-based behavioral health diagnostic screening more accessible within clinical care. First, study staff drafted approximately 1200 self-report items representing individual granular symptoms in the diagnostic criteria for the 8 primary SCID-CV modules. An expert panel iteratively reviewed, critiqued, and revised items. The resulting items were iteratively administered and revised through 3 rounds of cognitive interviewing with community mental health center participants. In the first 2 rounds, the SCID was also administered to participants to directly compare their Likert self-report and SCID responses. A second expert panel evaluated the final pool of items from cognitive interviewing and criteria in the DSM-5 to construct the SAGE-SR, a computerized adaptive instrument that uses branching logic from a screener section to administer appropriate follow-up questions to refine the differential diagnoses. The SAGE-SR was administered to healthy controls and outpatient mental health clinic clients to assess test duration and test-retest reliability. Cutoff scores for screening into follow-up diagnostic sections and criteria for inclusion of diagnoses in the differential diagnosis were evaluated. The expert panel reduced the initial 1200 test items to 664 items that panel members agreed collectively represented the SCID items from the 8 targeted modules and DSM criteria for the covered diagnoses. These 664 items were iteratively submitted to 3 rounds of cognitive interviewing with 50 community mental health center participants; the expert panel reviewed session summaries and agreed on a final set of 661 clear and concise self-report items representing the desired criteria in the DSM-5. The SAGE-SR constructed from this item pool took an average of 14 min to complete in a nonclinical sample versus 24 min in a clinical sample. Responses to individual items can be combined to generate DSM criteria endorsements and differential diagnoses, as well as provide indices of individual symptom severity. Preliminary measures of test-retest reliability in a small, nonclinical sample were promising, with good to excellent reliability for screener items in 11 of 13 diagnostic screening modules (intraclass correlation coefficient [ICC] or kappa coefficients ranging from .60 to .90), with mania achieving fair test-retest reliability (ICC=.50) and other substance use endorsed too infrequently for analysis. The SAGE-SR is a computerized adaptive self-report instrument designed to provide rigorous differential diagnostic information to clinicians. ©Benjamin Brodey, Susan E Purcell, Karen Rhea, Philip Maier, Michael First, Lisa Zweede, Manuela Sinisterra, M Brad Nunn, Marie-Paule Austin, Inger S Brodey. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.03.2018.

Posttraumatic stress disorder in hospitalized adolescents: psychiatric comorbidity and clinical correlates.

PubMed

Lipschitz, D S; Winegar, R K; Hartnick, E; Foote, B; Southwick, S M

1999-04-01

To describe the diagnostic comorbidity and clinical correlates of posttraumatic stress disorder (PTSD) in adolescent psychiatric inpatients. Seventy-four adolescent inpatients were given a structured diagnostic interview, the revised version of the Diagnostic Interview for Children and Adolescents, and a battery of standard self-report measures to assess general trauma exposure, posttraumatic stress symptoms, suicidal behavior, dissociation, and depression. Ninety-three percent of subjects reported exposure to at least one traumatic event such as being a witness/victim of community violence, witnessing family violence, or being the victim of physical/sexual abuse. Thirty-two percent of subjects met diagnostic criteria for current PTSD, with sexual abuse cited as the most common traumatic stressor in 69% of PTSD cases. Girls were significantly more likely to develop PTSD than boys, although the total number of types of trauma did not differ by gender. Compared with psychiatric controls, male youngsters with PTSD were significantly more likely to have comorbid diagnoses of eating disorders, other anxiety disorders, and somatization disorder. Furthermore, male and female youngsters with PTSD were significantly more likely to have attempted suicide and report greater depressive and dissociative symptoms. In clinical populations of hospitalized adolescents exposed to multiple forms of trauma, PTSD is a common, but highly comorbid disorder. Specific multimodal assessments and treatments targeted to both PTSD and its comorbidity profile are warranted.

Prevalence of restless legs syndrome in Ankara, Turkey: an analysis of diagnostic criteria and awareness.

PubMed

Yilmaz, Nesrin Helvaci; Akbostanci, Muhittin Cenk; Oto, Aycan; Aykac, Ozlem

2013-09-01

The aim of this study was threefold: (1) to investigate the prevalence of restless legs syndrome (RLS), in Ankara, Turkey; (2) to determine the predictive values of diagnostic criteria; and (3) to determine the frequency of physician referrals and the frequency of getting the correct diagnosis. A total of 815 individuals, from randomly selected addresses, above the age of 15, were reached using the questionnaire composed of the four diagnostic criteria. Individuals who responded by answering 'yes' for at least one question were interviewed by neurologists for the diagnosis of RLS. Frequency of physician referrals and frequency of getting the correct diagnosis of RLS were also determined for patients getting the final diagnoses of RLS. Prevalence of RLS in Ankara was 5.52 %; 41.0 % of the individuals diagnosed with RLS had replied 'yes' to either one, two or three questions asked by interviewers. However, only 21.3 % of individuals who replied 'yes' to all four questions received the diagnosis of RLS. Among the patients who had the final diagnosis of RLS, 25.7 % had referred to a physician for the symptoms and 22.2 % got the correct diagnosis. The RLS prevalence in Ankara was somewhere between Western and Far East countries compatible with the geographical location. Diagnostic criteria may not be fully predictive when applied by non-physician pollsters. Physician's probability of correctly diagnosing RLS is still low.

Validation of the 10/66 Dementia Research Group diagnostic assessment for dementia in Arabic: a study in Lebanon

PubMed Central

Phung, Kieu T. T.; Chaaya, Monique; Waldemar, Gunhild; Atweh, Samir; Asmar, Khalil; Ghusn, Husam; Karam, Georges; Sawaya, Raja; Khoury, Rose Mary; Zeinaty, Ibrahim; Salman, Sandrine; Hammoud, Salem; Radwan, Wael; Bassil, Nazem; Prince, Martin

2014-01-01

Objectives In the North Africa and Middle East region, the illiteracy rates among older people are high, posing a great challenge to cognitive assessment. Validated diagnostic instruments for dementia in Arabic are lacking, hampering the development of dementia research in the region. The study aimed at validating the Arabic version of the 10/66 Dementia Research Group (DRG) diagnostic assessment for dementia to determine if it is suitable for case ascertainment in epidemiological research. Methods 244 participants older than 65 years were included, 100 with normal cognition and 144 with mild to moderate dementia. Dementia was diagnosed by clinicians according to DSM-IV criteria. Depression was diagnosed using the Geriatric Mental State. Trained interviewers blind to the cognitive status of the participants administered the 10/66 DRG diagnostic assessment to the participants and interviewed the caregivers. The discriminatory ability of the 10/66 DRG assessment and its subcomponents were evaluated against the clinical diagnoses. Results Half of the participants had no formal education and 49% of them were depressed. The 10/66 DRG diagnostic assessment showed excellent sensitivity (92.0%), specificity (95.1%), positive predictive value (PPV, 92.9%), and low false positive rates (FPR) among controls with no formal education (8.1%) and depression (5.6%). Each subcomponent of the 10/66 DRG diagnostic assessment independently predicted dementia diagnosis. The predictive ability of the 10/66 DRG assessment was superior to that of its subcomponents. Conclusion 10/66 DRG diagnostic assessment for dementia is well suited for case ascertainment in epidemiological studies among Arabic speaking older population with high prevalence of illiteracy. PMID:24771602

Improvement in the Diagnostic Evaluation of a Positive Fecal Occult Blood Test in an Integrated Health Care Organization

PubMed Central

Miglioretti, Diana L.; Rutter, Carolyn M.; Bradford, Susan Carol; Zauber, Ann G.; Kessler, Larry G.; Feuer, Eric J.; Grossman, David C.

2014-01-01

Background Screening for fecal occult blood can be effective in reducing colorectal cancer mortality only if positive tests are appropriately followed up with complete diagnostic evaluation (i.e., colonoscopy or flexible sigmoidoscopy with double contrast barium enema) and treatment. Objectives To examine whether rates of complete diagnostic evaluation following a positive fecal occult blood test (FOBT) have improved over time after the implementation of tracking systems and physician guidelines within a large integrated health care organization. Research Design From 1993 to 2005, 8513 positive FOBTs were identified on 8291 enrollees aged 50–79 of a large health care system. Automated records were used to identify repeat FOBTs, colonoscopy, flexible sigmoidoscopy, and double-contrast barium enema within one year after the positive FOBT. National rates of complete diagnostic evaluation were estimated from the 2005 National Health Interview Survey. Results In this integrated health care organization, the percentage of positive FOBTs followed by complete diagnostic evaluation within one year increased from 57%–64% in 1993–1996 to 82%–86% from 2000–2005. Use of repeat FOBT following a positive FOBT decreased from 28–31% in 1993–1996 to 6–11% in 2000–2005. Based on the National Health Interview Survey, only 52% of positive FOBTs from 2000–2005 were followed by complete diagnostic evaluation nationally. Conclusions Adherence to recommendations for complete diagnostic evaluation following a positive FOBT has greatly improved over time in an integrated group medical practice. Through the use of tracking systems and screening guidelines, it may be possible to reach levels of follow-up that are comparable to those observed in randomized trials. PMID:18725839

The role and position of passive intervertebral motion assessment within clinical reasoning and decision-making in manual physical therapy: a qualitative interview study.

PubMed

van Trijffel, Emiel; Plochg, Thomas; van Hartingsveld, Frank; Lucas, Cees; Oostendorp, Rob A B

2010-06-01

Passive intervertebral motion (PIVM) assessment is a characterizing skill of manual physical therapists (MPTs) and is important for judgments about impairments in spinal joint function. It is unknown as to why and how MPTs use this mobility testing of spinal motion segments within their clinical reasoning and decision-making. This qualitative study aimed to explore and understand the role and position of PIVM assessment within the manual diagnostic process. Eight semistructured individual interviews with expert MPTs and three subsequent group interviews using manual physical therapy consultation platforms were conducted. Line-by-line coding was performed on the transcribed data, and final main themes were identified from subcategories. Three researchers were involved in the analysis process. Four themes emerged from the data: contextuality, consistency, impairment orientedness, and subjectivity. These themes were interrelated and linked to concepts of professionalism and clinical reasoning. MPTs used PIVM assessment within a multidimensional, biopsychosocial framework incorporating clinical data relating to mechanical dysfunction as well as to personal factors while applying various clinical reasoning strategies. Interpretation of PIVM assessment and subsequent decisions on manipulative treatment were strongly rooted within practitioners' practical knowledge. This study has identified the specific role and position of PIVM assessment as related to other clinical findings within clinical reasoning and decision-making in manual physical therapy in The Netherlands. We recommend future research in manual diagnostics to account for the multivariable character of physical examination of the spine.

Prevalence and correlates of fire-setting in the United States: results from the National Epidemiological Survey on Alcohol and Related Conditions.

PubMed

Vaughn, Michael G; Fu, Qiang; Delisi, Matt; Wright, John Paul; Beaver, Kevin M; Perron, Brian E; Howard, Matthew O

2010-01-01

Fire-setting is a serious and costly form of antisocial behavior. Our objective in this study was to examine the prevalence and correlates of intentional fire-setting behavior in the United States. Data were derived from a nationally representative sample of US residents 18 years and older. Structured psychiatric interviews (N = 43,093) were completed by trained lay interviewers between 2001 and 2002. Fire-setting as well as mood, anxiety, substance use, and personality disorders of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) version. The prevalence of lifetime fire-setting in the US population was 1.0%. Respondents who were men, white, 18 to 35 years old, born in the United States, and living in the western region of the United States had significantly higher rates of fire-setting than their counterparts. Fire-setting was significantly associated with a wide range of antisocial behaviors. Multivariate logistic regression analyses identified strong associations between lifetime alcohol and marijuana use disorders, conduct disorder, antisocial and obsessive-compulsive personality disorders, and family history of antisocial behavior. Intentional illicit fire-setting behavior is associated with a broad array of antisocial behaviors and psychiatric comorbidities. Given the substantial personal and social costs related to arson, prevention and treatment interventions targeting fire-setters potentially could save lives and property. 2010 Elsevier Inc. All rights reserved.

The role and position of passive intervertebral motion assessment within clinical reasoning and decision-making in manual physical therapy: a qualitative interview study

PubMed Central

van Trijffel, Emiel; Plochg, Thomas; van Hartingsveld, Frank; Lucas, Cees; Oostendorp, Rob A B

2010-01-01

Passive intervertebral motion (PIVM) assessment is a characterizing skill of manual physical therapists (MPTs) and is important for judgments about impairments in spinal joint function. It is unknown as to why and how MPTs use this mobility testing of spinal motion segments within their clinical reasoning and decision-making. This qualitative study aimed to explore and understand the role and position of PIVM assessment within the manual diagnostic process. Eight semistructured individual interviews with expert MPTs and three subsequent group interviews using manual physical therapy consultation platforms were conducted. Line-by-line coding was performed on the transcribed data, and final main themes were identified from subcategories. Three researchers were involved in the analysis process. Four themes emerged from the data: contextuality, consistency, impairment orientedness, and subjectivity. These themes were interrelated and linked to concepts of professionalism and clinical reasoning. MPTs used PIVM assessment within a multidimensional, biopsychosocial framework incorporating clinical data relating to mechanical dysfunction as well as to personal factors while applying various clinical reasoning strategies. Interpretation of PIVM assessment and subsequent decisions on manipulative treatment were strongly rooted within practitioners’ practical knowledge. This study has identified the specific role and position of PIVM assessment as related to other clinical findings within clinical reasoning and decision-making in manual physical therapy in The Netherlands. We recommend future research in manual diagnostics to account for the multivariable character of physical examination of the spine. PMID:21655394

The Phenomenology of the Diagnostic Process: A Primary Care-Based Survey.

PubMed

Donner-Banzhoff, Norbert; Seidel, Judith; Sikeler, Anna Maria; Bösner, Stefan; Vogelmeier, Maria; Westram, Anja; Feufel, Markus; Gaissmaier, Wolfgang; Wegwarth, Odette; Gigerenzer, Gerd

2017-01-01

While dichotomous tasks and related cognitive strategies have been extensively researched in cognitive psychology, little is known about how primary care practitioners (general practitioners [GPs]) approach ill-defined or polychotomous tasks and how valid or useful their strategies are. To investigate cognitive strategies used by GPs for making a diagnosis. In a cross-sectional study, we videotaped 282 consultations, irrespective of presenting complaint or final diagnosis. Reflective interviews were performed with GPs after each consultation. Recordings of consultations and GP interviews were transcribed verbatim and analyzed using a coding system that was based on published literature and systematically checked for reliability. In total, 134 consultations included 163 diagnostic episodes. Inductive foraging (i.e., the initial, patient-guided search) could be identified in 91% of consultations. It contributed an average 31% of cues obtained by the GP in 1 consultation. Triggered routines and descriptive questions occurred in 38% and 84% of consultations, respectively. GPs resorted to hypothesis testing, the hallmark of the hypothetico-deductive method, in only 39% of consultations. Video recordings and interviews presumably interfered with GPs' behavior and accounts. GPs might have pursued more hypotheses and collected more information than usual. The testing of specific disease hypotheses seems to play a lesser role than previously thought. Our data from real consultations suggest that GPs organize their search for information in a skillfully adapted way. Inductive foraging, triggered routines, descriptive questions, and hypotheses testing are essential building blocks to make a diagnosis in the generalist setting. © The Author(s) 2016.

Anxiety Disorders in Adolescents and Psychosocial Outcomes at Age 30

PubMed Central

Essau, Cecilia A.; Lewinsohn, Peter M.; Olaya, Beatriz; Seeley, John R.

2014-01-01

Background Anxiety disorders are associated with adverse psychosocial functioning, and are predictive of a wide range of psychiatric disorders in adulthood. Objective The present study examined the associations between anxiety disorders during childhood and adolescence and psychosocial outcomes at age 30, and sought to address the extent to which psychopathology after age 19 mediated these relations. Method Eight hundred and sixteen participants from a large community sample were interviewed twice during adolescence, at age 24, and at age 30. They completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Results Childhood anxiety only predicted less years of completed education at age 30, whereas adolescent anxiety predicted income, unemployment, maladjustment, poor coping skills, more chronic stress and life events. Adult major depressive disorder (MDD) was the only disorder predicted by childhood anxiety, whereas adolescent anxiety predicted MDD, substance (SUD) and alcohol abuse/dependence (AUD) in adulthood. No adult psychopathology mediated the relationship between childhood anxiety disorders and psychosocial outcomes at age 30. Adult MDD, SUD and AUD partially or completely mediated the association between adolescent anxiety and most domains of psychosocial functioning at age 30. Limitations The participants are ethically and geographically homogenous, and changes in the diagnostic criteria and the interview schedules across the assessment periods. Conclusion Adolescent anxiety, compared to childhood anxiety, is associated with more adverse psychosocial outcomes at age 30. Adolescent anxiety affects negative outcomes at age 30 directly and through MDD, SUD and AUD. PMID:24456837

"On the Sidelines": Access to Autism-Related Services in the West Bank

ERIC Educational Resources Information Center

Dababnah, Sarah; Bulson, Kathleen

2015-01-01

We examined access to autism-related services among Palestinians (N = 24) raising children with autism spectrum disorder (ASD) in the West Bank. Using qualitative methods, we identified five primary interview themes. Poor screening, diagnostic, and psychoeducational practices were prevalent, as parents reported service providers minimized parental…

Functional Gastrointestinal Symptoms in Children with Anxiety Disorders

ERIC Educational Resources Information Center

Waters, Allison M.; Schilpzand, Elizabeth; Bell, Clare; Walker, Lynn S.; Baber, Kari

2013-01-01

This study examined the incidence and correlates of functional gastrointestinal symptoms in children with anxiety disorders. Participants were 6-13 year old children diagnosed with one or more anxiety disorders (n = 54) and non-clinical control children (n = 51). Telephone diagnostic interviews were performed with parents to determine the presence…

Epidemiological Study of Mild Traumatic Brain Injury Sequelae Caused by Blast Exposure During Operations Iraqi Freedom and Enduring Freedom

DTIC Science & Technology

2014-11-01

Emily Lynn, BA Research Assistant April, 2010. (Departed program: July, 2012) Jasmine Smith, BA Research Assistant June, 2010 (Departed Program...final diagnostic algorithm represents the study clinicians’ collective interpretation of 10 the interview data. In essence , it provides a clinician

Attrition from an Adolescent Addiction Treatment Program: A Cross Validation.

ERIC Educational Resources Information Center

Mathisen, Kenneth S.; Meyers, Kathleen

Treatment attrition is a major problem for programs treating adolescent substance abusers. To isolate and cross validate factors which are predictive of addiction treatment attrition among adolescent substance abusers, screening interview and diagnostic variables from 119 adolescent in-patients were submitted to a discriminant equation analysis.…

Turkish Undergraduates' Misconceptions of Evaporation, Evaporation Rate, and Vapour Pressure

ERIC Educational Resources Information Center

Canpolat, Nurtac

2006-01-01

This study focused on students' misconceptions related to evaporation, evaporation rate, and vapour pressure. Open-ended diagnostic questions were used with 107 undergraduates in the Primary Science Teacher Training Department in a state university in Turkey. In addition, 14 students from that sample were interviewed to clarify their written…

Predicting Improvement in Social-Communication Symptoms of Autism Spectrum Disorders Using Retrospective Treatment Data

ERIC Educational Resources Information Center

Mazurek, Micah O.; Kanne, Stephen M.; Miles, Judith H.

2012-01-01

Data from 1433 children and adolescents with autism spectrum disorders (ASD) participating in the Simons Simplex Collection were examined to (1) investigate change in social-communication symptoms, and (2) examine predictors of improvement, particularly community-based treatments. Measures included the "Autism Diagnostic Interview--Revised"…

Oppositional Defiant Disorder in Children with Intellectual Disabilities

ERIC Educational Resources Information Center

Christensen, Lisa; Baker, Bruce L.; Blacher, Jan

2013-01-01

The study examines the epidemiology of oppositional defiant disorder (ODD) for children with intellectual disabilities (ID; n = 49), children with borderline intellectual functioning (BIF; n = 20), and typically developing children (TD; n = 115). The Diagnostic Interview Schedule for Children was administered to mothers at child ages 5, 6, 7, 8,…

Home Evaluation of Psychiatrically Impaired Elderly: Process and Outcome.

ERIC Educational Resources Information Center

Wasson, Wendy; And Others

1984-01-01

Describes a geropsychiatric outreach team that evaluated and treated psychiatrically impaired elderly (N=66) in their home. Initial diagnostic reports and three-month follow-up interviews suggested that most patients had improved or stabilized and were able to remain in the community. Intervention strategies and patient characteristics are…

DRGs and Family Care for the Elderly: A Case Study.

ERIC Educational Resources Information Center

Fischer, Lucy Rose; Eustis, Nancy N.

1988-01-01

Conducted interviews with family caregivers, patients, and staff of hospital before and after implementation of Diagnostic Related Groupings (DRGs). After DRGs, family and patients were more likely to express concern about problems in hospital admissions, discharge, and quality of care. Families increasingly served as mediators, supervisors, and…

Antisocial Behavior and Affiliation With Deviant Peers

ERIC Educational Resources Information Center

Toro, Paul A.; Urberg, Kathryn A.; Heinze, Hillary J.

2004-01-01

We examined the associations among gender, antisocial behavior, and peer-group affiliation in a high-risk sample of 401 homeless and matched housed adolescents (139 boys and 262 girls). The Diagnostic Interview Schedule for Children (Version 2.3, 1991; Costello, Edelbrock, Kalas, Kessler, & Klaric, 1982) yielded 2 measures of adolescent antisocial…

Prison Clinicians' Perceptions of Antisocial Personality Disorder as a Formal Diagnosis.

ERIC Educational Resources Information Center

Stevens, Gail Flint

1994-01-01

Surveyed and interviewed 53 clinicians who work with prison inmates. Results indicated that clinicians used diagnosis of antisocial personality disorder liberally among inmates and felt majority of inmates could be so diagnosed. Large minority of clinicians went beyond Diagnostic and Statistical Manual of Mental Disorders criteria and reported…

Management Qua Communication in Rocket Research and Development

ERIC Educational Resources Information Center

Tompkins, Phillip K.

1977-01-01

Reviews a diagnostic study conducted by a communication consultant within the George C Marshall Space Flight Center during the research and development of the Saturn V or "Moon Rocket". Participant observation and in-depth interview methodology yields information on organizational communication and systematic problems within a complex network. (MH)

Child Comorbidity, Maternal Mood Disorder, and Perceptions of Family Functioning among Bipolar Youth

ERIC Educational Resources Information Center

Esposito-Smythers, Christianne; Birmaher, Boris; Valeri, Sylvia; Chiappetta, Laurel; Hunt, Jeffrey; Ryan, Neal; Axelson, David; Strober, Michael; Leonard, Henrietta; Sindelar, Holly; Keller, Martin

2006-01-01

Objective: To examine the association between youth comorbid psychiatric disorders, maternal mood disorder, and perceptions of family cohesion and conflict among youth diagnosed with pediatric bipolar disorder (PBD). Method: Three hundred eighty-nine bipolar youths and their parents completed a diagnostic interview and instruments assessing family…

ADHD and Dyscalculia: Evidence for Independent Familial Transmission

ERIC Educational Resources Information Center

Monuteaux, Michael C.; Faraone, Stephen V.; Herzig, Kathleen; Navsaria, Neha; Biederman, Joseph

2005-01-01

The familial relationship between dyscalculia and attention-deficit/hyperactivity disorder (ADHD) was assessed. We conducted a familial risk analysis using probands with and without ADHD of both genders and their first-degree relatives. Participants were assessed with structured diagnostic interviews and a cognitive test battery. We found elevated…

Clinical vs. structured interview on anxiety and affective disorders by primary care physicians. understanding diagnostic discordance.

PubMed

Balestrieri, Matteo; Baldacci, Sandra; Bellomo, Antonello; Bellantuono, Cesario; Conti, Luciano; Perugi, Giulio; Nardini, Marcello; Borbotti, Marco; Viegi, Giovanni

2007-01-01

To assess in a national sample the ability of GPs to detect psychiatric disorders using a clinical vs. a standardized interview and to characterize the patients that were falsely diagnosed with an anxiety or affective disorder. This is a national, cross-sectional, epidemiological survey, carried out by GPs on a random sample of their patients. The GPs were randomly divided into two groups. Apart from the routine clinical interview, the experimental group (group A) had to administer the Mini-International Neuropsychiatric Interview (MINI). Data was collected by 143 GPs. 17.2% of all patients had a clinical diagnosis of an affective disorder, and 25.4% a clinical diagnosis of an anxiety disorder. In group A, the number of clinical diagnoses was about twice that of MINI diagnoses for affective disorders and one and a half times that for anxiety disorders. The majority of clinical diagnoses were represented by MINI subsyndromal cases (52.3%). Females showed a higher OR of being over-detected by GPs with anxiety disorders or of not being diagnosed with an affective disorder. Being divorced/separated/widowed increased the OR of over-detection of affective and anxiety disorders. The OR of over-detection of an affective or an anxiety disorder was higher for individuals with a moderate to poor quality of life. In the primary care a gap exists between clinical and standardized interviews in the detection of affective and anxiety disorders. Some experiential and social factors can increase this tendency. The use of a psycho.

Family Study of Borderline Personality Disorder and Its Sectors of Psychopathology

PubMed Central

Gunderson, John G.; Zanarini, Mary C.; Choi-Kain, Lois W.; Mitchell, Karen S.; Jang, Kerry L.; Hudson, James I.

2011-01-01

Context The familiality of borderline personality disorder (BPD) and its sectors of psychopathology are incompletely understood. Objectives To assess the familial aggregation of BPD and its 4 major sectors (affective, interpersonal, behavioral, and cognitive) and test whether the relationship of the familial and nonfamilial associations among these sectors can be accounted for by a latent BPD construct. Design Family study, with direct interviews of probands and relatives. Setting A psychiatric hospital (McLean Hospital) and the Boston-area community. Participants A total of 368 probands (132 with BPD, 134 without BPD, and 102 with major depressive disorder) and 885 siblings and parents of probands. Main Assessments The Diagnostic Interview for DSM-IV Personality Disorders and the Revised Diagnostic Interview for Borderlines (DIB-R) were used to assess borderline psychopathology, and the Structured Clinical Interview for DSM-IV was used to assess major depressive disorder. Results Borderline personality disorder meeting both DSM-IV and DIB-R criteria showed substantial familial aggregation for BPD in individuals with a family member with BPD vs those without a family member with BPD, using proband-relative pairs (risk ratio, 2.9; 95% confidence interval, 1.5–5.5) as well as using all pairs of family members (3.9; 1.7–9.0). All 4 sectors of BPD psychopathology aggregated significantly in families, using both DSM-IV and DIB-R definitions (correlation of traits among all pairs of family members ranged from 0.07 to 0.27), with the affective and interpersonal sectors showing the highest levels; however, the level of familial aggregation of BPD was higher than that of the individual sectors. The relationship among the sectors was best explained by a common pathway model in which the sectors represent manifestations of a latent BPD construct. Conclusions Familial factors contribute to BPD and its sectors of psychopathology. Borderline personality disorder may arise from a unitary liability that finds expression in its sectors of psychopathology. PMID:21727257

Family study of borderline personality disorder and its sectors of psychopathology.

PubMed

Gunderson, John G; Zanarini, Mary C; Choi-Kain, Lois W; Mitchell, Karen S; Jang, Kerry L; Hudson, James I

2011-07-01

The familiality of borderline personality disorder (BPD) and its sectors of psychopathology are incompletely understood. To assess the familial aggregation of BPD and its 4 major sectors (affective, interpersonal, behavioral, and cognitive) and test whether the relationship of the familial and nonfamilial associations among these sectors can be accounted for by a latent BPD construct. Family study, with direct interviews of probands and relatives. A psychiatric hospital (McLean Hospital) and the Boston-area community. A total of 368 probands (132 with BPD, 134 without BPD, and 102 with major depressive disorder) and 885 siblings and parents of probands. MAIN ASSESSMENTS: The Diagnostic Interview for DSM-IV Personality Disorders and the Revised Diagnostic Interview for Borderlines (DIB-R) were used to assess borderline psychopathology, and the Structured Clinical Interview for DSM-IV was used to assess major depressive disorder. Borderline personality disorder meeting both DSM-IV and DIB-R criteria showed substantial familial aggregation for BPD in individuals with a family member with BPD vs those without a family member with BPD, using proband-relative pairs (risk ratio, 2.9; 95% confidence interval, 1.5-5.5) as well as using all pairs of family members (3.9; 1.7-9.0). All 4 sectors of BPD psychopathology aggregated significantly in families, using both DSM-IV and DIB-R definitions (correlation of traits among all pairs of family members ranged from 0.07 to 0.27), with the affective and interpersonal sectors showing the highest levels; however, the level of familial aggregation of BPD was higher than that of the individual sectors. The relationship among the sectors was best explained by a common pathway model in which the sectors represent manifestations of a latent BPD construct. Familial factors contribute to BPD and its sectors of psychopathology. Borderline personality disorder may arise from a unitary liability that finds expression in its sectors of psychopathology.

Te Rau Hinengaro: the New Zealand Mental Health Survey: overview of methods and findings.

PubMed

Wells, J Elisabeth; Oakley Browne, Mark A; Scott, Kate M; McGee, Magnus A; Baxter, Joanne; Kokaua, Jesse

2006-10-01

To estimate the prevalence and severity of anxiety, mood, substance and eating disorders in New Zealand, and associated disability and treatment. A nationwide face-to-face household survey of residents aged 16 years and over was undertaken between 2003 and 2004. Lay interviewers administered a computerized fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Oversampling doubled the number of Māori and quadrupled the number of Pacific people. The outcomes reported are demographics, period prevalences, 12 month severity and correlates of disorder, and contact with the health sector, within the past 12 months. The response rate was 73.3%. There were 12,992 participants (2,595 Māori and 2,236 Pacific people). Period prevalences were as follows: 39.5% had met criteria for a DSM-IV mental disorder at any time in their life before interview, 20.7% had experienced disorder within the past 12 months and 11.6% within the past month. In the past 12 months, 4.7% of the population experienced serious disorder, 9.4% moderate disorder and 6.6% mild disorder. A visit for mental health problems was made to the health-care sector in the past 12 months by 58.0% of those with serious disorder, 36.5% with moderate disorder, 18.5% with mild disorder and 5.7% of those not diagnosed with a disorder. The prevalence of disorder and of serious disorder was higher for younger people and people with less education or lower household income. In contrast, these correlates had little relationship to treatment contact, after adjustment for severity. Compared with the composite Others group, Māori and Pacific people had higher prevalences of disorder, unadjusted for sociodemographic correlates, and were less likely to make treatment contact, in relation to need. Mental disorder is common in New Zealand. Many people with current disorder are not receiving treatment, even among those with serious disorder.

Are clinical impressions of adolescent substance use accurate?

PubMed

Wilson, Celeste R; Sherritt, Lon; Gates, Erin; Knight, John R

2004-11-01

To compare providers' impressions of adolescents' level of substance use with diagnostic classifications from a structured diagnostic interview. Secondary analysis of data was conducted from a validation study of the CRAFFT substance abuse screening test of 14- to 18-year-old medical clinic patients (n = 533) and their corresponding medical care providers (n = 109) at an adolescent clinic affiliated with a large tertiary care pediatric hospital. Medical care providers completed a form that recorded their clinical impressions of patients' level of alcohol and drug involvement (none, minimal, problem, abuse, dependence) and demographic characteristics. The form included brief diagnostic descriptions for each level of use. After the medical visit, patients completed the Adolescent Diagnostic Interview (ADI), a structured diagnostic interview that yields diagnoses of abuse and dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). On the basis of their past 12 months of alcohol and drug use on the ADI interview, adolescents were classified into 5 mutually exclusive diagnostic groups. "None" was defined by no reported use of alcohol or drugs during the past year. "Minimal use" was defined as use of alcohol or drugs but no report of any substance-related problems. "Problem use" was defined as reporting 1 or more substance-related problems but no diagnosis of abuse or dependence. "Abuse" was defined by meeting any 1 of 4 DSM-IV diagnostic criteria for either alcohol or drug abuse but no diagnosis of dependence. "Dependence" was defined by meeting any 3 of 7 diagnostic criteria for either alcohol or drug dependence, with or without a diagnosis of abuse. Proportions were compared using Fisher exact test. Agreement was assessed with the weighted kappa, and these analyses were stratified by substance used (ie, alcohol vs drug) and demographic characteristics. Sensitivity, specificity, and positive and negative predictive values were calculated from 2 x 2 tables. Compared with the criterion standard interview, providers identified significantly fewer patients with problem use and abuse and no patients with dependence. Of >100 patients whom the ADI classified with substance problem use, providers correctly identified 18. Of 50 patients who were classified with a diagnosis of alcohol or drug abuse, providers correctly identified 10. Of 36 patients who were classified with a diagnosis of alcohol or drug dependence, providers correctly identified none. For the 86 adolescents who were classified with a substance-related disorder (ie, abuse or dependence), providers' impressions were "none" (24.4%), "minimal use" (50%), "problem use" (15.1%), "abuse" (10.5%), and "dependence" (0%). There was only marginal agreement between providers' impressions and diagnoses related to alcohol use (kappa = .29), drug use (kappa = .31), and any substance use (kappa = .30). Kappa was not significantly affected by the patient's age, but it was by gender. Among boys, kappa was significantly higher for impressions of drug use versus alcohol use (kappa = .48 vs kappa = .27); and, among drug users, kappa was significantly higher among boys compared with girls (kappa = .48 vs kappa = .24). Kappa did not differ significantly across race/ethnicity subgroups, although there is a suggestive trend toward higher agreement for black non-Hispanic compared with white non-Hispanic adolescents (kappa = .35 vs kappa = .21). Kappa did not differ significantly on the basis of the visit type, but the size of this difference (kappa = .36 vs kappa = .24) suggests that the longer well-child visit yielded greater identification of substance-related pathology. Providers' impressions had a sensitivity of .63 for identifying use of alcohol or drugs. However, sensitivity was poor for identification of problem use (.14), abuse (.10), and dependence (0), whereas specificity and positive predictive values were high. Of the 86 adolescents with a diagnosis of abuse or dependence, 75.6% were correctly identified by providers as using substances; however, the level of use in 50% of these adolescents was reported by providers as minimal. In this study, clinical impressions of adolescents' alcohol/drug involvement underestimated substance-related pathology. When providers thought that use was present, there was a very high likelihood that a problem or disorder existed. The use of structured screening devices would likely improve identification of adolescents with substance-related pathology in primary care settings and should be considered for use with all adolescent patients, rather than only those who are perceived to be at higher risk.

Genetic testing: new challenges in the healthcare of women. Interview by Hannah Branch.

PubMed

Hofmann, Wera; Branch, Hannah

2013-11-01

Dr Wera Hofmann is an expert in biochemistry and has over 12 years of human genetic diagnostics experience. Until 2006, she supervised a diagnostic unit for BRCA gene testing at the Interdisciplinary Center for Hereditary Breast Cancer (Max Delbrück Center, Berlin, Germany). She has also been the Managing Director of the Professional Association of German Human Geneticists, BVDH, which is a trade association. In 2008, Hofmann became a Medical Director at LifeCodexx (Konstanz, Germany), where she has worked on the development of a noninvasive prenatal diagnostic test that detects chromosomal aneuploidies in fetuses.

When acute-stage psychosis and substance use co-occur: differentiating substance-induced and primary psychotic disorders.

PubMed

Caton, C L; Samet, S; Hasin, D S

2000-09-01

Substances such as alcohol, cocaine, amphetamine, and cannabis can produce psychotic reactions in individuals who are otherwise free of serious mental illness. However, persons with primary psychotic disorders, such as schizophrenia and bipolar disorder, who use these substances often present for treatment with signs and symptoms similar to those whose psychosis resulted from the use of drugs alone. While it is often difficult to distinguish substance-induced from primary psychoses, especially early in the course of treatment, this differential diagnosis has important implications for treatment planning. To help clinicians distinguish these two types of presentations, the authors first review the types of psychotic symptoms that can co-occur with substance use. They discuss the prevalence and patterns of substance use that have been found in patients with schizophrenia and other primary psychotic disorders and review the negative outcomes associated with substance use in this population. The prevalence of and types of symptoms and problems associated with psychotic symptoms that occur as a result of substance use alone are also reviewed. The authors describe assessment procedures for differentiating substance-induced and primary psychotic disorders. They stress the importance of accurately establishing the temporal relationship between the substance use and the onset and continuation of psychotic symptoms in making a differential diagnosis, as well as the importance of being familiar with the types of psychological symptoms that can occur with specific substances. The authors review the utility and limitations of a number of diagnostic instruments for assessing patients with co-occurring psychosis and substance use problems, including The Addiction Severity Index, The Michigan Alcohol Screening Test, and diagnostic interviews such as the Schedule for Affective Disorders and Schizophrenia and the Structured Clinical Interview for DSM. They then discuss the Psychiatric Research Interview for Substance and Mental Disorders (PRISM), an instrument that has been developed to address the lack of a diagnostic interview that is suitable for assessing the comorbidity of substance use and psychiatric disorders. The article concludes with a discussion of the importance of an appropriate match between diagnosis and treatment and the current state of our knowledge concerning the most appropriate types of treatment interventions for patients with substance-induced psychosis and those with dual diagnoses.

Not the End of the Odyssey: Parental Perceptions of Whole Exome Sequencing (WES) in Pediatric Undiagnosed Disorders.

PubMed

Rosell, Allyn McConkie; Pena, Loren D M; Schoch, Kelly; Spillmann, Rebecca; Sullivan, Jennifer; Hooper, Stephen R; Jiang, Yong-Hui; Mathey-Andrews, Nicolas; Goldstein, David B; Shashi, Vandana

2016-10-01

Due to the lack of empirical information on parental perceptions of primary results of whole exome sequencing (WES), we conducted a retrospective semi-structured interview with 19 parents of children who had undergone WES. Perceptions explored during the interview included factors that would contribute to parental empowerment such as: parental expectations, understanding of the WES and results, utilization of the WES information, and communication of findings to health/educational professionals and family members. Results of the WES had previously been communicated to families within a novel framework of clinical diagnostic categories: 5/19 had Definite diagnoses, 6/19 had Likely diagnoses, 3/19 had Possible diagnosis and 5/19 had No diagnosis. All parents interviewed expressed a sense of duty to pursue the WES in search of a diagnosis; however, their expectations were tempered by previous experiences with negative genetic testing results. Approximately half the parents worried that a primary diagnosis that would be lethal might be identified; however, the hope of a diagnosis outweighed this concern. Parents were accurately able to summarize their child's WES findings, understood the implications for recurrence risks, and were able to communicate these findings to family and medical/educational providers. The majority of those with a Definite/Likely diagnosis felt that their child's medical care was more focused, or there was a reduction in worry, despite the lack of a specific treatment. Irrespective of diagnostic outcome, parents recommended that follow-up visits be built into the process. Several parents expressed a desire to have all variants of unknown significance (VUS) reported to them so that they could investigate these themselves. Finally, for some families whose children had a Definite/Likely diagnosis, there was remaining frustration and a sense of isolation, due to the limited information that was available about the diagnosed rare disorders and the inability to connect to other families, suggesting that for families with rare genetic disorders, the diagnostic odyssey does not necessarily end with a diagnosis. Qualitative interviewing served a meaningful role in eliciting new information about parental motivations, expectations, and knowledge of WES. Our findings highlight a need for continued communication with families as we navigate the new landscape of genomic sequencing.

Obstetric care providers are able to assess psychosocial risks, identify and refer high-risk pregnant women: validation of a short assessment tool - the KINDEX Greek version.

PubMed

Spyridou, Andria; Schauer, Maggie; Ruf-Leuschner, Martina

2015-02-21

Prenatal assessment for psychosocial risk factors and prevention and intervention is scarce and, in most cases, nonexistent in obstetrical care. In this study we aimed to evaluate if the KINDEX, a short instrument developed in Germany, is a useful tool in the hands of non-trained medical staff, in order to identify and refer women in psychosocial risk to the adequate mental health and social services. We also examined the criterion-related concurrent validity of the tool through a validation interview carried out by an expert clinical psychologist. Our final objective was to achieve the cultural adaptation of the KINDEX Greek Version and to offer a valid tool for the psychosocial risk assessment to the obstetric care providers. Two obstetricians and five midwives carried out 93 KINDEX interviews (duration 20 minutes) with pregnant women to assess psychosocial risk factors present during pregnancy. Afterwards they referred women who they identified having two or more psychosocial risk factors to the mental health attention unit of the hospital. During the validation procedure an expert clinical psychologist carried out diagnostic interviews with a randomized subsample of 50 pregnant women based on established diagnostic instruments for stress and psychopathology, like the PSS-14, ESI, PDS, HSCL-25. Significant correlations between the results obtained through the assessment using the KINDEX and the risk areas of stress, psychopathology and trauma load assessed in the validation interview demonstrate the criterion-related concurrent validity of the KINDEX. The referral accuracy of the medical staff is confirmed through comparisons between pregnant women who have and have not been referred to the mental health attention unit. Prenatal screenings for psychosocial risks like the KINDEX are feasible in public health settings in Greece. In addition, validity was confirmed in high correlations between the KINDEX results and the results of the validation interviews. The KINDEX Greek version can be considered a valid tool, which can be used by non-trained medical staff providing obstetrical care to identify high-risk women and refer them to adequate mental health and social services. These kind of assessments are indispensable for the promotion of a healthy family environment and child development.

Prevalence, Persistence, and Sociodemographic Correlates of DSM-IV Disorders in the National Comorbidity Survey Replication Adolescent Supplement

PubMed Central

Kessler, Ronald C.; Avenevoli, Shelli; Costello, E. Jane; Georgiades, Katholiki; Green, Jennifer Greif; Gruber, Michael J.; He, Jian-ping; Koretz, Doreen; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen Ries

2012-01-01

Context Community epidemiological data on the prevalence and correlates of adolescent mental disorders are needed for policy planning purposes. Only limited data of this sort are available. Objective To present estimates of 12-month and 30-day prevalence, persistence (12-month prevalence among lifetime cases and 30-day prevalence among 12-month cases), and sociodemographic correlates of commonly occurring DSM-IV disorders among adolescents in the National Comorbidity Survey Replication Adolescent Supplement. Design The National Comorbidity Survey Replication Adolescent Supplement is a US national survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents based on face-to-face interviews in the homes of respondents with supplemental parent questionnaires. Setting Dual-frame household and school samples of US adolescents. Participants A total of 10 148 adolescents aged 13 to 17 years (interviews) and 1 parent of each adolescent (questionnaires). Main Outcome Measures The DSM-IV disorders assessed with the World Health Organization Composite International Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Good concordance (area under the receiver operating characteristic curve ≥0.80) was found between Composite International Diagnostic Interview and Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses. Results The prevalence estimates of any DSM-IV disorder are 40.3% at 12 months (79.5% of lifetime cases) and 23.4% at 30 days (57.9% of 12-month cases). Anxiety disorders are the most common class of disorders, followed by behavior, mood, and substance disorders. Although relative disorder prevalence is quite stable over time, 30-day to 12-month prevalence ratios are higher for anxiety and behavior disorders than mood or substance disorders, suggesting that the former are more chronic than the latter. The 30-day to 12-month prevalence ratios are generally lower than the 12-month to lifetime ratios, suggesting that disorder persistence is due more to episode recurrence than to chronicity. Sociodemographic correlates are largely consistent with previous studies. Conclusions Among US adolescents, DSM-IV disorders are highly prevalent and persistent. Persistence is higher for adolescents than among adults and appears to be due more to recurrence than chronicity of childadolescent onset disorders. PMID:22147808

Major Depressive Disorder with Sub-threshold Bipolarity in the National Comorbidity Survey Replication

PubMed Central

Angst, Jules; Cui, Lihong; Swendsen, J. Joel; Rothen, S.; Cravchik, Anibal; Kessler, Ronald; Merikangas, Kathleen

2011-01-01

Objectives There is growing clinical and epidemiologic evidence indicating that major mood disorders form a spectrum from Major Depressive Disorder (MDD) to pure mania. The present investigation examined the prevalence and clinical correlates of MDD with sub-threshold bipolarity vs. pure MDD in the National Comorbidity Survey Replication (NCS-R). Methods The NCS-R is a nationally representative face-to-face household survey of the U.S. population conducted between February, 2001 and April, 2003. Lifetime history of mood disorders, symptoms and clinical indicators of severity were collected using version 3.0 of the WHO Composite International Diagnostic Interview, a fully structured lay-administered diagnostic interview. Results Nearly 40% of study participants with a history of major depressive disorder had a history of sub-threshold hypomania. This subgroup had a younger age of disorder onset, more episodes of depression, and higher rates of comorbidity than those without a history of hypomania, and lower levels of clinical severity than those with bipolar II disorder. Conclusions The findings demonstrate heterogeneity of major depressive disorder and support the validity of inclusion of sub-threshold mania in the diagnostic classification. The broadening of criteria for bipolar disorder would have important implications for research and clinical practice. PMID:20713498

Childhood and Current Autistic Features in Adolescents with Schizotypal Personality Disorder

PubMed Central

Esterberg, Michelle L.; Trotman, Hanan D.; Brasfield, Joy L.; Compton, Michael T.; Walker, Elaine F.

2008-01-01

The diagnostic boundaries between autistic- and schizophrenia-spectrum disorders have varied over the years, and some overlap in diagnostic criteria persists. The present study examined childhood and current signs of autistic disorder (AD) in adolescents with schizotypal personality disorder (SPD) or other personality disorders, as well as healthy controls. A structured interview was administered to rate participants’ current symptoms. Participants’ guardians were interviewed with the Autism Diagnostic Inventory-Revised (ADI-R), a clinical assessment of childhood and current autistic signs. Compared to both the other personality-disordered and healthy groups, adolescents with SPD were rated as having significantly more impairment on childhood and current social functioning, and having more unusual interests and behaviors. For the entire sample, impaired childhood social functioning and unusual interests and behaviors were associated with higher negative symptom scores. Current impairments in social functioning, unusual interests and behaviors, and communication were also linked with greater negative symptoms. However, neither childhood nor current autistic features significantly predicted later conversion to an Axis I psychotic disorder over the course of three years of follow-up. The findings indicate that past and current autistic signs are more common in adolescents with SPD, but neither current nor childhood autistic features are linked with conversion to psychosis. PMID:18554872

Comorbid mental disorders among the patients with alcohol abuse and dependence in Korea.

PubMed Central

Cho, Maeng Je; Hahm, Bong-Jin; Suh, Tongwoo; Suh, Guk-Hee; Cho, Seong-Jin; Lee, Chung Kyoon

2002-01-01

This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pathological gambling. Male alcoholics had a tendency to begin with tobacco dependence, and some male pathological gamblers first had alcohol disorders. The presence of comorbid psychiatric disorders was associated with a more severe form and the later onset of alcohol disorders, and associated with help-seeking for alcohol abuse/dependence. PMID:11961310

Depressive disorder among Turkish women in the Netherlands: a qualitative study of idioms of distress.

PubMed

Borra, Ria

2011-11-01

The provision of mental health services to immigrants in the Netherlands is hampered by difficulty in establishing valid diagnoses of psychiatric disorders. To improve the process of diagnosing depressive disorder among Turkish women in Dutch mental healthcare, we conducted a qualitative study of women with depression in Rotterdam. A bilingual Turkish-Dutch diagnostic interview was developed to explore Turkish women's idioms of distress. Interviews were conducted with 20 women with a disputed diagnosis of depression. Results showed that distress among the Turkish women was characterized by a wide range of somatic complaints, with anxiety and agitation occurring as frequently as depressive complaints. Because the range of complaints is so varied, major depression may be underdiagnosed in the Turkish immigrant population.

Does the Cultural Formulation Interview for the fifth revision of the diagnostic and statistical manual of mental disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site.

PubMed

Aggarwal, Neil K; Desilva, Ravi; Nicasio, Andel V; Boiler, Marit; Lewis-Fernández, Roberto

2015-01-01

Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n = 64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Despite racial, ethnical, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient's perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but two codes fell under the implementation outcome of clinical utility, two fell under acceptability, and none fell under feasibility. Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes such as medication adherence, appointment retention, and health condition.

Does the Cultural Formulation Interview (CFI) for the Fifth Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site

PubMed Central

Aggarwal, Neil K.; DeSilva, Ravi; Nicasio, Andel V.; Boiler, Marit; Lewis-Fernández, Roberto

2014-01-01

Objectives Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. Design We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n=64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Results Despite racial, ethnic, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient’s perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but 2 codes fell under the implementation outcome of clinical utility, 2 fell under acceptability, and none fell under feasibility. Conclusion Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes such as medication adherence, appointment retention, and health condition. PMID:25372242

Prenatal Alcohol Exposure Is Associated with Conduct Disorder in Adolescence: Findings from a Birth Cohort

PubMed Central

Larkby, Cynthia A.; Goldschmidt, Lidush; Hanusa, Barbara H.; Day, Nancy L.

2010-01-01

Objective To evaluate the association between prenatal alcohol exposure and the rate of Conduct Disorder in exposed compared to unexposed adolescents. Method Data for these analyses are from a longitudinal study of prenatal substance exposures. Women were interviewed at their 4th and 7th prenatal months, and with their children, at birth, 8 and 18 months, 3, 6, 10, 14, and 16 years postpartum. Offspring were interviewed with the Diagnostic Interview Schedule-IV; maternal and adolescent diagnoses were made using DSM-IV criteria at age 16. The sample was 592 adolescents and their mothers/caretakers. Results Prenatal alcohol exposure is significantly associated with an increased rate of Conduct Disorder in the adolescents. This effect was detected above an average exposure of 1 or more drinks/day in the first trimester. The effect remained significant after controlling for other significant variables including measures of the environment, maternal psychopathology, and other prenatal exposures. Conclusion Prenatal alcohol use in the first trimester is a risk factor for Conduct Disorder in the exposed offspring. PMID:21334566

The effect of migration to the United States on substance use disorders among returned Mexican migrants and families of migrants.

PubMed

Borges, Guilherme; Medina-Mora, Maria Elena; Breslau, Joshua; Aguilar-Gaxiola, Sergio

2007-10-01

We examined the association between substance use disorders and migration to the United States in a nationally representative sample of the Mexican population. We used the World Mental Health version of the Composite International Diagnostic Interview to conduct structured, computer-assisted, face-to-face interviews with a cross-sectional sample of household residents aged 18 to 65 years who lived in Mexico in cities with a population of at least 2500 people in 2001 and 2002. The response rate was 76.6%, with 5826 respondents interviewed. Respondents who had migrated to the United States and respondents who had family members who migrated in the United States were more likely to have used alcohol, marijuana, or cocaine at least once in their lifetime; to develop a substance use disorder; and to have a current (in the past 12 months) substance use disorder than were other Mexicans. International migration appears to play a large role in transforming substance use norms and pathology in Mexico. Future studies should examine how networks extending over international boundaries influence substance use.

[Prevalence and Comorbidity of Self-Reported Diagnosis of Burnout Syndrome in the General Population - Results of the German Health Interview and Examination Survey for Adults (DEGS1)].

PubMed

Maske, Ulrike E; Riedel-Heller, Steffi G; Seiffert, Ingeburg; Jacobi, Frank; Hapke, Ulfert

2016-01-01

Objective: To determine the prevalence and comorbid mental disorders of self-reported diagnosis of burnout syndrome in the general population of Germany. Methods: In the German Health Interview and Examination Survey (DEGS1) self-reported diagnosis of a burnout syndrome made by a physician or psychotherapist was assessed in a standardized interview (N = 7987). For N = 4483 mental disorders were determined with the Composite International Diagnostic Interview (CIDI). Weighted lifetime and 12-month prevalences were calculated. Results: Lifetime prevalence of diagnosed burnout syndrome was 4.2 % (women 5.2 %, men 3.3 %), 12-month prevalence was 1.5 % (women 1.9 %, men 1.1 %). Highest prevalences were found in 40 - 59 year olds, in people with middle and high socio-economic status and in women with low and men with high social support. Among the 12-month cases, 70.9 % had at least one DSM-IV disorder. Associations were found for the diagnosis of burnout syndrome with somatoform, affective and anxiety disorders. Conclusion: The diagnosis of burnout syndrome is less frequently given and reported than expected. People with a burnout diagnosis often have a manifest mental disorder. © Georg Thieme Verlag KG Stuttgart · New York.

Interviews with children about their mental health problems: The congruence and validity of information that children report.

PubMed

Macleod, Emily; Woolford, June; Hobbs, Linda; Gross, Julien; Hayne, Harlene; Patterson, Tess

2017-04-01

To obtain a child's perspective during a mental health assessment, he or she is usually interviewed. Although researchers and clinicians generally agree that it is beneficial to hear a child's account of his or her presenting issues, there is debate about whether children provide reliable or valid clinical information during these interviews. Here, we examined whether children provide clinically and diagnostically relevant information in a clinical setting. In all, 31 children aged 5-12-years undergoing mental health assessments were asked open-ended questions about their presenting problems during a semi-structured interview. We coded the information that children reported to determine whether it was clinically relevant and could be used to diagnose their problems and to formulate and plan treatment. We also coded children's information to determine whether it was congruent with the children's presenting problems and their eventual clinical diagnoses. Most of the information that children reported was clinically relevant and included information about behaviour, affect, temporal details, thoughts, people, the environment, and the child's physical experiences. The information that children reported was also clinically valid; it was congruent with the problems that were discussed (84%) and also with the eventual diagnosis that the child received after a complete assessment (74%). We conclude that children can contribute relevant, clinically useful, valid information during clinical psychological assessments.

The relationship between temperament and character in conversion disorder and comorbid depression.

PubMed

Erten, Evrim; Yenilmez, Yelda; Fistikci, Nurhan; Saatcioglu, Omer

2013-05-01

The aim of this study was to compare conversion disorder patients with healthy controls in terms of temperament and character, and to determine the effect of these characteristics on comorbid depression, based on the idea that conversion disorder patients may have distinctive temperament and character qualities. The study involved 58 patients diagnosed with conversion disorder, based on the DSM-IV diagnostic criteria, under observation at the Bakırköy Psychiatric and Neurological Disorders Outpatient Center, Istanbul. The patients were interviewed with a Structured Clinical Interview (SCID-I) and 57 healthy volunteers, matched for age, sex and education level, were interviewed with a Structured Clinical Interview for people without a psychiatric disorder (SCID-I/NP). All the participants completed a sociodemographic form, the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Temperament and Character Inventory. The conversion disorder patients displayed more harm avoidance (P<.001), more impulsivity (P<.01) and more sentimentality (P<.01) than the healthy controls, but were less persistent (P<.05). In terms of character qualities, conversion disorder patients had high self-transcendence (P<.05), but were inadequate in terms of self-directedness (P<.001) and took on less responsibility (P<.05) than the healthy controls. Conversion disorder patients are significantly different from healthy controls on temperament and character measures of harm avoidance, persistence, self-transcendence and self-directedness. Copyright © 2013 Elsevier Inc. All rights reserved.

Stressful Life Events Predict Eating Disorder Relapse Following Remission: Six-Year Prospective Outcomes

PubMed Central

Grilo, Carlos M.; Pagano, Maria E.; Stout, Robert L.; Markowitz, John C.; Ansell, Emily B.; Pinto, Anthony; Zanarini, Mary C.; Yen, Shirley; Skodol, Andrew E.

2012-01-01

Objective To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not-otherwise-specified (EDNOS) and test for the effects of stressful life events (SLE) on relapse after remission from these eating disorders. Method 117 female patients with BN (N = 35) or EDNOS (N = 82) were prospectively followed for 72 months using structured interviews performed at baseline, 6- and 12-months, and then yearly thereafter. ED were assessed with the structured clinical interview for DSM-IV, and monitored over time with the longitudinal interval follow-up evaluation. Personality disorders were assessed with the diagnostic interview for DSM-IV-personality-disorders, and monitored over time with the follow-along-version. The occurrence and specific timing of SLE were assessed with the life events assessment interview. Cox proportional-hazard-regression-analyses tested associations between time-varying levels of SLE and ED relapse, controlling for comorbid psychiatric disorders, ED duration, and time-varying personality-disorder status. Results ED relapse probability was 43%; BN and EDNOS did not differ in time to relapse. Negative SLE significantly predicted ED relapse; elevated work and social stressors were significant predictors. Psychiatric comorbidity, ED duration, and time-varying personality-disorder status were not significant predictors. Discussion Higher work and social stress represent significant warning signs for triggering relapse for women with remitted BN and EDNOS. PMID:21448971

Increased access to care and appropriateness of treatment at private sector drug shops with integrated management of malaria, pneumonia and diarrhoea: a quasi-experimental study in Uganda.

PubMed

Awor, Phyllis; Wamani, Henry; Tylleskar, Thorkild; Jagoe, George; Peterson, Stefan

2014-01-01

Drug shops are a major source of care for children in low income countries but they provide sub-standard care. We assessed the feasibility and effect on quality of care of introducing diagnostics and pre-packaged paediatric-dosage drugs for malaria, pneumonia and diarrhoea at drug shops in Uganda. We adopted and implemented the integrated community case management (iCCM) intervention within registered drug shops. Attendants were trained to perform malaria rapid diagnostic tests (RDTs) in each fever case and count respiratory rate in each case of cough with fast/difficult breathing, before dispensing recommended treatment. Using a quasi-experimental design in one intervention and one non-intervention district, we conducted before and after exit interviews for drug seller practices and household surveys for treatment-seeking practices in May-June 2011 and May-June 2012. Survey adjusted generalized linear models and difference-in-difference analysis was used. 3759 (1604 before/2155 after) household interviews and 943 (163 before/780 after) exit interviews were conducted with caretakers of children under-5. At baseline, no child at a drug shop received any diagnostic testing before treatment in both districts. After the intervention, while no child in the non-intervention district received a diagnostic test, 87.7% (95% CI 79.0-96.4) of children with fever at the intervention district drug shops had a parasitological diagnosis of malaria, prior to treatment. The prevalence ratios of the effect of the intervention on treatment of cough and fast breathing with amoxicillin and diarrhoea with ORS/zinc at the drug shop were 2.8 (2.0-3.9), and 12.8 (4.2-38.6) respectively. From the household survey, the prevalence ratio of the intervention effect on use of RDTs was 3.2 (1.9-5.4); Artemisinin Combination Therapy for malaria was 0.74 (0.65-0.84), and ORS/zinc for diarrhoea was 2.3 (1.2-4.7). iCCM can be utilized to improve access and appropriateness of care for children at drug shops.

An electronic screen for triaging adolescent substance use by risk levels.

PubMed

Levy, Sharon; Weiss, Roger; Sherritt, Lon; Ziemnik, Rosemary; Spalding, Allegra; Van Hook, Shari; Shrier, Lydia A

2014-09-01

Screening adolescents for substance use and intervening immediately can reduce the burden of addiction and substance-related morbidity. Several screening tools have been developed to identify problem substance use for adolescents, but none have been calibrated to triage adolescents into clinically relevant risk categories to guide interventions. To describe the psychometric properties of an electronic screen and brief assessment tool that triages adolescents into 4 actionable categories regarding their experience with nontobacco substance use. Adolescent patients (age range, 12-17 years) arriving for routine medical care at 2 outpatient primary care centers and 1 outpatient center for substance use treatment at a pediatric hospital completed an electronic screening tool from June 1, 2012, through March 31, 2013, that consisted of a question on the frequency of using 8 types of drugs in the past year (Screening to Brief Intervention). Additional questions assessed severity of any past-year substance use. Patients completed a structured diagnostic interview (Composite International Diagnostic Interview-Substance Abuse Module), yielding Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) substance use diagnoses. For the entire screen and the Screening to Brief Intervention, sensitivity and specificity for identifying nontobacco substance use, substance use disorders, severe substance use disorders, and tobacco dependence were calculated using the Composite International Diagnostic Interview-Substance Abuse Module as the criterion standard. Of 340 patients invited to participate, 216 (63.5%) enrolled in the study. Sensitivity and specificity were 100% and 84% (95% CI, 76%-89%) for identifying nontobacco substance use, 90% (95% CI, 77%-96%) and 94% (95% CI, 89%-96%) for substance use disorders, 100% and 94% (95% CI, 90%-96%) for severe substance use disorders, and 75% (95% CI, 52%-89%) and 98% (95% CI, 95%-100%) for nicotine dependence. No significant differences were found in sensitivity or specificity between the full tool and the Screening to Brief Intervention. A single screening question assessing past-year frequency use for 8 commonly misused categories of substances appears to be a valid method for discriminating among clinically relevant risk categories of adolescent substance use.

The reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a German general practice population sample.

PubMed

Dybek, Inga; Bischof, Gallus; Grothues, Janina; Reinhardt, Susa; Meyer, Christian; Hapke, Ulfert; John, Ulrich; Broocks, Andreas; Hohagen, Fritz; Rumpf, Hans-Jürgen

2006-05-01

Our goal was to analyze the retest reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a primary-care setting and recommend a cut-off value for the different alcohol-related diagnoses. Participants recruited from general practices (GPs) in two northern German cities received the AUDIT, which was embedded in a health-risk questionnaire. In total, 10,803 screenings were conducted. The retest reliability was tested on a subsample of 99 patients, with an intertest interval of 30 days. Sensitivity and specificity at a number of different cut-off values were estimated for the sample of alcohol consumers (n=8237). For this study, 1109 screen-positive patients received a diagnostic interview. Individuals who scored less than five points in the AUDIT and also tested negative in a second alcohol-related screen were defined as "negative" (n=6003). This definition was supported by diagnostic interviews of 99 screen-negative patients from which no false negatives could be detected. As the gold standard for detection of an alcohol-use disorder (AUD), we used the Munich-Composite International Diagnostic Interview (MCIDI), which is based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. On the item level, the reliability, measured by the intraclass correlation coefficient (ICC), ranged between .39 (Item 9) and .98 (Item 10). For the total score, the ICC was .95. For cut-off values of eight points and five points, 87.5% and 88.9%, respectively, of the AUDIT-positives, and 98.9% and 95.1%, respectively, of the AUDIT-negatives were identically identified at retest, with kappa = .86 and kappa = .81. At the cut-off value of five points, we determined good combinations of sensitivity and specificity for the following diagnoses: alcohol dependence (sensitivity and specificity of .97 and .88, respectively), AUD (.97 and .92), and AUD and/or at-risk consumption (.97 and .91). Embedded in a health-risk questionnaire in primary-care settings, the AUDIT is a reliable and valid screening instrument to identify at-risk drinkers and patients with an AUD. Our findings strongly suggest a lowering of the recommended cut-off value of eight points.

Diagnostic accuracy for major depression in multiple sclerosis using self-report questionnaires

PubMed Central

Fischer, Anja; Fischer, Marcus; Nicholls, Robert A; Lau, Stephanie; Poettgen, Jana; Patas, Kostas; Heesen, Christoph; Gold, Stefan M

2015-01-01

Objective Multiple sclerosis and major depressive disorder frequently co-occur but depression often remains undiagnosed in this population. Self-rated depression questionnaires are a good option where clinician-based standardized diagnostics are not feasible. However, there is a paucity of data on diagnostic accuracy of self-report measures for depression in multiple sclerosis (MS). Moreover, head-to-head comparisons of common questionnaires are largely lacking. This could be particularly relevant for high-risk patients with depressive symptoms. Here, we compare the diagnostic accuracy of the Beck Depression Inventory (BDI) and 30-item version of the Inventory of Depressive Symptomatology Self-Rated (IDS-SR30) for major depressive disorder (MSS) against diagnosis by a structured clinical interview. Methods Patients reporting depressive symptoms completed the BDI, the IDS-SR30 and underwent diagnostic assessment (Mini International Neuropsychiatric Interview, M.I.N.I.). Receiver-Operating Characteristic analyses were performed, providing error estimates and false-positive/negative rates of suggested thresholds. Results Data from n = 31 MS patients were available. BDI and IDS-SR30 total score were significantly correlated (r = 0.82). The IDS-SR30total score, cognitive subscore, and BDI showed excellent to good accuracy (area under the curve (AUC) 0.86, 0.91, and 0.85, respectively). Conclusion Both the IDS-SR30 and the BDI are useful to quantify depressive symptoms showing good sensitivity and specificity. The IDS-SR30 cognitive subscale may be useful as a screening tool and to quantify affective/cognitive depressive symptomatology. PMID:26445703

Comorbidity of Enuresis in Children with Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Ghanizadeh, Ahmad

2010-01-01

Objective: To compare parental psychopathology and psychiatric disorders in ADHD children with and those without enuresis. Method: The participants of the clinical sample interviewed according to "DSM-IV" diagnostic criteria were 35 children with ADHD and enuresis, 153 ADHD children without enuresis, 115 fathers, and 172 mothers. Results: Only ODD…

Threat Related Selective Attention Predicts Treatment Success in Childhood Anxiety Disorders

ERIC Educational Resources Information Center

Legerstee, Jeroen S.; Tulen, Joke H. M.; Kallen, Victor L.; Dieleman, Gwen C.; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

2009-01-01

Threat-related selective attention was found to predict the success of the treatment of childhood anxiety disorders through administering a pictorial dot-probe task to 131 children with anxiety disorders prior to cognitive behavioral therapy. The diagnostic status of the subjects was evaluated with a semistructured clinical interview at both pre-…

"Something Is Wrong with My Child": A Phenomenological Account of a Search for a Diagnosis.

ERIC Educational Resources Information Center

Ahern, Kathy

2000-01-01

Notes children with movement difficulties do not receive neat diagnostic classification, as they have normal intelligence and minimal neurological signs. Details a study based on interviews of 11 parents of children with movement difficulties that revealed that parent involvement and knowledge is critical to acquiring professional attention.…

Association between history of abuse and borderline personality disorder for hospitalized adolescent girls.

PubMed

Atlas, J A

1995-12-01

Records of 38 hospitalized female adolescents were analyzed to evaluate the relationship between a history of earlier physical and/or sexual abuse and borderline personality. Those with histories of abuse were significantly more likely to score as Borderline Personality Disorder when assessed by the Diagnostic Interview for Borderlines--Revised.

Translating Research for Professional Development and Effective Clinical Practice with Older Adults

ERIC Educational Resources Information Center

Steffen, Ann M.

2012-01-01

This paper offers a commentary on the articles in the special series on cognitive behavior therapy with older adults (Carmin, 2012-this issue), noting the commonalities found across discussions of diagnostic interviewing and cognitive-behavioral assessment and treatment for late-life insomnia, depression and suicide risk, PTSD, and OCD. These case…

Establishing Ongoing, Early Identification Programs for Mental Health Problems in Our Schools: A Feasibility Study

ERIC Educational Resources Information Center

Nemeroff, Robin; Levitt, Jessica Mass; Faul, Lisa; Wonpat-Borja, Ahtoy; Bufferd, Sara; Setterberg, Stephen; Jensen, Peter S.

2008-01-01

The study evaluates the feasibility and effectiveness of several mental health screening and assessment tools in schools. A computerized version of the Diagnostic Interview Schedule for Children-IV proved to be feasible bridging the gap between mental health providers and unmet need of children accompanying risks.

Comorbidity and Phenomenology of Bipolar Disorder in Children with ADHD

ERIC Educational Resources Information Center

Serrano, Eduardo; Ezpeleta, Lourdes; Castro-Fornieles, Josefina

2013-01-01

Objective: To assess the comorbidity of bipolar disorder (BPD) in children with ADHD and to study the psychopathological profile of ADHD children with and without mania. Method: A total of 100 children with ADHD were assessed with a semistructured diagnostic interview and questionnaires of mania, ADHD, and general psychopathology. Results: 8% of…

Interviewing Children versus Tossing Coins: Accurately Assessing the Diagnosticity of Children's Disclosures of Abuse

ERIC Educational Resources Information Center

Lyon, Thomas D.; Ahern, Elizabeth C.; Scurich, Nicholas

2012-01-01

We describe a Bayesian approach to evaluating children's abuse disclosures and review research demonstrating that children's disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children's age. We discuss how some commentators understate the probative value of…

Enhanced Case Management versus Substance Abuse Treatment Alone among Substance Abusers with Depression

ERIC Educational Resources Information Center

Striley, Catherine W.; Nattala, Prasanthi; Ben Abdallah, Arbi; Dennis, Michael L.; Cottler, Linda B.

2013-01-01

This pilot study evaluated the effectiveness of enhanced case management for substance abusers with comorbid major depression, which was an integrated approach to care. One hundred and 20 participants admitted to drug treatment who also met Computerized Diagnostic Interview Schedule criteria for major depression at baseline were randomized to…

Psychiatric Comorbidity among Children with Gender Identity Disorder

ERIC Educational Resources Information Center

Wallien, Madeleine S.C.; Swaab, Hanna; Cohen-Kettenis, Peggy T.

2007-01-01

Objective: To investigate the prevalence and type of comorbidity in children with gender identity disorder (GID). Method: The Diagnostic Interview Schedule for Children--Parent Version was used to assess psychopathology according to the DSM in two groups of children. The first group consisted of 120 Dutch children (age range 4-11 years) who were…

Identification of Alcohol Disorders at a University Mental Health Centre, Using the CAGE.

ERIC Educational Resources Information Center

Ross, Helen E.; Tisdall, Gordon W.

1994-01-01

Examined usefulness of CAGE in screening for alcohol use disorders in university students (n=110) attending campus psychiatric health service. Fourteen students were identified as having current alcohol use disorder by means of Computerized Diagnostic Interview Schedule. Results suggest that CAGE is able in this population to detect usually mild…

Identification of Genetic Loci Underlying the Phenotypic Constructs of Autism Spectrum Disorders

ERIC Educational Resources Information Center

Liu, Xiao-Qing; Georgiades, Stelios; Duku, Eric; Thompson, Ann; Devlin, Bernie; Cook, Edwin H.; Wijsman, Ellen M.; Paterson, Andrew D.; Szatmari, Peter

2011-01-01

Objective: To investigate the underlying phenotypic constructs in autism spectrum disorders (ASD) and to identify genetic loci that are linked to these empirically derived factors. Method: Exploratory factor analysis was applied to two datasets with 28 selected Autism Diagnostic Interview-Revised (ADI-R) algorithm items. The first dataset was from…

Preschoolers' Observed Temperament and Psychiatric Disorders Assessed with a Parent Diagnostic Interview

ERIC Educational Resources Information Center

Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Dyson, Margaret; Olino, Thomas M.; Durbin, C. Emily; Klein, Daniel N.

2011-01-01

Evidence supports the role of temperament in the origins of psychiatric disorders. However, there are few data on associations between temperament and psychiatric disorders in early childhood. A community sample of 541 three-year-old preschoolers participated in a laboratory temperament assessment, and caregivers were administered a structured…

Correlations between the BDI and CES-D in a Sample of Adolescent Mothers.

ERIC Educational Resources Information Center

Wilcox, Holly; Field, Tiffany; Prodromidis, Margarita; Scafidi, Frank

1998-01-01

The adequacy of the Beck Depression Inventory (BDI) and Center for Epidemiological Studies-Depression (CES-D) as screening instruments for adolescent depression is examined. Both are correlated with the Diagnostic Interview Schedule for Children, a clinical measure. BDI correlates more highly with Major Depression subscale, CES-D to Dysthymia…

Working Models of Attachment in Psychiatrically Hospitalized Adolescents: Relation to Psychopathology and Personality.

ERIC Educational Resources Information Center

Rosenstein, Diana S.; Horowitz, Harvey A.

This study examined the role of attachment in adolescent psychopathology among psychiatrically hospitalized adolescents. Subjects consisted of 60 adolescents and 27 of their mothers. Measures included the Adult Attachment Interview classification for both the adolescents and their mothers, and a battery of diagnostic and personality assessment of…

Greek Young Adults with Specific Learning Disabilities Seeking Learning Assessments

ERIC Educational Resources Information Center

Bonti, Eleni; Bampalou, Christina E.; Kouimtzi, Eleni M.; Kyritsis, Zacharias

2018-01-01

The purpose of this study is to investigate the reasons why Greek young adults with Specific Learning Disabilities (SLD) seek learning assessments. The study sample consisted of 106 adults meeting Diagnostic and Statistical Manual of Mental Disorders criteria for SLD. Data were collected through self-report records (clinical interview) of adults…

Pre-Sleep Arousal and Sleep Problems of Anxiety-Disordered Youth

ERIC Educational Resources Information Center

Alfano, Candice A.; Pina, Armando A.; Zerr, Argero A.; Villalta, Ian K.

2010-01-01

The current study examined sleep problems and pre-sleep arousal among 52 anxious children and adolescents, aged 7-14 years, in relation to age, sex, ethnicity, and primary anxiety disorder. Assessment included structured diagnostic interviews and parent and child completed measures of sleep problems and pre-sleep arousal. Overall, 85% of parents…

Investigating the Structure of the Restricted, Repetitive Behaviours and Interests Domain of Autism

ERIC Educational Resources Information Center

Szatmari, Peter; Georgiades, Stelios; Bryson, Susan; Zwaigenbaum, Lonnie; Roberts, Wendy; Mahoney, William; Goldberg, Jeremy; Tuff, Lawrence

2006-01-01

Background: The Restricted, Repetitive Behaviours and Interests (RRBIs) are represented in the DSM-IV and measured by the Autism Diagnostic Interview-Revised (ADI-R) as one of the three homogeneous symptom categories of Pervasive Developmental Disorders. Although this conceptualisation is well accepted in the field, the grouping of symptoms is…

Measurement Equivalence of the Autism Symptom Phenotype in Children and Youth

ERIC Educational Resources Information Center

Duku, Eric; Szatmari, Peter; Vaillancourt, Tracy; Georgiades, Stelios; Thompson, Ann; Liu, Xiao-Qing; Paterson, Andrew D.; Bennett, Terry

2013-01-01

Background: The Autism Diagnostic Interview-Revised (ADI-R) is a gold standard assessment of Autism Spectrum Disorder (ASD) symptoms and behaviours. A key underlying assumption of studies using the ADI-R is that it measures the same phenotypic constructs across different populations (i.e. males/females, younger/older, verbal/nonverbal). The…

The Structured Clinical Interview for DSM-5 Internet Gaming Disorder: Development and Validation for Diagnosing IGD in Adolescents

PubMed Central

Koo, Hoon Jung; Han, Doug Hyun; Park, Sung-Yong

2017-01-01

Objective This study aimed to develop and validate a Structured Clinical Interview for Internet Gaming Disorder (SCI-IGD) in adolescents. Methods First, we generated preliminary items of the SCI-IGD based on the information from the DSM-5 literature reviews and expert consultations. Next, a total of 236 adolescents, from both community and clinical settings, were recruited to evaluate the psychometric properties of the SCI-IGD. Results First, the SCI-IGD was found to be consistent over the time period of about one month. Second, diagnostic concordances between the SCI-IGD and clinician's diagnostic impression were good to excellent. The Likelihood Ratio Positive and the Likelihood Ratio Negative estimates for the diagnosis of SCI-IGD were 10.93 and 0.35, respectively, indicating that SCI-IGD was ‘very useful test’ for identifying the presence of IGD and ‘useful test’ for identifying the absence of IGD. Third, SCI-IGD could identify disordered gamers from non-disordered gamers. Conclusion The implications and limitations of the study are also discussed. PMID:28096871

Family Functioning and Parental Bonding During Childhood in Adults Diagnosed With ADHD.

PubMed

Montejo, José E; Durán, Mariona; Del Mar Martínez, María; Hilari, Ainoa; Roncalli, Nicoletta; Vilaregut, Anna; Corrales, Montserrat; Nogueira, Mariana; Casas, Miguel; Linares, Juan Luis; Ramos-Quiroga, J Antoni

2015-08-24

This work assesses family functioning, parental bonding, and the relationship between the two in adults diagnosed with ADHD. The study used a retrospective, ex post facto design and consisted of 100 adult participants, who were distributed into two groups: with and without diagnosis of ADHD. Two family assessment instruments were applied: the Family Adaptability and Cohesion Evaluation Scale short spanish version (FACES-20esp)) and the Parental Bonding Instrument (PBI). The diagnosis of ADHD was done by using a semistructured interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria (Conners' Adult ADHD Diagnostic Interview for DSM-IV [CAADID]). The results showed that higher rigidity and lower emotional connection were significantly associated with ADHD family functioning. Regarding parental bonding, the results showed significant differences only in the care dimension, with the ADHD group reporting lower care than the control group. The results suggest that ADHD families present dysfunctional family functioning with a rigid, separated typology, and parental bonding based on control without affection. © 2015 SAGE Publications.

Mental Health Needs and Service Utilization by Hispanic Immigrants Residing in Mid-Southern United States

PubMed Central

Bridges, Ana J.; Andrews, Arthur R.; Deen, Tisha L.

2014-01-01

Purpose This study assessed mental health needs and service utilization patterns in a convenience sample of Hispanic immigrants. Design and Method A total of 84 adult Hispanic participants completed a structured diagnostic interview and a semistructured service utilization interview with trained bilingual research assistants. Results In the sample, 36% met diagnostic criteria for at least one mental disorder. Although 42% of the sample saw a physician in the prior year, mental health services were being rendered primarily by religious leaders. The most common barriers to service utilization were cost (59%), lack of health insurance (35%), and language (31%). Although more women than men met criteria for a disorder, service utilization rates were comparable. Participants with a mental disorder were significantly more likely to have sought medical, but not psychiatric, services in the prior year and faced significantly more cost barriers than participants without a mental disorder. Conclusions Findings suggest that Hispanic immigrants, particularly those with a mental illness, need to access services but face numerous systemic barriers. The authors recommend specific ways to make services more affordable and linguistically accessible. PMID:22802297

Anxiety and depression following cumulative low-level exposure to organophosphate pesticides.

PubMed

Harrison, Virginia; Mackenzie Ross, Sarah

2016-11-01

Previous research suggests that individuals with a prior history of pesticide poisoning are at increased risk of psychiatric disorder (Freire and Koifman, 2013), but findings regarding the impact of cumulative low-level exposure are inconsistent. The aim of the current study was to investigate whether sheep farmers with a history of low-level exposure to organophosphate pesticides (1) report a higher level of psychological distress on subjective symptom questionnaires, compared to unexposed controls (2) also meet internationally agreed diagnostic criteria for a psychiatric disorder more often than unexposed controls. 127sheep farmers were evaluated and compared to 78 unexposed controls, matched in terms of gender, education, level of intelligence, working status and area of residence. Both self-report measures and structured clinical interviews were used to assess mental health. The exposed cohort reported significantly higher rates of anxiety and depression when self-report questionnaires were used to evaluate mood, even when stressful life events, demographic and physical health factors were taken into account. However, when diagnostic interviews were used to assess mood, this pattern only held true for anxiety. Copyright © 2016 Elsevier Inc. All rights reserved.

Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys

PubMed Central

McLaughlin, Katie A.; Gadermann, Anne M.; Hwang, Irving; Sampson, Nancy A.; Al-Hamzawi, Ali; Andrade, Laura Helena; Angermeyer, Matthias C.; Benjet, Corina; Bromet, Evelyn J.; Bruffaerts, Ronny; Caldas-de-Almeida, José Miguel; de Girolamo, Giovanni; de Graaf, Ron; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hinkov, Hristo Ruskov; Horiguchi, Itsuko; Hu, Chiyi; Karam, Aimee Nasser; Kovess-Masfety, Viviane; Lee, Sing; Murphy, Samuel D.; Nizamie, S. Haque; Posada-Villa, José; Williams, David R.; Kessler, Ronald C.

2012-01-01

Background Associations between specific parent and offspring mental disorders are likely to have been overestimated in studies that have failed to control for parent comorbidity. Aims To examine the associations of parent with respondent disorders. Method Data come from the World Health Organization (WHO) World Mental Health Surveys (n = 51 507). Respondent disorders were assessed with the Composite International Diagnostic Interview and parent disorders with informant-based Family History Research Diagnostic Criteria interviews. Results Although virtually all parent disorders examined (major depressive, generalised anxiety, panic, substance and antisocial behaviour disorders and suicidality) were significantly associated with offspring disorders in multivariate analyses, little specificity was found. Comorbid parent disorders had significant sub-additive associations with offspring disorders. Population-attributable risk proportions for parent disorders were 12.4% across all offspring disorders, generally higher in high- and upper-middle- than low-/lower-middle-income countries, and consistently higher for behaviour (11.0-19.9%) than other (7.1-14.0%) disorders. Conclusions Parent psychopathology is a robust non-specific predictor associated with a substantial proportion of offspring disorders. PMID:22403085

A qualitative study of the cultural appropriateness of the Diagnostic Interview Schedule for Children (DISC-IV) in South Africa

PubMed Central

Skinner, Donald; Serekoane, Motsaathebe; Ross, Michael W.

2012-01-01

Background The Diagnostic Interview Schedule for Children (DISC-IV) has been designed for use by trained laypersons. It therefore shows great promise for use in developing countries such as South Africa, where there is a lack of clinically trained and skilled professionals at the primary care level. Against this background, the aim of the current study was to investigate the sociocultural appropriateness of the DISC-IV for use with Sesotho families in South Africa. Methods Qualitative methodology of expert review and contextualized content analyses were used. Ten Sesotho-speaking clinicians were recruited through a snowball sampling technique to the review the DISC through expert review reports. Results Several themes emerged, including the structure of the DISC-IV, its computerized nature, Americanisms, problems in interpretation due to the adversity children live under, language problems, the effect of rural settings and education level, and cultural norms regarding psychiatric symptoms, gender, the experience of time, the expression of emotion, and family structure. Conclusion Recommendations for the sociocultural adaptation and translation of the DISC into Sesotho are made. PMID:20526764

Analizing Student Biology Education Misconception And Scientific Argumentation Ability Using Diagnostic Question Clusters (Dqcs) Of Molecular Genetic Concept

NASA Astrophysics Data System (ADS)

Nurlaila, L.; Sriyati, S.; Riandi

2017-02-01

The purpose of this research is to describe the profile of misconceptions and scientific argumentation ability using Diagnostic Question Cluster (DQCs) of molecular genetics concept. This research use descriptive research method and biology education students as a research subject. The Instrument that used in this research are DQCs, sheets interviews, observations, and field notes. The DQCs tested by writing and oral that used to analyze misconceptions and scientific argumentation ability. Sheets interviews, observations and field notes, are used to analyze the possible factors causing misconceptions and scientific argumentation ability. The results showed that misconception of molecular genetics are: DNA (23.75%), genes (18.75%) of chromosomes (15%) and protein synthesis (5.5%). The pattern of the highest misconceptions owned Misconception-Understand Partial. The average scientific argumentation ability is 55% and still categorized warrant (W). The pattern of the scientific argumentation abilities formed is level 2 to level 2 that consists of the arguments in the form of a claim with a counter claim that accompanied by data, collateral (warrant) or support (backing) but does not contain a disclaimer (rebutal).

Association between Internet gaming disorder and adult attention deficit and hyperactivity disorder and their correlates: Impulsivity and hostility.

PubMed

Yen, Ju-Yu; Liu, Tai-Ling; Wang, Peng-Wei; Chen, Cheng-Sheng; Yen, Cheng-Fang; Ko, Chih-Hung

2017-01-01

Internet gaming disorder (IGD) and attention deficit and hyperactivity disorder (ADHD) are associated with impulsivity and hostility. This study evaluated the associations among ADHD, impulsivity, hostility, and IGD. We recruited 87 individuals with IGD and 87 controls without a history of IGD. All participants underwent a diagnostic interview based on the DSM-5 IGD criteria and DSM-IV-TR ADHD criteria and completed a questionnaire regarding impulsivity and hostility. The information from the diagnostic interviews was assessed using the clinical global impression scale. The results suggested that IGD is associated with ADHD among young adults and that young adults with both IGD and ADHD have higher impulsivity and hostility. Furthermore, impulsivity and hostility mediate the association between ADHD and IGD. Thus, ADHD is a common comorbidity of IGD among young adults, and impulsivity and hostility are major factors involved in comorbid ADHD and IGD. Young adults with ADHD should be thoroughly assessed, particularly for their impulsivity and hostility, and interventions for IGD should be developed. Copyright © 2016. Published by Elsevier Ltd.

Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits.

PubMed

Poyer, Stephen; Musuva, Anne; Njoki, Nancy; Okara, Robi; Cutherell, Andrea; Sievers, Dana; Lussiana, Cristina; Memusi, Dorothy; Kiptui, Rebecca; Ejersa, Waqo; Dolan, Stephanie; Charman, Nicole

2018-03-13

Private sector availability and use of malaria rapid diagnostic tests (RDTs) lags behind the public sector in Kenya. Increasing channels through which quality malaria diagnostic services are available can improve access to testing and help meet the target of universal diagnostic testing. Registered pharmacies are currently not permitted to perform blood tests, and evidence of whether malaria RDTs can be used by non-laboratory private providers in line with the national malaria control guidelines is required to inform ongoing policy discussions in Kenya. Two rounds of descriptive cross-sectional exit interviews and mystery client surveys were conducted at private health facilities and registered pharmacies in 2014 and 2015, 6 and 18 months into a multi-country project to prime the private sector market for the introduction of RDTs. Data were collected on reported RDT use, medicines received and prescribed, and case management of malaria test-negative mystery clients. Analysis compared outcomes at facilities and pharmacies independently for the two survey rounds. Across two rounds, 534 and 633 clients (including patients) from 130 and 120 outlets were interviewed, and 214 and 250 mystery client visits were completed. Reported testing by any malaria diagnostic test was higher in private health facilities than registered pharmacies in both rounds (2014: 85.6% vs. 60.8%, p < 0.001; 2015: 85.3% vs. 56.3%, p < 0.001). In registered pharmacies, testing by RDT was 52.1% in 2014 and 56.3% in 2015. At least 75% of test-positive patients received artemisinin-based combination therapy (ACT) in both rounds, with no significant difference between outlet types in either round. Provision of any anti-malarial for test-negative patients ranged from 0 to 13.9% across outlet types and rounds. In 2015, mystery clients received the correct (negative) diagnosis and did not receive an anti-malarial in 75.5% of visits to private health facilities and in 78.4% of visits to registered pharmacies. Non-laboratory staff working in registered pharmacies in Kenya can follow national guidelines for diagnosis with RDTs when provided with the same level of training and supervision as private health facility staff. Performance and compliance to treatment recommendations are comparable to diagnostic testing outcomes recorded in private health facilities.

Validity of prototype diagnosis for mood and anxiety disorders.

PubMed

DeFife, Jared A; Peart, Joanne; Bradley, Bekh; Ressler, Kerry; Drill, Rebecca; Westen, Drew

2013-02-01

CONTEXT With growing recognition that most forms of psychopathology are best represented as dimensions or spectra, a central question becomes how to implement dimensional diagnosis in a way that is empirically sound and clinically useful. Prototype matching, which involves comparing a patient's clinical presentation with a prototypical description of the disorder, is an approach to diagnosis that has gained increasing attention with forthcoming revisions to both the DSM and the International Classification of Diseases. OBJECTIVE To examine prototype diagnosis for mood and anxiety disorders. DESIGN, SETTING, AND PATIENTS In the first study, we examined clinicians' DSM-IV and prototype diagnoses with their ratings of the patients' adaptive functioning and patients' self-reported symptoms. In the second study, independent interviewers made prototype diagnoses following either a systematic clinical interview or a structured diagnostic interview. A third interviewer provided independent ratings of global adaptive functioning. Patients were recruited as outpatients (study 1; N = 84) and from primary care clinics (study 2; N = 143). MAIN OUTCOME MEASURES Patients' self-reported mood, anxiety, and externalizing symptoms along with independent clinical ratings of adaptive functioning. RESULTS Clinicians' prototype diagnoses showed small to moderate correlations with patient-reported psychopathology and performed as well as or better than DSM-IV diagnoses. Prototype diagnoses from independent interviewers correlated on average r = .50 and showed substantial incremental validity over DSM-IV diagnoses in predicting adaptive functioning. CONCLUSIONS Prototype matching is a viable alternative for psychiatric diagnosis. As in research on personality disorders, mood and anxiety disorder prototypes outperformed DSM-IV decision rules in predicting psychopathology and global functioning. Prototype matching has multiple advantages, including ease of use in clinical practice, reduced artifactual comorbidity, compatibility with naturally occurring cognitive processes in diagnosticians, and ready translation into both categorical and dimensional diagnosis.

Benefits for employees with children with ADHD: findings from the Collaborative Employee Benefit Study.

PubMed

Perrin, James M; Fluet, Chris; Kuhlthau, Karen A; Anderson, Betsy; Wells, Nora; Epstein, Susan; Allen, Debby; Tobias, Carol

2005-02-01

Parents of most children with attention-deficit hyperactivity disorder (ADHD) are employed. Employers have interest in decreasing employee absenteeism and improving workplace productivity, partly through employee benefits. The authors interviewed employers to (1) determine how they view the needs of employees with children with ADHD and (2) identify benefits that might help employees with children with ADHD. The authors carried out a systematic interview study of mainly family-friendly, large employers in four U.S. urban markets (Boston, Cleveland, Miami, Seattle). Multidisciplinary interview teams used a protocol to gather basic company information, benefit philosophy, current insurance and other employee benefits, and knowledge of ADHD and its impacts on employees. Initially, the interview team and then the larger project team reviewed all protocols for common themes. The authors interviewed staff of 41 employers (human resource managers, work/life program directors, benefits directors). Only 15 of 41 interviewees knew about ADHD, its prevalence, or its effects on parents. They had little knowledge of how differences in managed behavioral health may affect families' access to diagnostic and treatment services for ADHD, although most had experience with primary care management of depression among employees. Employers offer a variety of other benefits, including work/life and employee assistance programs, occasionally providing employees help with caring for a child with a mental health condition, on-site parent training programs, or assistance with child care. Other potentially useful employee benefits include flexible work and leave policies and information and referral services that can link parents with community programs. Although employers have limited awareness of ADHD and its potential effect on employees' work, this study identified opportunities to improve both health insurance and other benefits for employees with children with ADHD.

Can Depression be Diagnosed by Response to Mother's Face? A Personalized Attachment-Based Paradigm for Diagnostic fMRI

PubMed Central

Zhang, Xian; Yaseen, Zimri S.; Galynker, Igor I.; Hirsch, Joy; Winston, Arnold

2011-01-01

Objective Objective measurement of depression remains elusive. Depression has been associated with insecure attachment, and both have been associated with changes in brain reactivity in response to viewing standard emotional and neutral faces. In this study, we developed a method to calculate predicted scores for the Beck Depression Inventory II (BDI-II) using personalized stimuli: fMRI imaging of subjects viewing pictures of their own mothers. Methods 28 female subjects ages 18–30 (14 healthy controls and 14 unipolar depressed diagnosed by MINI psychiatric interview) were scored on the Beck Depression Inventory II (BDI-II) and the Adult Attachment Interview (AAI) coherence of mind scale of global attachment security. Subjects viewed pictures of Mother (M), Friend (F) and Stranger (S), during functional magnetic resonance imaging (fMRI). Using a principal component regression method (PCR), a predicted Beck Depression Inventory II (BDI-II) score was obtained from activity patterns in the paracingulate gyrus (Brodmann area 32) and compared to clinical diagnosis and the measured BDI-II score. The same procedure was performed for AAI coherence of mind scores. Results Activity patterns in BA-32 identified depressed subjects. The categorical agreement between the derived BDI-II score (using the standard clinical cut-score of 14 on the BDI-II) and depression diagnosis by MINI psychiatric interview was 89%, with sensitivity 85.7% and specificity 92.8%. Predicted and measured BDI-II scores had a correlation of 0.55. Prediction of attachment security was not statistically significant. Conclusions Brain activity in response to viewing one's mother may be diagnostic of depression. Functional magnetic resonance imaging using personalized paradigms has the potential to provide objective assessments, even when behavioral measures are not informative. Further, fMRI based diagnostic algorithms may enhance our understanding of the neural mechanisms of depression by identifying distinctive neural features of the illness. PMID:22180777

Clinical utility of the DSM-5 alternative model for borderline personality disorder: Differential diagnostic accuracy of the BFI, SCID-II-PQ, and PID-5.

PubMed

Fowler, J Christopher; Madan, Alok; Allen, Jon G; Patriquin, Michelle; Sharp, Carla; Oldham, John M; Frueh, B Christopher

2018-01-01

With the publication of DSM 5 alternative model for personality disorders it is critical to assess the components of the model against evidence-based models such as the five factor model and the DSM-IV-TR categorical model. This study explored the relative clinical utility of these models in screening for borderline personality disorder (BPD). Receiver operator characteristics and diagnostic efficiency statistics were calculated for three personality measures to ascertain the relative diagnostic efficiency of each measure. A total of 1653 adult inpatients at a specialist psychiatric hospital completed SCID-II interviews. Sample 1 (n=653) completed the SCID-II interviews, SCID-II Questionnaire (SCID-II-PQ) and the Big Five Inventory (BFI), while Sample 2 (n=1,000) completed the SCID-II interviews, Personality Inventory for DSM5 (PID-5) and the BFI. BFI measure evidenced moderate accuracy for two composites: High Neuroticism+ low agreeableness composite (AUC=0.72, SE=0.01, p<0.001) and High Neuroticism+ Low+Low Conscientiousness (AUC=0.73, SE=0.01, p<0.0001). The SCID-II-PQ evidenced moderate-to-excellent accuracy (AUC=0.86, SE=0.02, p<0.0001) with a good balance of specificity (SP=0.80) and sensitivity (SN=0.78). The PID-5 BPD algorithm (consisting of elevated emotional lability, anxiousness, separation insecurity, hostility, depressivity, impulsivity, and risk taking) evidenced moderate-to-excellent accuracy (AUC=0.87, SE=0.01, p<0.0001) with a good balance of specificity (SP=0.76) and sensitivity (SN=0.81). Findings generally support the use of SCID-II-PQ and PID-5 BPD algorithm for screening purposes. Furthermore, findings support the accuracy of the DSM 5 alternative model Criteria B trait constellation for diagnosing BPD. Limitations of the study include the single inpatient setting and use of two discrete samples to assess PID-5 and SCID-II-PQ. Copyright © 2017 Elsevier Inc. All rights reserved.

Motivation and challenges for use of malaria rapid diagnostic tests among informal providers in Myanmar: a qualitative study.

PubMed

Sudhinaraset, May; Briegleb, Christina; Aung, Moe; Khin, Hnin Su Su; Aung, Tin

2015-02-06

Rapid diagnostic tests (RDTs) for malaria enable proper diagnosis and have been shown to reduce overuse of artemisinin combination therapy. Few studies have evaluated the feasibility and use of RDTs in the private sector in Myanmar. The objectives of the study were to: 1) understand the acceptability of using RDTs in the informal sector in Myanmar; 2) examine motivations for use among informal providers; and, 3) highlight decision-making and knowledge of providers for diagnostic testing and treatment. Qualitative interviews were conducted with 30 informal providers. Purposeful sampling was used to enrol study participants in the Mon and Shan State in Myanmar. All interviews were conducted in Burmese, translated into English, and two researchers coded all interviews using Atlas ti. Major themes identified included: 1) informal provider and outlet characteristics, including demographic and background characteristics; 2) the benefits and challenges of using RDTs according to providers; 3) provider experiences with using RDTs, including motivations for using the RDT; 4) adherence to test results, either positive or negative; and, 5) recommendations from informal providers to promote increased use of RDTs in their communities. This study found that introducing RDTs to informal providers in Myanmar was feasible, resulting in improved provider empowerment and patient-provider relationships. Specific challenges included facility infrastructure to use and dispose RDTs and provider knowledge. This varied across the type of informal provider, with itinerant drug vendors more comfortable and knowledgeable about RDTs compared to general retail sellers and medical drug representatives. This study found informal providers in Myanmar found the introduction of RDTs to be highly acceptable. Providers discussed improvement in service quality including provider empowerment and patient-provider relationships. The study also highlighted a number of challenges that informal providers face which may be used for future development of interventions.

Ten-Year Course of Borderline Personality Disorder

PubMed Central

Gunderson, John G.; Stout, Robert L.; McGlashan, Thomas H.; Shea, M. Tracie; Morey, Leslie C.; Grilo, Carlos M.; Zanarini, Mary C.; Yen, Shirley; Markowitz, John C.; Sanislow, Charles; Ansell, Emily; Pinto, Anthony; Skodol, Andrew E.

2011-01-01

Context Borderline personality disorder (BPD) is traditionally considered chronic and intractable. Objective To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. Design A collaborative study of treatment-seeking, 18-to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning. Setting Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities. Participants Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 with MDD but no personality disorder. Main Outcome Measures The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose personality disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Results Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P<.001) and minimally slower than for other personality disorders (P<.03). Twelve percent of patients with BPD relapsed, a rate less frequent and slower than for patients with MDD (P<.001) and other personality disorders (P=.008). All BPD criteria declined at similar rates. Social function scores showed severe impairment with only modest albeit statistically significant improvement; patients with BPD remained persistently more dysfunctional than the other 2 groups (P<.001). Reductions in criteria predicted subsequent improvements in DSM-IV Axis V Global Assessment of Functioning scores (P<.001). Conclusions The 10-year course of BPD is characterized by high rates of remission, low rates of relapse, and severe and persistent impairment in social functioning. These results inform expectations of patients, families, and clinicians and document the severe public health burden of this disorder. PMID:21464343

Lifetime Prevalence and Correlates of Schizophrenia-Spectrum, Affective, and Other Non-affective Psychotic Disorders in the Chinese Adult Population.

PubMed

Chang, Wing Chung; Wong, Corine Sau Man; Chen, Eric Yu Hai; Lam, Linda Chiu Wa; Chan, Wai Chi; Ng, Roger Man Kin; Hung, Se Fong; Cheung, Eric Fuk Chi; Sham, Pak Chung; Chiu, Helen Fung Kum; Lam, Ming; Lee, Edwin Ho Ming; Chiang, Tin Po; Chan, Lap Kei; Lau, Gary Kar Wai; Lee, Allen Ting Chun; Leung, Grace Tak Yu; Leung, Joey Shuk Yan; Lau, Joseph Tak Fai; van Os, Jim; Lewis, Glyn; Bebbington, Paul

2017-10-21

Lifetime prevalence of psychotic disorders varies widely across studies. Epidemiological surveys have rarely examined prevalences of specific psychotic disorders other than schizophrenia, and the majority used a single-phase design without employing clinical reappraisal interview for diagnostic verification. The current study investigated lifetime prevalence, correlates and service utilization of schizophrenia-spectrum, affective, and other non-affective psychotic disorders in a representative sample of community-dwelling Chinese adult population aged 16-75 years (N = 5719) based on a territory-wide, population-based household survey for mental disorders in Hong Kong. The survey adopted a 2-phase design comprising first-phase psychosis screening and second-phase diagnostic verification incorporating clinical information from psychiatrist-administered semi-structured interview and medical record review to ascertain DSM-IV lifetime diagnosis for psychotic disorders. Data on sociodemographics, psychosocial characteristics and service utilization were collected. Our results showed that lifetime prevalence was 2.47% for psychotic disorder overall, 1.25% for schizophrenia, 0.15% for delusional disorder, 0.38% for psychotic disorder not otherwise specified, 0.31% for bipolar disorder with psychosis, and 0.33% for depressive disorder with psychosis. Schizophrenia-spectrum disorder was associated with family history of psychosis, cigarette smoking and variables indicating socioeconomic disadvantage. Victimization experiences were significantly related to affective psychoses and other non-affective psychoses. Around 80% of participants with any psychotic disorder sought some kind of professional help for mental health problems in the past year. Using comprehensive diagnostic assessment involving interview and record data, our results indicate that approximately 2.5% of Chinese adult population had lifetime psychotic disorder which represents a major public health concern. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Development of the 7-Item Binge-Eating Disorder Screener (BEDS-7)

PubMed Central

Deal, Linda S.; DiBenedetti, Dana B.; Nelson, Lauren; Fehnel, Sheri E.; Brown, T. Michelle

2016-01-01

Objective Develop a brief, patient-reported screening tool designed to identify individuals with probable binge-eating disorder (BED) for further evaluation or referral to specialists. Methods Items were developed on the basis of the DSM-5 diagnostic criteria, existing tools, and input from 3 clinical experts (January 2014). Items were then refined in cognitive debriefing interviews with participants self-reporting BED characteristics (March 2014) and piloted in a multisite, cross-sectional, prospective, noninterventional study consisting of a semistructured diagnostic interview (to diagnose BED) and administration of the pilot Binge-Eating Disorder Screener (BEDS), Binge Eating Scale (BES), and RAND 36-Item Short-Form Health Survey (RAND-36) (June 2014–July 2014). The sensitivity and specificity of classification algorithms (formed from the pilot BEDS item-level responses) in predicting BED diagnosis were evaluated. The final algorithm was selected to minimize false negatives and false positives, while utilizing the fewest number of BEDS items. Results Starting with the initial BEDS item pool (20 items), the 13-item pilot BEDS resulted from the cognitive debriefing interviews (n = 13). Of the 97 participants in the noninterventional study, 16 were diagnosed with BED (10/62 female, 16%; 6/35 male, 17%). Seven BEDS items (BEDS-7) yielded 100% sensitivity and 38.7% specificity. Participants correctly identified (true positives) had poorer BES scores and RAND-36 scores than participants identified as true negatives. Conclusions Implementation of the brief, patient-reported BEDS-7 in real-world clinical practice is expected to promote better understanding of BED characteristics and help physicians identify patients who may have BED. PMID:27486542

Development of the 7-Item Binge-Eating Disorder Screener (BEDS-7).

PubMed

Herman, Barry K; Deal, Linda S; DiBenedetti, Dana B; Nelson, Lauren; Fehnel, Sheri E; Brown, T Michelle

2016-01-01

Develop a brief, patient-reported screening tool designed to identify individuals with probable binge-eating disorder (BED) for further evaluation or referral to specialists. Items were developed on the basis of the DSM-5 diagnostic criteria, existing tools, and input from 3 clinical experts (January 2014). Items were then refined in cognitive debriefing interviews with participants self-reporting BED characteristics (March 2014) and piloted in a multisite, cross-sectional, prospective, noninterventional study consisting of a semistructured diagnostic interview (to diagnose BED) and administration of the pilot Binge-Eating Disorder Screener (BEDS), Binge Eating Scale (BES), and RAND 36-Item Short-Form Health Survey (RAND-36) (June 2014-July 2014). The sensitivity and specificity of classification algorithms (formed from the pilot BEDS item-level responses) in predicting BED diagnosis were evaluated. The final algorithm was selected to minimize false negatives and false positives, while utilizing the fewest number of BEDS items. Starting with the initial BEDS item pool (20 items), the 13-item pilot BEDS resulted from the cognitive debriefing interviews (n = 13). Of the 97 participants in the noninterventional study, 16 were diagnosed with BED (10/62 female, 16%; 6/35 male, 17%). Seven BEDS items (BEDS-7) yielded 100% sensitivity and 38.7% specificity. Participants correctly identified (true positives) had poorer BES scores and RAND-36 scores than participants identified as true negatives. Implementation of the brief, patient-reported BEDS-7 in real-world clinical practice is expected to promote better understanding of BED characteristics and help physicians identify patients who may have BED.

Prevalence and Predictors of Major Depressive Disorder for Fertility Treatment Patients and their Partners

PubMed Central

Holley, Sarah R.; Pasch, Lauri A.; Bleil, Maria E.; Gregorich, Steven; Katz, Patricia K.; Adler, Nancy E.

2015-01-01

Structured Abstract Objective To examine the prevalence and predictors of major depressive disorder (MDD) for women and their partners during the course of fertility treatment. Design Prospective cohort study over an 18-month period. Participants completed interviews and questionnaires at baseline and at 4, 10, and 18 months follow-up. Setting Five community and academic fertility practices. Patients 174 women and 144 of their male partners who did not have a successful child-related outcome during the timeframe of the study. Interventions No interventions administered. Main Outcome Measures MDD was assessed using the Composite International Diagnostic Interview (CIDI) Major Depression module, a structured diagnostic interview. Additional variables were assessed with self-report questionnaire measures. Results 39.1% of the women and 15.3% of the men met the criteria for MDD during the 18-month course of the study. A binary logistic covariate-adjusted model including showed that, for both women and men, past MDD was a significant predictor of MDD during treatment. Past MDD further predicted significant risk for MDD during treatment after controlling for other well-established risk factors (i.e., baseline levels of depression, anxiety, and partner support). Conclusions MDD was highly prevalent for fertility treatment patients and their partners. Past MDD predicted risk for MDD during treatment, and it contributed to MDD risk over and above other commonly-assessed risk factors. This suggests patients and their partners would benefit from being routinely assessed for a history of MDD prior to the start of treatment in order to best direct psychosocial support and interventions to those most in need. PMID:25796319

Sexuality and sexual health among female youth with borderline personality disorder pathology.

PubMed

Thompson, Katherine N; Betts, Jennifer; Jovev, Martina; Nyathi, Yolanda; McDougall, Emma; Chanen, Andrew M

2017-10-27

Borderline personality disorder (BPD) is a severe mental disorder that is characterized by unstable relationships, impulsive behaviours and identity disturbance. BPD usually has its onset between puberty and young adulthood and presents disproportionately among females in clinical settings. Taken together, this makes young women with BPD a particularly vulnerable group with regard to healthy psychosexual development. It was hypothesized that female youth with BPD pathology would be more likely to score worse on measures of sexual health and safety, and to show greater uncertainty in sexual identity formation. Fifty 15 to 24 yr-old females with 3 or more Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) BPD criteria were compared with 204 females from a nationally representative sample. Both groups were interviewed using a comprehensive interview for sexual health and relationships. The patient group completed a structured diagnostic interview. Young women with borderline personality pathology engaged in sexual relationships at a younger age, with more sexual partners in the previous year, in more casual relationships. They were more likely to practice unsafe sex for their first sexual experience, to be coerced into unwanted sexual activity, to be unclear about their sexual identity or their sexual attraction, and to report worse overall health status. BPD pathology in youth is associated with poor sexual health and safety, and uncertainty in sexual identity formation. These findings support the need for assessment of the sexuality and sexual health of youth with BPD, along with the need for routine screening in sexual health services for BPD features among high-risk youth. © 2017 John Wiley & Sons Australia, Ltd.

Reciprocal Effects of Social Support in Major Depression Epidemiology

PubMed Central

Patten, Scott B; Williams, Jeanne V.A; Lavorato, Dina H; Bulloch, Andrew G.M

2010-01-01

Background: The clinical course and epidemiology of major depressive episodes (MDEs) may be influenced by reciprocal interactions between an individual and the social environment. Epidemiological data concerning these interactions may assist with anticipating the clinical needs of depressed patients. Methods: The data source for this study was a Canadian longitudinal study, the National Population Health Survey (NPHS), which provided 8 years of follow-up data. The NPHS interview included a brief diagnostic indicator for MDE, the Composite International Diagnostic Interview Short Form for Major Depression (CIDI-SFMD). The NPHS interview also incorporated the Medical Outcomes Study Social Support Scale (MOSSS) and a set of relevant demographic and health-related measures. The MOSSS assesses total social support and four specific dimensions of social support. Hazard ratios (HR) were used to quantify associations in the longitudinal data. Results: Lower quartile total social support ratings predicted MDE incidence: the HR adjusted for age and sex was 1.9 (95% CI 1.6 – 2.2). Lower quartile ratings in specific social support dimensions yielded similar HRs. MDE was associated with emergence of lower-quartile affection social support (age and sex adjusted HR 1.3, 95% CI 1.1 – 1.7), but other aspects of social support were not consistently associated with MDE. Conclusions: Low social support appears to be a robust risk factor for MDE and can be used to identify persons at higher risk of MDE. Evidence that MDE has a negative effect on social support was weaker and was restricted to affection social support. PMID:21253020

Cultural adaptation of the Latin American version of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI) (v 3.0) for use in Spain.

PubMed

Navarro-Mateu, Fernando; Morán-Sánchez, Inés; Alonso, Jordi; Tormo, Ma José; Pujalte, Ma Luisa; Garriga, Ascensión; Aguilar-Gaxiola, Sergio; Navarro, Carmen

2013-01-01

To develop a Spanish version of the WHO-Composite International Diagnostic Interview (WHO-CIDI) applicable to Spain, through cultural adaptation of its most recent Latin American (LA v 20.0) version. A 1-week training course on the WHO-CIDI was provided by certified trainers. An expert panel reviewed the LA version, identified words or expressions that needed to be adapted to the cultural or linguistic norms for Spain, and proposed alternative expressions that were agreed on through consensus. The entire process was supervised and approved by a member of the WHO-CIDI Editorial Committee. The changes were incorporated into a Computer Assisted Personal Interview (CAPI) format and the feasibility and administration time were pilot tested in a convenience sample of 32 volunteers. A total of 372 questions were slightly modified (almost 7% of approximately 5000 questions in the survey) and incorporated into the CAPI version of the WHO-CIDI. Most of the changes were minor - but important - linguistic adaptations, and others were related to specific Spanish institutions and currency. In the pilot study, the instrument's mean completion administration time was 2h and 10min, with an interquartile range from 1.5 to nearly 3h. All the changes made were tested and officially approved. The Latin American version of the WHO-CIDI was successfully adapted and pilot-tested in its computerized format and is now ready for use in Spain. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

A descriptive study of psychiatric disorders and psychosocial burden in rehabilitation patients with musculoskeletal diseases.

PubMed

Härter, Martin; Reuter, Katrin; Weisser, Bettina; Schretzmann, Beate; Aschenbrenner, Astrid; Bengel, Jürgen

2002-04-01

To investigate current, 12-month, and lifetime prevalence rates, and associated psychosocial burden of psychiatric disorders in rehabilitation inpatients with musculoskeletal diseases. Two-stage epidemiologic survey. Four orthopedic rehabilitation inpatient clinics in southwest Germany. A total of 910 inpatients with different musculoskeletal diseases participated in the survey. According to their General Health Questionnaire-12 scores, 205 patients were selected randomly for standardized interviews. Not applicable. Psychosocial burden (Hospital Anxiety and Depression Scale, Lübeck Alcoholism Screening Test) and quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey), assessment of diagnosis and somatic parameters through standardized medical records. Clinical interview (Munich Composite International Diagnostic Interview) in the second-stage examination to obtain Diagnostic and Statistical Manual of Mental Disorders (4th edition) diagnoses of psychiatric disorders. Prevalence rates of psychiatric disorders are 31.1% for the 4-week period, 47.1% for the 12-month period, and 64.6% for the lifetime period. The most prevalent current disorders are anxiety (15%), affective (10.7%), and substance-related disorders (9.2%). Half of the comorbid ill patients have 2 or more simultaneous psychiatric disorders and report elevated levels of psychosocial burden (eg, intense pain, low quality of life, more days of sick leave). Patients undergoing musculoskeletal rehabilitation should be assessed carefully for comorbid psychiatric illnesses. Further research should be undertaken to evaluate the effectiveness of psychosocial interventions for comorbid psychiatric disorders on life quality, therapeutic compliance, and outcome of rehabilitation treatment. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

The use of alcohol use disorders identification test (AUDIT) in detecting alcohol use disorder and risk drinking in the general population: validation of AUDIT using schedules for clinical assessment in neuropsychiatry.

PubMed

Lundin, Andreas; Hallgren, Mats; Balliu, Natalja; Forsell, Yvonne

2015-01-01

The alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) are commonly used in population surveys but there are few validations studies in the general population. Validity should be estimated in samples close to the targeted population and setting. This study aims to validate AUDIT and AUDIT-C in a general population sample (PART) in Stockholm, Sweden. We used a general population subsample age 20 to 64 that answered a postal questionnaire including AUDIT who later participated in a psychiatric interview (n = 1,093). Interviews using Schedules for Clinical Assessment in Neuropsychiatry was used as criterion standard. Diagnoses were set according to the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Agreement between the diagnostic test and criterion standard was measured with area under the receiver operator characteristics curve (AUC). A total of 1,086 (450 men and 636 women) of the interview participants completed AUDIT. There were 96 individuals with DSM-IV-alcohol dependence, 36 DSM-IV-Alcohol Abuse, and 153 Risk drinkers. AUCs were for DSM-IV-alcohol use disorder 0.90 (AUDIT-C 0.85); DSM-IV-dependence 0.94 (AUDIT-C 0.89); risk drinking 0.80 (AUDIT-C 0.80); and any criterion 0.87 (AUDIT-C 0.84). In this general population sample, AUDIT and AUDIT-C performed outstanding or excellent in identifying dependency, risk drinking, alcohol use disorder, any disorder, or risk drinking. Copyright © 2015 by the Research Society on Alcoholism.

Virtual humans and formative assessment to train diagnostic skills in bulimia nervosa.

PubMed

Gutiérrez-Maldonado, José; Ferrer-Garcia, Marta; Pla, Joana; Andrés-Pueyo, Antonio

2014-01-01

Carrying out a diagnostic interview requires skills that need to be taught in a controlled environment. Virtual Reality (VR) environments are increasingly used in the training of professionals, as they offer the most realistic alternative while not requiring students to face situations for which they are yet unprepared. The results of the training of diagnostic skills can also be generalized to any other situation in which effective communication skills play a major role. Our aim with this study has been to develop a procedure of formative assessment in order to increment the effectiveness of virtual learning simulation systems and then to assess their efficacy.

Socio-economic, gender and health services factors affecting diagnostic delay for tuberculosis patients in urban Zambia.

PubMed

Needham, D M; Foster, S D; Tomlinson, G; Godfrey-Faussett, P

2001-04-01

In-depth interviews regarding health seeking behaviour were conducted with 202 adults registered with pulmonary tuberculosis at the centralized Chest Clinic in Lusaka, Zambia. The median (mean) diagnostic delay was 8.6 (9) weeks, and was significantly associated with the following factors: female sex, lower education, more than six instances of health-seeking encounters, outpatient diagnosis of tuberculosis, and visiting a private doctor or traditional healer. More effective tuberculosis control interventions require novel methods of accessing women and less educated people. Decentralization of public tuberculosis care and improved integration with private sector health providers may also reduce diagnostic delay.

Interviewee Perceptions of Employment Screening Interviews: Relationships among Perceptions of Communication Satisfaction, Interviewer Credibility and Trust, Interviewing Experience, and Interview Outcomes.

ERIC Educational Resources Information Center

Jablin, Fredric M.; And Others

A study examined employment screening interviews to determine the relationships between an interviewee's perceptions of interview communication satisfaction, interviewer credibility and trust, previous interviewing experiences, and a number of interview outcomes, including expectation of a second interview. Data were collected from 69 students…

Students' Learning Strategies with Multiple Representations: Explanations of the Human Breathing Mechanism

ERIC Educational Resources Information Center

Won, Mihye; Yoon, Heojeong; Treagust, David F.

2014-01-01

The purpose of this study was to understand how students utilized multiple representations to learn and explain science concepts, in this case the human breathing mechanism. The study was conducted with Grade 11 students in a human biology class. Semistructured interviews and a two-tier diagnostic test were administered to evaluate students'…

Assessing Posttraumatic Stress Disorder Using the Trauma Symptom Checklist for Young Children

ERIC Educational Resources Information Center

Pollio, Elisabeth S.; Glover-Orr, L. Ellen; Wherry, Jeffrey N.

2008-01-01

This pilot study assessed the performance of the Trauma Symptom Checklist for Young Children (TSCYC) in correctly classifying the presence or absence of PTSD, as determined by the Diagnostic Interview for children and Adolescents-Parent (DICA-P). Participants included 34 children, ages 4 to 12, referred for outpatient treatment. The 11…

Standardized Observational Assessment of Attention Deficit Hyperactivity Disorder Combined and Predominantly Inattentive Subtypes. II. Classroom Observations

ERIC Educational Resources Information Center

McConaughy, Stephanie H.; Ivanova, Masha Y.; Antshel, Kevin; Eiraldi, Ricardo B.; Dumenci, Levent

2009-01-01

Trained classroom observers used the Direct Observation Form (DOF; McConaughy & Achenbach, 2009) to rate observations of 163 6- to 11-year-old children in their school classrooms. Participants were assigned to four groups based on a parent diagnostic interview and parent and teacher rating scales: Attention Deficit Hyperactivity Disorder…

Insight in Frontotemporal Dementia: Conceptual Analysis and Empirical Evaluation of the Consensus Criterion ''Loss of Insight'' in Frontotemporal Dementia

ERIC Educational Resources Information Center

Evers, Kathinka; Kilander, Lena; Lindau, Maria

2007-01-01

The objective of this study was to suggest a new formulation of the core research diagnostic consensus criterion ''loss of insight'' in frontotemporal dementia (FTD). Eight patients with FTD (diagnoses made by interviews, medical and neuropsychological examination, CT scan, and regional cerebral glucose metabolism measured by positron emission…

Self-Regulation and Inhibition in Comorbid ADHD Children: An Evaluation of Executive Functions

ERIC Educational Resources Information Center

Sarkis, Stephanie Moulton; Sarkis, Elias H.; Marshall, David; Archer, James

2005-01-01

The relationship between executive function and comorbid diagnoses in ADHD children is examined. One hundred six children between 7 and 15 years of age are assessed using the Tower of London (TOL), a test of executive function, and the Kiddie Schedule of Affective Disorders and Schizophrenia, Present and Lifetime Version, a diagnostic interview.…

Students' Concept of Force: The Importance of Understanding Newton's Third Law.

ERIC Educational Resources Information Center

Brown, David E.

This paper analyzes the misconceptions high school students have about force and suggests that the misunderstanding of Newton's third law is the key to these misconceptions. Clinical interview and diagnostic test data (N=104) indicates that many students have a naive view of force as an acquired or innate property of single objects rather than…

Development of a Three-Tier Test to Assess Misconceptions about Simple Electric Circuits

ERIC Educational Resources Information Center

Pesman, Haki; Eryilmaz, Ali

2010-01-01

The authors aimed to propose a valid and reliable diagnostic instrument by developing a three-tier test on simple electric circuits. Based on findings from the interviews, open-ended questions, and the related literature, the test was developed and administered to 124 high school students. In addition to some qualitative techniques for…

Assessing Internalizing, Externalizing, and Attention Problems in Young Children: Validation of the MacArthur HBQ

ERIC Educational Resources Information Center

Lemery-Chalfant, Kathryn; Schreiber, Jane E.; Schmidt, Nicole L.; Van Hulle, Carol A.; Essex, Marilyn J.; Goldsmith, H. H.

2007-01-01

Objective: To test the validity of the MacArthur Health and Behavior Questionnaire (HBQ) using receiver operating characteristic (ROC) analysis to determine optimal thresholds for the HBQ in predicting Diagnostic Interview Schedule for Children Version-IV (DISC-IV)diagnoses. The roles of child sex, level of impairment, and physical health in…

Emergence of Autism Spectrum Disorder in Children from Simplex Families: Relations to Parental Perceptions of Etiology

ERIC Educational Resources Information Center

Goin-Kochel, Robin P.; Mire, Sarah S.; Dempsey, Allison G.

2015-01-01

Current research describes a four-category scheme of Autism Spectrum Disorder (ASD) onset: early, regressive, plateau, delay + regression. To replicate prevalence of different onset types, ASD onset (per the "Autism Diagnostic Interview-Revised") was examined in a large North American sample; for a subset, parents' causal beliefs were…

Differential Impairment as an Indicator of Sex Bias in DSM-IV Criteria for Four Personality Disorders

ERIC Educational Resources Information Center

Boggs, Christina D.; Morey, Leslie C.; Skodol, Andrew E.; Shea, M. Tracie; Sanislow, Charles A.; Grilo, Carlos M.; McGlashan, Thomas H.; Zanarini, Mary C.; Gunderson, John G.

2005-01-01

The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were…

Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

ERIC Educational Resources Information Center

Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

2014-01-01

This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

Disparity in Report of Autism-Related Behaviors by Social Demographic Characteristics: Findings from a Community-Based Study in Taiwan

ERIC Educational Resources Information Center

Tsai, Peng-Chou; Harrington, Rebecca A.; Lung, For-Wey; Lee, Li-Ching

2017-01-01

The Social Communication Questionnaire is one of the most commonly used screening tools for autism spectrum disorder. The Social Communication Questionnaire is a caregiver-reported questionnaire with 40 items based on questions from the Autism Diagnostic Interview-Revised. This study collected Social Communication Questionnaire data from a…

Brief Report: Symptom Onset Patterns and Functional Outcomes in Young Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Shumway, Stacy; Thurm, Audrey; Swedo, Susan E.; Deprey, Lesley; Barnett, Lou Ann; Amaral, David G.; Rogers, Sally J.; Ozonoff, Sally

2011-01-01

This study examined the relationship between onset status and current functioning using a recently proposed onset classification system in 272 young children with autism spectrum disorder (ASD). Participants were classified into one of the following groups, based on parent report using the Autism Diagnostic Interview-Revised: Early Onset (symptoms…

Correspondence between Self-Report and Interview-Based Assessments of Antisocial Personality Disorder

ERIC Educational Resources Information Center

Guy, Laura S.; Poythress, Norman G.; Douglas, Kevin S.; Skeem, Jennifer L.; Edens, John F.

2008-01-01

Antisocial personality disorder (ASPD) is associated with suicide, violence, and risk-taking behavior and can slow response to first-line treatment for Axis I disorders. ASPD may be assessed infrequently because few efficient diagnostic tools are available. This study evaluated 2 promising self-report measures for assessing ASPD--the ASPD scale of…

Testing Structural Models of DSM-IV Symptoms of Common Forms of Child and Adolescent Psychopathology

ERIC Educational Resources Information Center

Lahey, Benjamin B.; Rathouz, Paul J.; Van Hulle, Carol; Urbano, Richard C.; Krueger, Robert F.; Applegate, Brooks; Garriock, Holly A.; Chapman, Derek A.; Waldman, Irwin D.

2008-01-01

Confirmatory factor analyses were conducted of "Diagnostic and Statistical Manual of Mental Disorders", Fourth Edition (DSM-IV) symptoms of common mental disorders derived from structured interviews of a representative sample of 4,049 twin children and adolescents and their adult caretakers. A dimensional model based on the assignment of symptoms…

The Unity and Diversity of Inattention and Hyperactivity/Impulsivity in ADHD: Evidence for a General Factor with Separable Dimensions

ERIC Educational Resources Information Center

Toplak, Maggie E.; Pitch, Ashley; Flora, David B.; Iwenofu, Linda; Ghelani, Karen; Jain, Umesh; Tannock, Rosemary

2009-01-01

To examine the unity and diversity of inattention and hyperactivity/impulsivity symptom domains of Attention-Deficit/Hyperactivity Disorder (ADHD) in a clinical sample of adolescents with ADHD. Parents and adolescents were administered a semi-structured diagnostic interview, the Schedule for Affective Disorders and Schizophrenia for School-Age…

Association of Parental ADHD and Depression with Externalizing and Internalizing Dimensions of Child Psychopathology

ERIC Educational Resources Information Center

Humphreys, Kathryn L.; Mehta, Natasha; Lee, Steve S.

2012-01-01

Objective: To study the independent association of parental depression and ADHD on three dimensions of child psychopathology among 178 children aged 5 to 10 years. Method: Self-reported measures of parental depression and ADHD as well as rating scales and structure diagnostic interviews of child internalizing, ADHD, and externalizing problems were…

Narratives of Self-Neglect: Patterns of Traumatic Personal Experiences and Maladaptive Behaviors in Cognitively Intact Older Adults.

PubMed

Lien, Cynthia; Rosen, Tony; Bloemen, Elizabeth M; Abrams, Robert C; Pavlou, Maria; Lachs, Mark S

2016-11-01

To identify patterns of personal experience or behavior in self-neglect by exploring narratives of cognitively intact older adults. Descriptive study involving semistructured interviews and unstructured narratives. A parent study of self-neglect characteristics. Cognitively intact, self-neglecting older adults referred from 11 community-based senior services agencies (N = 69). Interviews included a comprehensive psychiatric assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis-I and II Disorders and an unstructured interview that allowed subjects to describe important elements of their life stories. Content analysis was used to identify personal experiences and behavior patterns in each subject's narrative. Four types of traumatic personal experiences (psychologically traumatic loss, separation or abandonment (29%); violent victimization, physical trauma, or sexual abuse (19%); exposure to war or political violence (9%); prolonged mourning (7%)) and five behavior patterns (significant financial instability (23%), severe lifelong mental illness (16%), mistrust of people or paranoia (13%), distrust and avoidance of the medical establishment (13%), substance abuse or dependence (13%)) were identified in the life stories. Patterns of traumatic personal experiences and maladaptive behaviors that self-neglecters frequently report were identified. Experiences, perceptions, and behaviors developed over a lifetime may contribute to elder self-neglect. Further exploration and better understanding of these patterns may identify potential risk factors and areas for future targeted screening, intervention, and prevention. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Examining the Application of the DC-IA-A Diagnostic Criteria for Internet Addiction Disorder in At-Risk College Students.

PubMed

Hsu, Wen-Yu; Chang, Shan-Mei; Chiu, Nan-Ying; Lin, Sunny S J; Tseng, Yin-Hsing

2015-01-01

Internet addiction disorder is a relatively new condition, and the criteria for its diagnosis have been developed only over the last several years. The criteria for Internet addiction remain controversial. We strive to further elucidate the clinical validity of the diagnostic criteria for Internet addiction. To test items of the diagnostic criteria for Internet addiction among adolescents, we conducted a clinical interview study of college students based on longitudinal data on their risky use of the Internet. Forty-one high-risk cases were selected from a 3-year 5-time point longitudinal survey of 716 college freshmen. We examined disputes relevant to symptoms and impairment in the DC-IA-A (Diagnostic Criteria for Internet Addiction among Taiwanese Adolescents). Of the 41 cases, 21 were diagnosed with Internet addiction via a psychiatric interview. In the Internet addiction disorder group, 23.8% of cases had a diagnosis of depression, whereas only 15.0% of the cases in the non-Internet addiction group had a diagnosis of depression. Two major criteria (A8 and A3) had low incidences in these high-risk college students and thus did not help provide a differential diagnosis between the groups. We suggest that A8, 'excessive effort spent on activities necessary to obtain access to the Internet', should be omitted, and that A3, 'tolerance: a marked increase in the duration of Internet use needed to achieve satisfaction', should be modified. A1 and A9 should be discussed regarding their role in the diagnosis of Internet addiction disorder. Additional well-designed studies examining the diagnostic criteria and the relationship between factors are needed. © 2015 S. Karger AG, Basel.

Latent class-derived subgroups of depressive symptoms in a community sample of older adults: the Cache County Study.

PubMed

Lee, Chien-Ti; Leoutsakos, Jeannie-Marie; Lyketsos, Constantine G; Steffens, David C; Breitner, John C S; Norton, Maria C

2012-10-01

We sought to identify possible subgroups of elders that varied in depressive symptomatology and to examine symptom patterns and health status differences between subgroups. The Cache County memory study is a population-based epidemiological study of dementia with 5092 participants. Depressive symptoms were measured with a modified version of the diagnostic interview schedule-depression. There were 400 nondemented participants who endorsed currently (i.e., in the past 2 weeks) experiencing at least one of the three "gateway" depressive symptoms and then completed a full depression interview. Responses to all nine current depressive symptoms were modeled using the latent class analysis. Three depression subgroups were identified: a significantly depressed subgroup (62%), with the remainder split evenly between a subgroup with low probability of all symptoms (21%), and a subgroup with primarily psychomotor changes, sleep symptoms, and fatigue (17%). Latent class analysis derived subgroups of depressive symptoms and Diagnostic and statistical manual of mental disorders, fourth edition depression diagnostic group were nonredundant. Age, gender, education, marital status, early or late onset, number of episodes, current episode duration, and functional status were not significant predictors of depression subgroup. The first subgroup was more likely to be recently bereaved and had less physical health problems, whereas the third subgroup were less likely to be using antidepressants compared with the second subgroup. There are distinct subgroups of depressed elders, which are not redundant with the Diagnostic and statistical manual of mental disorders, fourth edition classification scheme, offering an alternative diagnostic approach to clinicians and researchers. Future work will examine whether these depressive symptom profiles are predictive of incident dementia and earlier mortality. Copyright © 2011 John Wiley & Sons, Ltd.

Manifestations, acquisition and diagnostic categories of dental fear in a self-referred population.

PubMed

Moore, R; Brødsgaard, I; Birn, H

1991-01-01

This study aimed to clarify how manifestations and acquisition relate to diagnostic categories of dental fear in a population of self-referred dental fear patients, since diagnostic criteria specifically related to dental fear have not been validated. DSM III-R diagnostic criteria for phobias were used to compare with four existing dental fear diagnostic categories, referred to as the Seattle system. Subjects were 208 persons with dental fear who were telephone interviewed, of whom a subsample of 155 responded to a mailed Dental Anxiety Scale (DAS), State-Trait Anxiety Inventory and a modified FSS-II Geer Fear Scale (GFS). Personal interviews and a Dental Beliefs Scale of perceived trust and social interaction with dentists were also used to evaluate a subsample of 80 patients selected by sex and high dental fear. Results showed that the majority of the 80 patients (66%), suffered from social embarrassment about their dental fear problem and their inability to do something about it. The largest cause of their fear (84%) was reported to be traumatic dental experiences, especially in childhood (70%). A minority of patients (16%) could not isolate traumatic experiences and had a history of general fearfulness or anxiety. Analysis of GFS data for the 155 subjects showed that fear of snakes and injuries were highest among women; heights and injections among men. Fear of blood was rarely reported. Spearman correlations between GFS individual items and DAS scores indicated functional independence between dental fear and common fears such as blood, injections and enclosures in most cases. Only in specific types of dental fear did these results support Rachman and Lopatka's contention that fears are thought to summate.(ABSTRACT TRUNCATED AT 250 WORDS)

Unwrapping the diagnosis of tuberculosis in primary care: a qualitative study.

PubMed

Metcalf, Elizabeth P; Davies, Joanne C; Wood, Fiona; Butler, Christopher C

2007-02-01

Although tuberculosis (TB) is relatively rare in the UK, its diagnosis is important because diagnostic delays can result in worse outcomes for patients and expose others to the risk of infection. Atypical presentations may be common, and patients' help-seeking behaviour may influence the diagnostic process in primary care. Little is known about the process of diagnosing TB in primary care in developed countries. To understand the process of diagnosing TB in UK primary care. Qualitative inductive study with paired semi-structured interviews. Communities and general practices in south-east Wales. Interviews were conducted with 17 patients diagnosed with TB in the previous 6 months and 16 GPs involved with their care. Data were analysed thematically. In response to expected classical features, GPs generally ordered specific tests. Both GPs and patients reported atypical presentations, and then the diagnostic and referral net was appropriately widened in most cases. Identified barriers to prompt diagnosis included atypical presentations and low clinical suspicion of TB, lack of continuity of care, workload demands that limit time with patients, and suboptimal clinician-patient communication. GPs recognised the growing problem of TB nationally and the need for improved education among health professionals. GPs' and patients' accounts about the process of diagnosing TB suggest that delays can occur, although they are not typical. Where diagnosis is clear, GPs generally test specifically and refer appropriately; where diagnosis is less clear, the diagnostic net is cast further. It is only when certain core values of general practice are not applied (including continuity of care, considering context appropriately, and eliciting and responding appropriately to patients' explanatory models) that clinicians and patients identify a suboptimal diagnostic process.

Specificity of Incident Diagnostic Outcomes in Patients at Clinical High Risk for Psychosis

PubMed Central

Webb, Jadon R; Addington, Jean; Perkins, Diana O; Bearden, Carrie E; Cadenhead, Kristin S; Cannon, Tyrone D; Cornblatt, Barbara A; Heinssen, Robert K; Seidman, Larry J; Tarbox, Sarah I; Tsuang, Ming; Walker, Elaine; McGlashan, Thomas H; Woods, Scott W

2015-01-01

Abstract It is not well established whether the incident outcomes of the clinical high-risk (CHR) syndrome for psychosis are diagnostically specific for psychosis or whether CHR patients also are at elevated risk for a variety of nonpsychotic disorders. We collected 2 samples (NAPLS-1, PREDICT) that contained CHR patients and a control group who responded to CHR recruitment efforts but did not meet CHR criteria on interview (help-seeking comparison patients [HSC]). Incident diagnostic outcomes were defined as the occurrence of a SIPS-defined psychosis or a structured interview diagnosis from 1 of 3 nonpsychotic Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) groups (anxiety, bipolar, or nonbipolar mood disorder), when no diagnosis in that group was present at baseline. Logistic regression revealed that the CHR vs HSC effect did not vary significantly across study for any emergent diagnostic outcome; data from the 2 studies were therefore combined. CHR (n = 271) vs HSC (n = 171) emergent outcomes were: psychosis 19.6% vs 1.8%, bipolar disorders 1.1% vs 1.2%, nonbipolar mood disorders 4.4% vs 5.3%, and anxiety disorders 5.2% vs 5.3%. The main effect of CHR vs HSC was statistically significant (OR = 13.8, 95% CI 4.2–45.0, df = 1, P < .001) for emergent psychosis but not for any emergent nonpsychotic disorder. Sensitivity analyses confirmed these findings. Within the CHR group emergent psychosis was significantly more likely than each nonpsychotic DSM-IV emergent disorder, and within the HSC group emergent psychosis was significantly less likely than most emergent nonpsychotic disorders. The CHR syndrome is specific as a marker for research on predictors and mechanisms of developing psychosis. PMID:26272875

Diagnostic accuracy of the Patient Health Questionnaire-9 for assessment of depression in type II diabetes mellitus and/or coronary heart disease in primary care.

PubMed

van der Zwaan, G Lennart; van Dijk, Susan E M; Adriaanse, Marcel C; van Marwijk, Harm W J; van Tulder, Maurits W; Pols, Alide D; Bosmans, Judith E

2016-01-15

Depression is common among type 2 diabetes mellitus (DM2)/coronary heart disease (CHD) patients and is associated with adverse health effects. A promising strategy to reduce burden of disease is to identify patients at risk for depression in order to offer indicated prevention. This study aims to assess the diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) to be used as a tool to identify high risk patients. In this cross-sectional study, 586 consecutive DM2/CHD patients aged >18 were recruited through 23 general practices. PHQ-9 outcomes were compared to the Mini International Neuropsychiatric Interview (MINI), which was considered the reference standard. Diagnostic accuracy was evaluated for minor and major depression, comparing both sum- and algorithm based PHQ-9 scores. For minor depression, the optimal cut-off score was 8 (sensitivity 71%, specificity 71% and an AUC of 0.74). For major depression, the optimal cut-off score was 10 resulting in a sensitivity of 84%, a specificity of 82%, and an AUC of 0.88. The positive predictive value of the PHQ-9 algorithm for diagnosing minor and major depression was 25% and 33%, respectively. Two main limitations apply. MINI Interviewers were not blinded for PHQ-9 scores and less than 10% of all invited patients could be included in the analyses. This could have resulted in biased outcomes. The PHQ-9 sum score performs well in identifying patients at high risk of minor and major depression. However, the PHQ-9 showed suboptimal results for diagnostic purposes. Therefore, it is recommended to combine the use of the PHQ-9 with further diagnostics to identify depression. Copyright © 2015 Elsevier B.V. All rights reserved.

Diagnostic crossover and outcome predictors in eating disorders according to DSM-IV and DSM-V proposed criteria: a 6-year follow-up study.

PubMed

Castellini, Giovanni; Lo Sauro, Carolina; Mannucci, Edoardo; Ravaldi, Claudia; Rotella, Carlo Maria; Faravelli, Carlo; Ricca, Valdo

2011-04-01

To evaluate in a 6-year follow-up study the course of a large clinical sample of patients with eating disorders (EDs) who were treated with individual cognitive behavior therapy. The diagnostic crossover, recovery, and relapses were assessed, applying both Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the DSM-V proposed criteria. Patients with EDs move in and out of illness states over time, display frequent relapses, show a relevant lifetime psychiatric comorbidity, and migrate between different diagnoses. A total of 793 patients (including anorexia nervosa, bulimia nervosa, binge eating disorder, and EDs not otherwise specified) were evaluated on the first day of admission, at the end of treatment, 3 years after the end of treatment, and 3 years after the first follow-up. Clinical data were collected through a face-to-face interview; diagnosis was performed by means of the Structured Clinical Interview for DSM-IV and the Eating Disorder Examination Questionnaire was applied. A consistent rate of relapse and crossover between the different diagnoses over time was observed. Mood disorders comorbidity has been found to be an important determinant of diagnostic instability, whereas the severity of shape concern represented a relevant outcome modifier. Using the DSM-V proposed criteria, most patients of EDs not otherwise specified were reclassified, so that the large majority of ED patients seeking treatment would be included in full-blown diagnoses. Among EDs, there are different subgroups of patients displaying various courses and outcomes. The diagnostic instability involves the large majority of patients. An integration of categorical and dimensional approaches could improve the psychopathological investigation and the treatment choices.

Prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder in a nationwide sample of Korean women.

PubMed

Hong, Jin Pyo; Park, Subin; Wang, Hee-Ryung; Chang, Sung Man; Sohn, Jee Hoon; Jeon, Hong Jin; Lee, Hae Woo; Cho, Seong-Jin; Kim, Byung-Soo; Bae, Jae Nam; Cho, Maeng Je

2012-12-01

We examined the prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder (PMDD) according to the DSM-IV criteria in a nationwide sample of Korean women. A total of 2,499 women aged 18-64 years participated in this study. Diagnostic assessments were based on the Korean version of the Composite International Diagnostic Interview (CIDI) 2.1 and its 12-month PMDD diagnostic module, which were administered by lay interviewers. The frequencies of DSM-IV psychiatric disorders, insomnia, and suicidal tendency were analyzed among PMDD cases and compared with non-PMDD cases, and both odds ratios and significance levels were calculated. The 12-month prevalence rate of DSM-IV-diagnosed PMDD was 2.4 %. Among subjects with PMDD, 59.3 % had at least one psychiatric illness; in comparison, the control frequency was 21.8 %. Associations between PMDD and alcohol abuse/dependence, major depressive disorder, post-traumatic stress disorder, social phobia, specific phobia, somatoform disorder, insomnia, and suicidality were overwhelmingly positive and significant (p < 0.05), after controlling for age. Physical illness and being underweight were associated with increased risks of PMDD (p < 0.05). PMDD was prevalent in the nationwide sample of Korean women and was frequently associated with other psychiatric disorders, insomnia, and suicidality, suggesting the need to detect and treat women who experience PMDD.

Preliminary investigation into application of problem-based learning in the practical teaching of diagnostics

PubMed Central

Rui, Zeng; Rong-Zheng, Yue; Hong-Yu, Qiu; Jing, Zeng; Xue-Hong, Wan; Chuan, Zuo

2015-01-01

Background Problem-based learning (PBL) is a pedagogical approach based on problems. Specifically, it is a student-centered, problem-oriented teaching method that is conducted through group discussions. The aim of our study is to explore the effects of PBL in diagnostic teaching for Chinese medical students. Methods A prospective, randomized controlled trial was conducted. Eighty junior clinical medical students were randomly divided into two groups. Forty students were allocated to a PBL group and another 40 students were allocated to a control group using the traditional teaching method. Their scores in the practice skills examination, ability to write and analyze medical records, and results on the stage test and behavior observation scale were compared. A questionnaire was administered in the PBL group after class. Results There were no significant differences in scores for writing medical records, content of interviewing, physical examination skills, and stage test between the two groups. However, compared with the control group, the PBL group had significantly higher scores on case analysis, interviewing skills, and behavioral observation scales. Conclusion The questionnaire survey revealed that PBL could improve interest in learning, cultivate an ability to study independently, improve communication and analytical skills, and good team cooperation spirit. However, there were some shortcomings in systematization of imparting knowledge. PBL has an obvious advantage in teaching with regard to diagnostic practice. PMID:25848334

On the association between diabetes and mental disorders in a community sample: results from the German National Health Interview and Examination Survey.

PubMed

Kruse, Johannes; Schmitz, Norbert; Thefeld, Wolfgang

2003-06-01

To determine the relationship between mental disorders and diabetes in a representative community sample. This was a cross-sectional study. Data on diabetes and HbA(1c) values were obtained by structured questionnaires and by laboratory assessments. Current psychiatric disorders were diagnosed by a modified version of the Composite International Diagnostic Interview (CIDI). People with diabetes (PWD) were not more likely to meet Diagnostic and Statistical Manual of Psychiatric Disorders, 4th edition (DSM-IV) criteria for at least one mental disorder than were individuals without diabetes. However, a different diagnostic pattern occurred compared with the general population: odds ratios (ORs) for anxiety disorders in PWD were higher (OR 1.93, 95% CI 1.19-3.14). Although PWD had higher prevalence rates of affective disorders, the relationship between diabetes and affective disorders was not statistically significant after controlling for age, sex, marital status, and socioeconomic status. In contrast, the relationship between diabetes and anxiety disorders remained significant after controlling for these variables. In contrast to individuals without mental disorders, PWD with affective or anxiety disorders more frequently had adequate glycemic control. Diabetes was associated with an increased likelihood of anxiety disorders. The association between mental disorders, diabetes, and glycemic control should be evaluated carefully in terms of potentially confounding sociodemographic variables, sample characteristics, and definitions of the disorders.

The Diagnostic Validity and Reliability of an Internet-Based Clinical Assessment Program for Mental Disorders

PubMed Central

Klein, Britt; Meyer, Denny; Austin, David William; Abbott, Jo-Anne M

2015-01-01

Background Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. Objective The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. Methods Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. Results With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder: κ=.37) to strong (eg, panic disorder: κ=.62). Although the e-PASS’ sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia: κ=.54) to substantial (eg, bulimia nervosa: κ=.87). Conclusions The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders. Trial Registration Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG). PMID:26392066

Talking with patients and peers: medical students' difficulties with learning communication skills.

PubMed

Lumma-Sellenthin, Antje

2009-06-01

Patient-centered communication skills, such as an empathic attitude towards patients and a holistic perspective on health, are difficult to acquire. Designing effective courses requires better understanding of the difficulties that students perceive with learning to talk with patients The study aimed at exploring students' common difficulties with learning patient-centered communication skills. Group discussions about student-patient interviews were videotaped and analyzed with regard to issues that students perceived as difficult and to their reflections about these difficulties. The students reported feeling intrusive as they explored the patient's psychosocial situation. They avoided being empathic and felt insecure about coping adequately with emotionally loaded topics. Their difficulties were mainly due to insufficient understanding of the functional relations between psychosocial issues and health conditions. Moreover, students were insecure concerning the function of affective feedback in the diagnostic process. However, the group discussions generated a language for analyzing and structuring interviews that helped develop the students' professional identities. Students experienced moral qualms about applying major aspects of patient-centered interviewing. Instruction in communication skills should aim at filling the students' knowledge gaps and fostering their awareness and expression of emotional perceptions. Long-term relationships with patients could help develop patient-centered communication.

Association study of T102C 5-HT2A polymorphism in schizophrenic patients: diagnosis, psychopathology, and suicidal behavior

PubMed Central

Correa, Humberto; De Marco, Luiz; Boson, Wolfanga; Nicolato, Rodrigo; Teixeira, Antó L.; Campo, Valdir R.; Romano-Silva, Marco A.

2007-01-01

The objective of this study was to examine the association between the serotonin (5-HT)2A gene polymorphism (102T/C) and suicidal behavior in schizophrenic inpatients. We studied 129 subjects who met the diagnostic criteria for schizophrenia according to a structured clinicai interview (MINI-PLUS), Patients underwent a semistructured interview to assess suicide attempt history and its characteristics, in addition, at least one close relative of the patient was interviewed to assess prohand and family suicidal behavior. Healthy controls were students and hospital staff members free of psychiatric and medical illness. Genotypes were determined after polymerase chain reaction amplification of the region of 5-HT2A/T102C containing the polymorphic site and digestion with the restriction enzyme Hpall, We found no association between suicidal attempt history and suicide attempt characteristics and genotypic or aileie frequencies. Suicidal behavior was also not associated with demographic or psychopathological characteristics. These results suggest that the S-HT2A gene polymorphism (102T/C) is not involved in genetic susceptibility to suicidal behavior, but further studies in a larger sample are needed. PMID:17506229

Empirical testing of criteria for dissociative schizophrenia.

PubMed

Laferrière-Simard, Marie-Christine; Lecomte, Tania; Ahoundova, Lola

2014-01-01

This study examined the validity of dissociative schizophrenia diagnostic criteria. In the first phase, 50 participants with a psychotic disorder were administered the Dissociative Experiences Scale and the Childhood Trauma Questionnaire to identify those with dissociative characteristics. In the second phase, we selected those who had a score of 15 or above on the Dissociative Experiences Scale. Fifteen of these participants were evaluated thoroughly with the Structured Clinical Interview for DSM-IV Axis I, Structured Clinical Interview for DSM-IV Axis II, and Structured Clinical Interview for DSM-IV Dissociative Disorders to determine whether they met the criteria for dissociative schizophrenia and to generate a clinical description. Our results indicated that 24% of the individuals we tested met these criteria. We propose making mandatory 1 of the 3 dissociative symptoms of the criteria to eliminate people with only nonspecific symptoms (e.g., extensive comorbidity). According to this modified criterion, 14% of our sample would receive a diagnosis of dissociative schizophrenia. However, a more comprehensive look at the clinical picture begs the question of whether dissociative schizophrenia is truly present in every person meeting the criteria. We discuss the relevance of creating a new schizophrenia subtype and offer recommendations for clinicians.

The process of recovery from bipolar I disorder: a qualitative analysis of personal accounts in relation to an integrative cognitive model.

PubMed

Mansell, Warren; Powell, Seth; Pedley, Rebecca; Thomas, Nia; Jones, Sarah Amelia

2010-06-01

This study explored the process of recovery from bipolar I disorder from a phenomenological and cognitive perspective. A semi-structured interview was coded and analysed using interpretative phenomenological analysis. Eleven individuals over the age of 30 with a history of bipolar disorder were selected on the basis of having remained free from relapse, and without hospitalization for at least 2 years, as confirmed by a diagnostic interview (Standardised Interview for DSM-IV; SCID-I). This arbitrary and equivocal criterion for 'recovery' provided an objective method of defining the sample for the study. The analysis revealed two overarching themes formed from four themes each. Ambivalent approaches referred to approaches that participants felt had both positive and negative consequences: avoidance of mania, taking medication, prior illness versus current wellness, and sense of identity following diagnosis. Helpful approaches referred to approaches that were seen as universally helpful: understanding, life-style fundamentals, social support and companionship, and social change. These themes were then interpreted in the light of the existing literature and an integrative cognitive model of bipolar disorder. Limitations and future research directions are discussed.

The Effect of Migration to the United States on Substance Use Disorders Among Returned Mexican Migrants and Families of Migrants

PubMed Central

Borges, Guilherme; Medina-Mora, Maria Elena; Breslau, Joshua; Aguilar-Gaxiola, Sergio

2007-01-01

Objectives. We examined the association between substance use disorders and migration to the United States in a nationally representative sample of the Mexican population. Methods. We used the World Mental Health version of the Composite International Diagnostic Interview to conduct structured, computer-assisted, face-to-face interviews with a cross-sectional sample of household residents aged 18 to 65 years who lived in Mexico in cities with a population of at least 2500 people in 2001 and 2002. The response rate was 76.6%, with 5826 respondents interviewed. Results. Respondents who had migrated to the United States and respondents who had family members who migrated in the United States were more likely to have used alcohol, marijuana, or cocaine at least once in their lifetime; to develop a substance use disorder; and to have a current (in the past 12 months) substance use disorder than were other Mexicans. Conclusions. International migration appears to play a large role in transforming substance use norms and pathology in Mexico. Future studies should examine how networks extending over international boundaries influence substance use. PMID:17761563

Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia

PubMed Central

Kayhan, Fatih; Küçük, Adem; Satan, Yılmaz; İlgün, Erdem; Arslan, Şevket; İlik, Faik

2016-01-01

Background We aimed to investigate the current prevalence of sexual dysfunction (SD), mood, anxiety, and personality disorders in female patients with fibromyalgia (FM). Methods This case–control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Results Fifty of the 96 patients (52.1%) suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had a mood or anxiety disorder and 13 (13.5%) had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%), generalized anxiety disorder (8.3%), and histrionic personality disorder (10.4%). Conclusion SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM. PMID:26937190

Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia.

PubMed

Kayhan, Fatih; Küçük, Adem; Satan, Yılmaz; İlgün, Erdem; Arslan, Şevket; İlik, Faik

2016-01-01

We aimed to investigate the current prevalence of sexual dysfunction (SD), mood, anxiety, and personality disorders in female patients with fibromyalgia (FM). This case-control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Fifty of the 96 patients (52.1%) suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had a mood or anxiety disorder and 13 (13.5%) had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%), generalized anxiety disorder (8.3%), and histrionic personality disorder (10.4%). SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM.

Compulsive buying. Demography, phenomenology, and comorbidity in 46 subjects.

PubMed

Schlosser, S; Black, D W; Repertinger, S; Freet, D

1994-05-01

Compulsive buying has been generally ignored in the psychiatric literature, although it is apparently frequent, underrecognized, and can lead to severe financial and legal consequences for its sufferers. The current investigation was designed to assess the overall life-style and problems of subjects identified as compulsive shoppers. Forty-six compulsive buyers were assessed for comorbid psychiatric disorders with the Diagnostic Interview Schedule, the Structured Interview for DSM-III-R Personality Disorders, and a semistructured interview to assess buying behavior. The typical shopper was a 31-year-old female who had developed compulsive buying at age 18 years. Subjects spent their money on clothing, shoes, and records/compact discs. The average debt load accrued was $5,422 out of an average yearly income of $23,443. More than two-thirds met lifetime criteria for a major (Axis I) mental disorder, most commonly anxiety, substance abuse, and mood disorders. Nearly 60% were found to meet criteria for a DSM-III-R personality disorder, most commonly the obsessive-compulsive, borderline, and avoidant types. The authors conclude that compulsive buying is a definable clinical syndrome which can cause its sufferers significant distress and is associated with significant psychiatric comorbidity.

Qualitative study: the experience and impact of living with Behcet's syndrome.

PubMed

Tai, Vicky; Lindsay, Karen; Sims, Joanne L; McQueen, Fiona M

2017-09-22

Behcet's syndrome is a rare chronic multisystemic vasculitis of unknown aetiology, is unpredictable and can cause life-threatening complications. This qualitative study aims to explore the experiences of patients living with Behcet's syndrome in New Zealand. Eight English-speaking patients participated in in-depth semi-structured interviews about their experiences of living with Behcet's syndrome. Interviews were recorded and transcribed. Data were analysed using a general inductive thematic approach. Five themes related to the experience of Behcet's syndrome emerged from the interviews: diagnosis (diagnostic challenge and closure), impact of disease (pain, fatigue, reduced vision, fear and uncertainty), loneliness and isolation (lack of support and information, invisible illness), acquiring resilience (coping, gaining sense of control, support group) and ongoing interactions with health system (specialist care, primary care, need for multidisciplinary care, doctor-patient relationship). Behcet's syndrome patients experience difficulties in obtaining a timely and correct diagnosis and contend numerous physical and emotional challenges, often experiencing loneliness and isolation. Establishing trusting doctor-patient relationships, allowing timely access to specialist care and recruiting psychosocial supports will help patients better cope with their illness. Diagnosis and management of Behcet's syndrome requires close collaboration and communication among specialists and general practitioners and improved education on Behcet's syndrome.

[Mental disorders among relatives of patients with anorexia nervosa and bulimia nervosa].

PubMed

Wagner, Angela; Wöckel, Lars; Bölte, Sven; Radeloff, Daniel; Lehmkuhl, Gerd; Schmidt, Martin H; Poustka, Fritz

2008-05-01

Family studies of anorexia (AN) and bulimia (BN) nervosa in relatives of patients with eating disorders compared to control subjects are rare in German-speaking countries. A German multicenter study compared first-, second- and third-degree relatives of 65 adolescent AN subjects (n = 746), 21 adolescent BN subjects (n = 265) and relatives of 11 adolescent depressive control subjects (n = 157), as well as those of 37 adolescent healthy control subjects (n = 480). Assessments included the Diagnostic Interview for Genetic Studies (DIGS), the short form of the Family Interview of Genetic Studies (FIGS), and the Eating Disorder Family History Interview. Rates of anorexia nervosa and major depressive disorder (trend) were significantly (p < .01) higher among the first- and second-degree relatives of anorexic and bulimic subjects than among the relatives of healthy controls. Most results were more prominent among relatives of bulimic index patients. Nevertheless, the frequencies were lower in this sample than in comparable US-American samples. The data confirm the hypothesis of familial vulnerability to anorexia and bulimia nervosa. The observed differences in comorbidity patterns among eating-disordered relatives may be due to an age effect of the index patients.

Prevalence, Work-Loss Days and Quality of Life of Community Dwelling Subjects with Depressive Symptoms

PubMed Central

Sohn, Jee Hoon; Ahn, Seung Hee; Seong, Su Jeong; Ryu, Ji Min

2013-01-01

The nationwide prevalence of major depressive disorder in Korea is lower than most countries, despite the high suicide rate. To explain this unexpectedly low prevalence, we examined the functional disability and quality of life in community-dwelling subjects with significant depressive symptoms not diagnosable as depressive disorder. A total of 1,029 subjects, randomly chosen from catchment areas, were interviewed with the Center for Epidemiologic Studies Depression scale, Mini International Neuropsychiatric Interview, WHO Quality of Life scale, and the WHO Disability Assessment Schedule. Those with scores over 21 on the depression scale were interviewed by a psychiatrist for diagnostic confirmation. Among community-dwelling subjects, the 1-month prevalence of major depressive disorder was 2.2%, but the 1-month prevalence of depressive symptoms not diagnosable as depressive disorder was 14.1%. Depressive disorders were the cause of 24.7% of work loss days, while depressive symptoms not diagnosable as depressive disorder were the cause of 17.2% of work loss days. These findings support the dimensional or spectrum approach to depressive disorder in the community and might be the missing link between the apparent low prevalence of depressive disorder and high suicide rate in Korea. PMID:23399785

Dual Diagnosis Motivational Interviewing: a modification of Motivational Interviewing for substance-abusing patients with psychotic disorders

PubMed Central

Martino, Steve; Carroll, Kathleen; Kostas, Demetrios; Perkins, Jennifer; Rounsaville, Bruce

2013-01-01

Motivational Interviewing (MI) is a brief treatment approach for helping patients develop intrinsic motivation to change addictive behaviors. While initially developed to target primary substance using populations, professionals are increasingly recognizing the promise this approach has for addressing the motivational dilemmas faced by patients who have co-occurring psychiatric and psychoactive substance use disorders. Unfortunately, this recognition has not lead to a clear explication of how MI might be adopted for specific diagnostic populations of dually diagnosed patients. In this article we describe how we have applied the principles and practices of MI to patients who have psychotic disorders and co-occurring drug or alcohol use problems. Specifically, we provide two supplemental guidelines to augment basic MI principles (adopting an integrated dual diagnosis approach, accommodating cognitive impairments and disordered thinking). We present recommended modifications to primary MI skill sets (simplifying open-ended questions, refining reflective listening skills, heightening emphasis on affirmations, integrating psychiatric issues into personalized feedback and decisional balance matrices). Finally, we highlight other clinical considerations (handling psychotic exacerbation and crisis events, recommended professional qualifications) when using MI with psychotic disordered dually diagnosed patients. PMID:12495791

Prospective Associations between Religiousness/Spirituality and Depression and Mediating Effects of Forgiveness in a Nationally Representative Sample of United States Adults.

PubMed

Toussaint, Loren L; Marschall, Justin C; Williams, David R

2012-01-01

The present investigation examines the prospective associations of religiousness/spirituality with depression and the extent to which various dimensions of forgiveness act as mediating mechanisms of these associations. Data are from a nationally representative sample of United States adults who were first interviewed in 1998 and reinterviewed six months later. Measures of religiousness/spirituality, forgiveness, and various sociodemographics were collected. Depression was assessed using the Composite International Diagnostic Interview administered by trained interviewers. Results showed that religiousness/spirituality, forgiveness of oneself and others, and feeling forgiven by God were associated, both cross-sectionally and longitudinally, with depressive status. After controlling for initial depressive status, only forgiveness of oneself and others remained statistically significant predictors of depression. Path analyses revealed that religiousness/spirituality conveyed protective effects, prospectively, on depression by way of an indirect path through forgiveness of others but not forgiveness of oneself. Hence, forgiveness of others acts as a mechanism of the salutary effect of religiousness/spirituality, but forgiveness of oneself is an independent predictor. Conclusions regarding the continued development of this type of research and for the treatment of clients with depression are offered.

Prospective Associations between Religiousness/Spirituality and Depression and Mediating Effects of Forgiveness in a Nationally Representative Sample of United States Adults

PubMed Central

Toussaint, Loren L.; Marschall, Justin C.; Williams, David R.

2012-01-01

The present investigation examines the prospective associations of religiousness/spirituality with depression and the extent to which various dimensions of forgiveness act as mediating mechanisms of these associations. Data are from a nationally representative sample of United States adults who were first interviewed in 1998 and reinterviewed six months later. Measures of religiousness/spirituality, forgiveness, and various sociodemographics were collected. Depression was assessed using the Composite International Diagnostic Interview administered by trained interviewers. Results showed that religiousness/spirituality, forgiveness of oneself and others, and feeling forgiven by God were associated, both cross-sectionally and longitudinally, with depressive status. After controlling for initial depressive status, only forgiveness of oneself and others remained statistically significant predictors of depression. Path analyses revealed that religiousness/spirituality conveyed protective effects, prospectively, on depression by way of an indirect path through forgiveness of others but not forgiveness of oneself. Hence, forgiveness of others acts as a mechanism of the salutary effect of religiousness/spirituality, but forgiveness of oneself is an independent predictor. Conclusions regarding the continued development of this type of research and for the treatment of clients with depression are offered. PMID:22675623

Dementia diagnosis and post-diagnostic support in Scottish rural communities: experiences of people with dementia and their families.

PubMed

Innes, Anthea; Szymczynska, Paulina; Stark, Cameron

2014-03-01

This paper explores the reported difficulties and satisfactions with diagnostic processes and post-diagnostic support offered to people with dementia and their families living in the largest remote and rural region in Scotland. A consultation with 18 participants, six people with dementia and 12 family members, was held using semi-structured interviews between September and November 2010. Three points in the diagnostic process were explored: events and experiences pre-diagnosis; the experience of the diagnostic process; and post-diagnostic support. Experiences of people with dementia and their carers varied at all three points in the diagnostic process. Participant experiences in this study suggest greater efforts are required to meet Government diagnosis targets and that post-diagnostic support needs to be developed and monitored to ensure that once a diagnosis is given people are well-supported. Without post-diagnostic provision Government targets for diagnosis are just that, quota targets, rather than a means to improve service experiences.

Protocol and methodology of Study epidemiological mental health in Andalusia: PISMA-ep.

PubMed

Cervilla, Jorge A; Ruiz, Isabel; Rodríguez-Barranco, Miguel; Rivera, Margarita; Ibáñez-Casas, Inmaculada; Molina, Esther; Valmisa, Eulalio; Carmona-Calvo, José; Moreno-Küstner, Berta; Muñoz-Negro, José Eduardo; Ching-López, Ana; Gutiérrez, Blanca

This is the general methods describing paper of a cross-sectional study that aims to detect the prevalence of major mental disorders in Andalusia (Southern Spain), and their correlates or potential risk factors, using a large representative sample of community-dwelling adults. This is a cross-sectional study. We undertook a multistage sampling using different standard stratification levels and aimed to interview 4,518 randomly selected participants living in all 8 provinces of the Andalusian region utilizing a door-knocking approach. The Spanish version of the MINI International Neuropsychiatric Interview, a valid screening instrument ascertaining ICD-10/DSM-IV compatible mental disorder diagnoses was used as our main diagnostic tool. A large battery of other instruments was used to explore global functionality, medical comorbidity, personality traits, cognitive function and exposure to psychosocial potential risk factors. A saliva sample for DNA extraction was also obtained for a sub-genetic study. The interviews were administered and completed by fully trained interviewers, despite most tools used are compatible with lay interviewer use. A total of 3,892 (70.8%) of 5,496 initially attempted households had to be substituted for equivalent ones due to either no response (37.7%) or not fulfilling the required participant quota (33%). Thence, out of 5,496 eligible participants finally approached, 4,507 (83.7%) agreed to take part in the study, completed the interview and were finally included in the study (n=4,507) and 4,286 (78%) participants also agreed and consented to provide a saliva sample for DNA study. On the other hand, 989 (16.3%) approached potential participants refused to take part in the study. This is the largest mental health epidemiological study developed in the region of Spain (Andalusia). The response rates and representativeness of the sample obtained are fairly high. The method is particularly comprehensive for this sort of studies and includes both, personality and cognitive assessments, as well as a large array of bio-psycho-social risk measures. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

The effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics.

PubMed

Verheul, R; Hartgers, C; Van den Brink, W; Koeter, M W

1998-03-01

OBJECTIVE. In a recent review of empirical studies on the prevalence of DSM-III-R personality disorders among substance abusers, wide ranges of prevalence rates for overall Axis II, antisocial personality disorder (APD) and borderline personality disorder (BPD) were shown. Utilizing subsamples from within a single study population, the current report explores the effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics. Personality disorders were assessed with the Personality Diagnostic Questionnaire Revised (PDQR) at two times of measurement (Time 1 n = 459; Time 2 n = 90). In addition, APD was measured with the Composite International Diagnostic Interview (CIDI; n = 587). Finally, an unselected subgroup (n = 136) was interviewed with the International Personality Disorder Examination (IPDE). There were few differences between inpatients or outpatients or between males and females. Using the IPDE, the exclusion of substance-related pathology did not affect the prevalence estimate. However, the prevalence rates according to the PDQR varied greatly across age groups. In a representative subsample (n = 109), the prevalence rates also varied greatly across assessment methods (PDQR, 52% vs IPDE, 31%). The prevalence estimate of APD according to the CIDI was related to setting, gender, age group and the applied time-frame. These findings indicate the examined factors to be necessary qualifiers of prevalence estimates and, consequently, support the use of a multiple-criteria/multimethod assessment battery in research as well as in clinical work.

Psychiatric Disorders in Smokers Seeking Treatment for Tobacco Dependence: Relations with Tobacco Dependence and Cessation

PubMed Central

Piper, Megan E.; Smith, Stevens S.; Schlam, Tanya R.; Fleming, Michael F.; Bittrich, Amy A.; Brown, Jennifer L.; Leitzke, Cathlyn J.; Zehner, Mark E.; Fiore, Michael C.; Baker, Timothy B.

2009-01-01

Objective The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes. Method Data were collected from 1504 smokers (58.2% women, 83.9% white, 44.67 [SD = 11.08] years old) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined using the Composite International Diagnostic Interview (CIDI) structured clinical interview. Tobacco dependence was assessed using the Fagerstrom Test of Nicotine Dependence (FTND) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). Results Diagnostic groups included those who were never diagnosed, ever diagnosed (at any time, including in the past year), and those with past-year diagnoses (with or without prior diagnosis). Some diagnostic groups had lower follow-up abstinence rates than did the never diagnosed group (p’s < .05). At 8 weeks post-quit, strong associations were found between cessation outcome and both past-year mood disorder and ever-diagnosed anxiety disorder. At 6 months post-quit those ever diagnosed with an anxiety disorder (OR = .72, p = .02) and those ever diagnosed with more than one psychiatric diagnosis (OR = .74, p = .03) had lower abstinence rates. The diagnostic categories did not differ in smoking heaviness or the FTND, but they did differ in dependence motives assessed with the WISDM. Conclusion Information on recent or lifetime psychiatric disorders may help clinicians gauge relapse risk and may suggest dependence motives that are particularly relevant to affected patients. These findings also illustrate the importance of using multidimensional tobacco dependence assessments. PMID:20099946

Subjective cognitive complaints included in diagnostic evaluation of dementia helps accurate diagnosis in a mixed memory clinic cohort.

PubMed

Salem, L C; Vogel, A; Ebstrup, J; Linneberg, A; Waldemar, G

2015-12-01

Our objective was to examine the quantity and profile of subjective cognitive complaints in young patients as compared with elderly patients referred to a memory clinic. Patients were consecutively recruited from the Copenhagen University Hospital Memory Clinic at Rigshospitalet. In total, 307 patients and 149 age-matched healthy controls were included. Patients were classified in 4 diagnostic groups: dementia, mild cognitive impairment, affective disorders and no cognitive impairment. Subjective memory was assessed with subjective memory complaints (SMC) scale. Global cognitive functions were assessed with the Mini-mental state examination (MMSE) and Addenbrooke's cognitive examination (ACE), and symptoms of depression were rated with Major Depression Inventory (MDI). All interviews and the diagnostic conclusion were blinded to the SMC score. We found that young patients with dementia have a significantly higher level and a different profile of subjective cognitive complaints as compared with elderly patients with dementia. Furthermore, young patients, diagnosed with an affective disorder, had the highest level of subjective cognitive complaints of all patients in a memory clinic. The age of the patients and MDI score (but not MMSE or ACE) had significant impact on the level of subjective cognitive complaints. We have established that young patients with dementia have a different profile of subjective cognitive complaints than elderly patients, and further studies are needed to clarify possible relation to specific subtypes of dementia. Altogether, a systematic interview on subjective cognitive complaints may contribute to the diagnostic evaluation of patients referred to a memory clinic. Copyright © 2015 John Wiley & Sons, Ltd.

Impact of Repeated Questioning on Interviewers: Learning From a Forensic Interview Training Project.

PubMed

Duron, Jacquelynn F; Cheung, Monit

2016-01-01

Forensic interviewers have a difficult job with high risk for career burnout and secondary trauma. Few studies have addressed how new forensic interviewers or trainees experience repeated questioning and multiple interviews. This study simulated the process of training new forensic interviewers through the creation of two interview videos in which social work graduate students participated as actors portraying the roles of interviewer and child. These films served as instructional aids preparing graduate social work students for professional child welfare roles while promoting research-based approaches to interviewing children about sexual abuse allegations. Qualitative data from two cohorts of student actors were collected to analyze interviewers' perspectives on repeated questioning and interviews in child sexual abuse cases. Two themes were extracted from the subjects' experiences: "It is emotionally taxing" and "Navigating the interviewer role is unexpectedly complex." Exposure to repeated questions and multiple interviews affected the performance and confidence of the interviewers.

The Role of Web-Based Health Information in Help-Seeking Behavior Prior to a Diagnosis of Lung Cancer: A Mixed-Methods Study

PubMed Central

Jay, Caroline; Harper, Simon; Todd, Chris

2017-01-01

Background Delays to diagnosis in lung cancer can lead to reduced chance of survival, and patients often wait for several months before presenting symptoms. The time between first symptom recognition until diagnosis has been theorized into three intervals: symptom appraisal, help-seeking, and diagnostic interval (here: “pathway to diagnosis”). Interventions are needed to reduce delays to diagnosis in lung cancer. The Web has become an important lay health information source and could potentially play a role in this pathway to diagnosis. Objective Our overall aim was to gain a preliminary insight into whether Web-based information plays a role in the pathway to diagnosis in lung cancer in order to assess whether it may be possible to leverage this information source to reduce delays to diagnosis. Methods Patients diagnosed with lung cancer in the 6 months before study entry completed a survey about whether (and how, if yes) they had used the Web to appraise their condition prior to diagnosis. Based on survey responses, we purposively sampled patients and their next-of-kin for semistructured interviews (24 interviews; 33 participants). Interview data were analyzed qualitatively using Framework Analysis in the context of the pathway to diagnosis model. Results A total of 113 patients completed the survey (age: mean 67.0, SD 8.8 years). In all, 20.4% (23/113) reported they or next-of-kin had researched their condition online before the diagnosis. The majority of searches (20/23, 87.0%) were conducted by or with the help of next-of-kin. Interview results suggest that patients and next-of-kin perceived an impact of the information found online on all three intervals in the time to diagnosis. In the appraisal interval, participants used online information to evaluate symptoms and possible causes. In the help-seeking interval, the Web was used to inform the decision of whether to present to health services. In the diagnostic interval, it was used to evaluate health care professionals’ advice, to support requests for further investigation of symptoms, and to understand medical jargon. Within this interval, we identified two distinct subintervals (before/after relevant diagnostic tests were initiated), in which the Web reportedly played different roles. Conclusions Because only 20.4% of the sample reported prediagnosis Web searches, it seems the role of the Web before diagnosis of lung cancer is at present still limited, but this proportion is likely to increase in the future, when barriers such as unfamiliarity with technology and unwillingness to be informed about one’s own health are likely to decrease. Participants’ perceptions suggest that the Web can have an impact on all three intervals in the pathway to diagnosis. Thus, the Web may hold the potential to reduce delays in the diagnostic process, and this should be explored in future research and interventions. Our results also suggest a division of the diagnostic interval into two subintervals may be useful. PMID:28596146

The Role of Web-Based Health Information in Help-Seeking Behavior Prior to a Diagnosis of Lung Cancer: A Mixed-Methods Study.

PubMed

Mueller, Julia; Jay, Caroline; Harper, Simon; Todd, Chris

2017-06-08

Delays to diagnosis in lung cancer can lead to reduced chance of survival, and patients often wait for several months before presenting symptoms. The time between first symptom recognition until diagnosis has been theorized into three intervals: symptom appraisal, help-seeking, and diagnostic interval (here: "pathway to diagnosis"). Interventions are needed to reduce delays to diagnosis in lung cancer. The Web has become an important lay health information source and could potentially play a role in this pathway to diagnosis. Our overall aim was to gain a preliminary insight into whether Web-based information plays a role in the pathway to diagnosis in lung cancer in order to assess whether it may be possible to leverage this information source to reduce delays to diagnosis. Patients diagnosed with lung cancer in the 6 months before study entry completed a survey about whether (and how, if yes) they had used the Web to appraise their condition prior to diagnosis. Based on survey responses, we purposively sampled patients and their next-of-kin for semistructured interviews (24 interviews; 33 participants). Interview data were analyzed qualitatively using Framework Analysis in the context of the pathway to diagnosis model. A total of 113 patients completed the survey (age: mean 67.0, SD 8.8 years). In all, 20.4% (23/113) reported they or next-of-kin had researched their condition online before the diagnosis. The majority of searches (20/23, 87.0%) were conducted by or with the help of next-of-kin. Interview results suggest that patients and next-of-kin perceived an impact of the information found online on all three intervals in the time to diagnosis. In the appraisal interval, participants used online information to evaluate symptoms and possible causes. In the help-seeking interval, the Web was used to inform the decision of whether to present to health services. In the diagnostic interval, it was used to evaluate health care professionals' advice, to support requests for further investigation of symptoms, and to understand medical jargon. Within this interval, we identified two distinct subintervals (before/after relevant diagnostic tests were initiated), in which the Web reportedly played different roles. Because only 20.4% of the sample reported prediagnosis Web searches, it seems the role of the Web before diagnosis of lung cancer is at present still limited, but this proportion is likely to increase in the future, when barriers such as unfamiliarity with technology and unwillingness to be informed about one's own health are likely to decrease. Participants' perceptions suggest that the Web can have an impact on all three intervals in the pathway to diagnosis. Thus, the Web may hold the potential to reduce delays in the diagnostic process, and this should be explored in future research and interventions. Our results also suggest a division of the diagnostic interval into two subintervals may be useful. ©Julia Mueller, Caroline Jay, Simon Harper, Chris Todd. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.06.2017.

Symptoms of Major Depression in a Sample of Fathers of Infants: Sociodemographic Correlates and Links to Father Involvement

ERIC Educational Resources Information Center

Bronte-Tinkew, Jacinta; Moore, Kristin A.; Matthews, Gregory; Carrano, Jennifer

2007-01-01

Depression has been extensively studied for mothers but not for fathers. This study examines the sociodemographic correlates of symptoms of depression and how depression is associated with father involvement using the Composite International Diagnostic Interview-Short Form (CIDI-SF) for major depression. The study uses a sample of 2,139 resident…

Test-Retest Reliability of the Preschool Age Psychiatric Assessment (PAPA)

ERIC Educational Resources Information Center

Egger, Helen Link; Erkanli, Alaattin; Keeler, Gordon; Potts, Edward; Walter, Barbara Keith; Angold, Adrian

2006-01-01

Objective: To examine the test-retest reliability of a new interviewer-based psychiatric diagnostic measure (the Preschool Age Psychiatric Assessment) for use with parents of preschoolers 2 to 5 years old. Method: A total of 1,073 parents of children attending a large pediatric clinic completed the Child Behavior Checklist 1 1/2-5. For 18 months,…

Reliability of the ADI-R: Multiple Examiners Evaluate a Single Case

ERIC Educational Resources Information Center

Cicchetti, Domenic V.; Lord, Catherine; Koenig, Kathy; Klin, Ami; Volkmar, Fred R.

2008-01-01

The authors assessed the reliability of the Autism Diagnostic Interview (ADI-R). Seven Clinical Examiners evaluated a three and one half year old female toddler suspected of being on the Autism Spectrum. Examiners showed agreement levels of 94-96% across all items, with weighted kappa (K[subscript w]) between 0.80 and 0.88. They were in 100%…

Psychiatric disorders, spouse abuse and child abuse.

PubMed

Bland, R C; Orn, H

1986-01-01

The results of 2000 standardized psychiatric diagnostic interviews of randomly selected adult household residents of Edmonton showed that having had any psychiatric diagnosis increased the risk for being involved in spouse and child abuse, particularly for those with alcohol abuse/dependence plus anti-social personality or depression. Altogether 56% of spouse abusers and 69% of child abusers had a lifetime psychiatric diagnosis.

Brief Report: DSM-5 Sensory Behaviours in Children with and without an Autism Spectrum Disorder

ERIC Educational Resources Information Center

Green, Dido; Chandler, Susie; Charman, Tony; Simonoff, Emily; Baird, Gillian

2016-01-01

Atypical responses to sensory stimuli are a new criterion in DSM-5 for the diagnosis of an autism spectrum disorder (ASD) but are also reported in other developmental disorders. Using the Short Sensory profile (SSP) and Autism Diagnostic Interview-Revised we compared atypical sensory behaviour (hyper- or hypo-reactivity to sensory input or unusual…

Colorado Upper-Division Electrostatics Diagnostic: A Conceptual Assessment for the Junior Level

ERIC Educational Resources Information Center

Chasteen, Stephanie V.; Pepper, Rachel E.; Caballero, Marcos D.; Pollock, Steven J.; Perkins, Katherine K.

2012-01-01

As part of an effort to systematically improve our junior-level E&M I course, we have developed a tool to assess student conceptual learning of electrostatics at the upper division. Together with a group of physics faculty, we established a list of learning goals for the course that, with results from student observations and interviews,…

Primer for the Assessment, Diagnosis and Delivery of Internet Interventions for (Mainly) Panic Disorder. Lessons Learned from Our Research Groups

ERIC Educational Resources Information Center

Andersson, Gerhard; Ritterband, Lee M.; Carlbring, Per

2008-01-01

With the advent of the Internet, delivered assessment applications are likely to make a difference in clinical psychology and in health care in general. The purpose of the present paper was to present an overview of the authors' experience regarding Internet administration of diagnostic interviews, questionnaires, and information processing tests.…

Informativeness of Maternal Reports on the Diagnosis of ADHD: An Analysis of Mother and Youth Reports

ERIC Educational Resources Information Center

Biederman, Joseph; Ball, Sarah W.; Mick, Eric; Monuteaux, Michael C.; Kaiser, Roselinde; Bristol, Elyssa; Faraone, Stephen V.

2007-01-01

Objective: We evaluated correlates of the diagnosis of ADHD in youth by informant source. Method: Ninety-four pairs of mother reports and youth self-reports on ADHD were independently assessed, using diagnostic interviews from a large study of youth of both genders with and without ADHD. Comparisons were made on measures of interpersonal, school,…

[Is evidence-based assessment fact or fiction? A bibliometric analysis of three German journals].

PubMed

Petermann, Franz; Schüssler, Gerhard; Glaesmer, Heide

2008-01-01

Despite the ongoing process for the development and dissemination of empirically supported treatments, little attention has been paid to the development of evidence-based diagnostics. The article aims at evaluating diagnostic procedures and instruments in current clinical research in terms of evidence-based assessment. Volumes 2006 and 2007 of three German psychological journals "Psychotherapeut," "Psychotherapie, Psychosomatik und Medizinische Psychologie," and "Zeitschrift für Psychiatrie, Psychologie und Psychotherapie" were screened for empirical reports and articles dealing with diagnostic issues. 93 articles were identified and evaluated. Most studies used psychometrically valid and established instruments for assessment. However, diagnostic interviews were relatively scarce, as were multimodal assessments. Measures used for outcome evaluation often lacked evidence of sensitivity to change. Clinical assessment to date does not meet criteria for evidence-based diagnostics. Implications for research and guideline development are discussed.

Gender incongruence: a comparative study using ICD-10 and DSM-5 diagnostic criteria.

PubMed

Soll, Bianca M; Robles-García, Rebeca; Brandelli-Costa, Angelo; Mori, Daniel; Mueller, Andressa; Vaitses-Fontanari, Anna M; Cardoso-da-Silva, Dhiordan; Schwarz, Karine; Abel-Schneider, Maiko; Saadeh, Alexandre; Lobato, Maria-Inês-Rodrigues

2018-01-01

To compare the presence of criteria listed in the DSM-5 and ICD-10 diagnostic manuals in a Brazilian sample of transgender persons seeking health services specifically for physical transition. This multicenter cross-sectional study included a sample of 103 subjects who sought services for gender identity disorder in two main reference centers in Brazil. The method involved a structured interview encompassing the diagnostic criteria in the two manuals. The results revealed that despite theoretical disagreement about the criteria, the manuals overlap regarding diagnosis confirmation; the DSM-5 was more inclusive (97.1%) than the ICD-10 (93.2%) in this population. Although there is no consensus on diagnostic criteria on transgenderism in the diversity of social and cultural contexts, more comprehensive diagnostic criteria are evolving due to society's increasing inclusivity.

[Therapeutic goals and indications: psychotherapy patient's self-reports during diagnostic assessment].

PubMed

Faller, H

2000-07-01

Although individual therapeutic goals are considered to be important factors motivating patients to engage in therapeutic work, they have gained little attention in empirical research. In the present study, patients were given a questionnaire containing 24 therapeutic goals which could be rated according to their subjective relevance on a 5-point scale. N = 152 patients (mean age 34.5 years, 59.2% female) who presented at a university psychotherapy outpatient department to attend a diagnostic interview participated in the study. "To solve my problems" and "to get relief from my complaints" were the goals that were rated as most important. Goals pertaining to mental health such as more contentness and calmness, self-assertion and insight scored high, too. Three rational scales were constructed: 1. insight, 2. sociability, and 3. self-assertion. These scales were correlated with both patients' causal attributions and therapy expectations in plausible ways. However, the general strength of intercorrelations point of the conception patients goals were not very succinct at the time of the intake interview. Indication groups regarding specific therapeutic measures did not differ with respect to therapy goals. Only the general decision whether to recommend a psychotherapeutic intervention or not seemed to be influenced by patients' therapeutic aims.

The World Health Organization World Mental Health Survey Initiative.

PubMed

Kessler, Ronald C; Haro, Josep Maria; Heeringa, Steven G; Pennell, Beth-Ellen; Ustün, T Bedirhan

2006-01-01

To present an overview of the World Health Organization World Mental Health (WMH) Survey Initiative. The discussion draws on knowledge gleaned from the authors' participation as principals in WMH. WMH has carried out community epidemiological surveys in more than two dozen countries with more than 200,000 completed interviews. Additional surveys are in progress. Clinical reappraisal studies embedded in WMH surveys have been used to develop imputation rules to adjust prevalence estimates for within- and between-country variation in accuracy. WMH interviews include detailed information about sub-threshold manifestations to address the problem of rigid categorical diagnoses not applying equally to all countries. Investigations are now underway of targeted substantive issues. Despite inevitable limitations imposed by existing diagnostic systems and variable expertise in participating countries, WMH has produced an unprecedented amount of high-quality data on the general population cross-national epidemiology of mental disorders. WMH collaborators are in thoughtful and subtle investigations of cross-national variation in validity of diagnostic assessments and a wide range of important substantive topics. Recognizing that WMH is not definitive, finally, insights from this round of surveys are being used to carry out methodological studies aimed at improving the quality of future investigations.

Cognitive Risk and Protective Factors for Suicidal Ideation: A Two Year Longitudinal Study in Adolescence

PubMed Central

Burke, Taylor A.; Connolly, Samantha L.; Hamilton, Jessica L.; Stange, Jonathan P.; Abramson, Lyn Y.; Alloy, Lauren B.

2015-01-01

Adolescence is a developmental period associated with heightened risk for both the onset and escalation of suicidal ideation (SI). Given that SI is a potent predictor of suicidal behavior, it is important to develop models of vulnerability for and protection against SI, particularly among young adolescents. This study examined the relative impact of several cognitive vulnerabilities, as well as protective factors, for SI among young adolescents over a 2-year interval encompassing their transition to mid-adolescence. At baseline, 324 adolescents (M=12.39 years; SD=0.63; 52.5 % female) completed measures of depressive symptoms, self-referent information processing biases, negative inferential style, and responses to negative affect. Further, the adolescents and their mothers were administered a diagnostic interview to assess current and past depressive disorders and SI. Over follow-up, adolescents and their mothers were administered the diagnostic interview every 12 months and adolescents completed a self-report measure inquiring about SI every 6 months to assess interviewer-rated and self-reported SI. Logistic regressions indicated that preferential endorsement of negative adjectives as self-referent (only among girls), rumination in response to negative affect, and a negative inferential style prospectively predicted SI. Additionally, young adolescents’ tendency to respond to negative affect with distraction and problem-solving buffered against their risk for exhibiting SI. When these factors were entered simultaneously, preferential endorsement of negative adjectives as self-referent and the use of distraction and problem-solving skills remained the only significant prospective predictors of SI. No previous studies have examined these variables as predictors of SI, thereby highlighting their potential utility in improving the predictive validity of extant models of suicide risk and resilience. PMID:26597963

Prevalence and predictors of major depressive disorder for fertility treatment patients and their partners.

PubMed

Holley, Sarah R; Pasch, Lauri A; Bleil, Maria E; Gregorich, Steven; Katz, Patricia K; Adler, Nancy E

2015-05-01

To examine the prevalence and predictors of major depressive disorder (MDD) for women and their partners during the course of fertility treatment. Prospective cohort study during an 18-month period. Participants completed interviews and questionnaires at baseline and at 4, 10, and 18 months of follow-up. Five community and academic fertility practices. A total of 174 women and 144 of their male partners who did not have a successful child-related outcome during the time frame of the study. No interventions administered. The MDD was assessed using the Composite International Diagnostic Interview Major Depression module, a structured diagnostic interview. Additional variables were assessed with self-report questionnaire measures. Of the women 39.1% and of the men 15.3% met the criteria for MDD during the 18-month course of the study. A binary logistic covariate-adjusted model showed that, for both women and men, past MDD was a significant predictor of MDD during treatment. Past MDD further predicted significant risk for MDD during treatment after controlling for other well-established risk factors (i.e., baseline levels of depression, anxiety, and partner support). The MDD was highly prevalent for fertility treatment patients and their partners. Past MDD predicted risk for MDD during treatment, and it contributed to MDD risk more than other commonly assessed risk factors. This suggests that patients and their partners would benefit from being routinely assessed for a history of MDD before the start of treatment to best direct psychosocial support and interventions to those most in need. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

A life shaped by pain: women and endometriosis.

PubMed

Huntington, Annette; Gilmour, Jean A

2005-10-01

The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. Symptomatic endometriosis significantly affects women's quality of life. Characteristically the condition causes severe pain and has a negative impact on the ability to work, on family relationships and self-esteem. There has been little discussion about women's experience of endometriosis in nursing literature. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. This is a fertile area for the development of the Nurse Practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.

'Multiple-test' approach to the laboratory diagnosis of tuberculosis -perception of medical doctors from Ujjain, India.

PubMed

Purohit, Manju Raj; Sharma, Megha; Rosales-Klintz, Senia; Lundborg, Cecilia Stålsby

2015-08-11

Delay in diagnosis is one of the most important factors for the control of tuberculosis (TB) in endemic countries like India. As laboratory diagnosis is the mainstay for identification of active disease, we aim to explore and understand the opinions of medical doctors about the laboratory diagnosis of TB in Ujjain, India. Sixteen qualified specialist medical doctors from Ujjain were purposefully selected for the study. Individual interviews with the doctors (13 men and 3 women), were conducted. As one interview could not be completed, data from 15 interviews were analyzed using manifest and latent content analysis. Based on perception of the doctors, the theme; 'challenges and need for the laboratory diagnosis of TB' emerged from the following subthemes: (i) Relationship between basic element of the TB diseases process such as 'Symptoms prior to diagnoses' and 'Clinical characteristics of TB', which were not specific enough to diagnose TB (ii) The prevailing conditions such as lack of explicit diagnostic tools, lead to the doctors using the 'multiple tests' or 'empiric treatment' approach (iii) The doctors proposed that there is a need for access to a rapid, single and simple diagnostic test, and a need for awareness and knowledge of the practitioners regarding specific TB investigations, and early referral to improve the situation at resource-limited settings. The medical specialists use a 'multiple test' or 'empiric treatment' approach to diagnose TB. According to the participants, there is a low dependence and uptake of the available laboratory TB investigations by medical practitioners. There is an urgent need to have a specific, simple and reliable test, and a protocol, to improve diagnosis of TB and to prevent development of resistant TB.

Parents perspectives on whole genome sequencing for their children: qualified enthusiasm?

PubMed

Anderson, J A; Meyn, M S; Shuman, C; Zlotnik Shaul, R; Mantella, L E; Szego, M J; Bowdin, S; Monfared, N; Hayeems, R Z

2017-08-01

To better understand the consequences of returning whole genome sequencing (WGS) results in paediatrics and facilitate its evidence-based clinical implementation, we studied parents' experiences with WGS and their preferences for the return of adult-onset secondary variants (SVs)-medically actionable genomic variants unrelated to their child's current medical condition that predict adult-onset disease. We conducted qualitative interviews with parents whose children were undergoing WGS as part of the SickKids Genome Clinic, a research project that studies the impact of clinical WGS on patients, families, and the healthcare system. Interviews probed parents' experience with and motivation for WGS as well as their preferences related to SVs. Interviews were analysed thematically. Of 83 invited, 23 parents from 18 families participated. These parents supported WGS as a diagnostic test, perceiving clear intrinsic and instrumental value. However, many parents were ambivalent about receiving SVs, conveying a sense of self-imposed obligation to take on the 'weight' of knowing their child's SVs, however unpleasant. Some parents chose to learn about adult-onset SVs for their child but not for themselves. Despite general enthusiasm for WGS as a diagnostic test, many parents felt a duty to learn adult-onset SVs. Analogous to 'inflicted insight', we call this phenomenon 'inflicted ought'. Importantly, not all parents of children undergoing WGS view the best interests of their child in relational terms, thereby challenging an underlying justification for current ACMG guidelines for reporting incidental secondary findings from whole exome and WGS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Lung cancer diagnosed following an emergency admission: Mixed methods study of the management, outcomes and needs and experiences of patients and carers.

PubMed

Wilcock, Andrew; Crosby, Vincent; Hussain, Asmah; McKeever, Tricia M; Manderson, Cathann; Farnan, Sarah; Freer, Sarah; Freemantle, Alison; Littlewood, Fran; Caswell, Glenys; Seymour, Jane

2016-05-01

In the UK, although 40% of patients with lung cancer are diagnosed following an emergency admission (EA), data is limited on their needs and experiences as they progress through diagnostic and treatment pathways. Prospective data collection using medical records, questionnaires and in-depth interviews. Multivariate logistic regression explored associations between diagnosis following EA and aspects of interest. Questionnaire responses with 95% confidence intervals were compared with local and national datasets. A grounded theory approach identified patient and carer themes. Of 401 patients, 154 (38%) were diagnosed following EA; 37 patients and six carers completed questionnaires and 13 patients and 10 carers were interviewed. Compared to those diagnosed electively, EA patients adjusted results found no difference in treatment recommendation, treatment intent or place of death. Time to diagnosis, review, or treatment was 7-14 days quicker but fewer EA patients had a lung cancer nurse present at diagnosis (37% vs. 62%). Palliative care needs were high (median [IQR] 21 [13-25] distressing or bothersome symptoms/issues) and various information and support needs unmet. Interviews highlighted in particular, perceived delays in obtaining investigations/specialist referral and factors influencing success or failure of the cough campaign. Presentation as an EA does not appear to confer any inherent disadvantage regarding progress through lung cancer diagnostic and treatment pathways. However, given the frequent combination of advanced disease, poor performance status and prognosis, together with the high level of need and reported short-fall in care, we suggest that a specialist palliative care assessment is routinely offered. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pre-adult versus adult onset major depressive disorder in a naturalistic patient sample: the Leiden Routine Outcome Monitoring Study.

PubMed

van Noorden, M S; Minkenberg, S E; Giltay, E J; den Hollander-Gijsman, M E; van Rood, Y R; van der Wee, N J; Zitman, F G

2011-07-01

Pre-adult onset of major depressive disorder (MDD) may predict a more severe phenotype of depression. As data from naturalistic psychiatric specialty care settings are scarce, we examined phenotypic differences between pre-adult and adult onset MDD in a large sample of consecutive out-patients. Altogether, 1552 out-patients, mean age 39.2 ± 11.6 years, were diagnosed with current MDD on the Mini-International Neuropsychiatric Interview Plus diagnostic interview as part of the usual diagnostic procedure. A total of 1105 patients (71.2%) had complete data on all variables of interest. Pre-adult onset of MDD was defined as having experienced the signs and symptoms of a first major depressive episode before the age of 18 years. Patients were stratified according to the age at interview (20-40/40-65 years). Correlates of pre-adult onset were analysed using logistic regression models adjusted for age, age squared and gender. Univariate analyses showed that pre-adult onset of MDD had a distinct set of demographic (e.g. less frequently living alone) and clinical correlates (more co-morbid DSM-IV - Text Revision diagnoses, more social phobia, more suicidality). In the multivariate model, we found an independent association only for a history of suicide attempts [odds ratio (OR) 3.15, 95% confidence intervals (CI) 1.97-5.05] and current suicidal thoughts (OR 1.81, 95% CI 1.26-2.60) in patients with pre-adult versus adult onset MDD. Pre-adult onset of MDD is associated with more suicidality than adult onset MDD. Age of onset of depression is an easy to ascertain characteristic that may help clinicians in weighing suicide risk.

Dissociation in Posttraumatic Stress Disorder: Evidence from the World Mental Health Surveys

PubMed Central

Stein, Dan J.; Koenen, Karestan C.; Friedman, Matthew J.; Hill, Eric; McLaughlin, Katie A.; Petukhova, Maria; Ruscio, Ayelet Meron; Shahly, Victoria; Spiegel, David; Borges, Guilherme; Bunting, Brendan; Caldas-de-Almeida, Jose Miguel; de Girolamo, Giovanni; Demyttenaere, Koen; Florescu, Silvia; Haro, Josep Maria; Karam, Elie G.; Kovess-Masfety, Viviane; Lee, Sing; Matschinger, Herbert; Mladenova, Maya; Posada-Villa, Jose; Tachimori, Hisateru; Viana, Maria Carmen; Kessler, Ronald C.

2012-01-01

Background Although the proposal for a dissociative subtype of posttraumatic stress disorder (PTSD) in DSM-5 is supported by considerable clinical and neurobiological evidence, this evidence comes mostly from referred samples in Western countries. Cross-national population epidemiologic surveys were analyzed to evaluate generalizability of the subtype in more diverse samples. Methods Interviews were administered to 25,018 respondents in 16 countries in the World Health Organization World Mental Health Surveys. The Composite International Diagnostic Interview was used to assess 12-month DSM-IV PTSD and other common DSM-IV disorders. Items from a checklist of past-month nonspecific psychological distress were used to assess dissociative symptoms of depersonalization and derealization. Differences between PTSD with and without these dissociative symptoms were examined across a variety of domains, including index trauma characteristics, prior trauma history, childhood adversity, sociodemographic characteristics, psychiatric comorbidity, functional impairment, and treatment seeking. Results Dissociative symptoms were present in 14.4% of respondents with 12-month DSM-IV/Composite International Diagnostic Interview PTSD and did not differ between high and low/middle income countries. Symptoms of dissociation in PTSD were associated with high counts of re-experiencing symptoms and net of these symptom counts with male sex, childhood onset of PTSD, high exposure to prior (to the onset of PTSD) traumatic events and childhood adversities, prior histories of separation anxiety disorder and specific phobia, severe role impairment, and suicidality. Conclusion These results provide community epidemiologic data documenting the value of the dissociative subtype in distinguishing a meaningful proportion of severe and impairing cases of PTSD that have distinct correlates across a diverse set of countries. PMID:23059051

Traditional Chinese medicine--women's experiences in the treatment of infertility.

PubMed

Alfred, Ann; Ried, Karin

2011-09-01

Infertility affects about 15% of couples. Many women proceed to reproductive clinics for in vitro fertilisation, with some exploring a range of alternative or complementary options. We explored women's experiences with traditional Chinese medicine (TCM) for the treatment of infertility. We interviewed 25 women with primary or secondary infertility, recurrent miscarriage or stillbirth who had consulted TCM practitioners. We explored women's experience of TCM and fertility clinics and analysed interviews thematically. Women appreciated the noninvasive diagnostic techniques TCM practitioners used to identify 'imbalances' causing infertility, learnt how to assess fertility indicators, and valued the focused personal care provided. All noticed improved menstrual cycles. Women wished for integration of holistic therapies in infertility management. Our study highlights the need for patient centred care and fertility education, and suggests that some women see a possible role for TCM as part of infertility management.

Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire.

PubMed

Hirschfeld, R M; Williams, J B; Spitzer, R L; Calabrese, J R; Flynn, L; Keck, P E; Lewis, L; McElroy, S L; Post, R M; Rapport, D J; Russell, J M; Sachs, G S; Zajecka, J

2000-11-01

Bipolar spectrum disorders, which include bipolar I, bipolar II, and bipolar disorder not otherwise specified, frequently go unrecognized, undiagnosed, and untreated. This report describes the validation of a new brief self-report screening instrument for bipolar spectrum disorders called the Mood Disorder Questionnaire. A total of 198 patients attending five outpatient clinics that primarily treat patients with mood disorders completed the Mood Disorder Questionnaire. A research professional, blind to the Mood Disorder Questionnaire results, conducted a telephone research diagnostic interview by means of the bipolar module of the Structured Clinical Interview for DSM-IV. A Mood Disorder Questionnaire screening score of 7 or more items yielded good sensitivity (0.73) and very good specificity (0.90). The Mood Disorder Questionnaire is a useful screening instrument for bipolar spectrum disorder in a psychiatric outpatient population.

Equity in interviews: do personal characteristics impact on admission interview scores?

PubMed

Lumb, Andrew B; Homer, Matthew; Miller, Amy

2010-11-01

Research indicates that some social groups are disadvantaged by medical school selection systems. The stage(s) of a selection process at which this occurs is unknown, but at interview, when applicant and interviewer are face-to-face, there is potential for social bias to occur. We performed a detailed audit of the interview process for a single-entry year to a large UK medical school. Our audit included investigating the personal characteristics of both interviewees and interviewers to find out whether any of these factors, including the degree of social matching between individual pairs of interviewees and interviewers, influenced the interview scores awarded. A total of 320 interviewers interviewed 734 applicants, providing complete data for 2007 interviewer-interviewee interactions. The reliability of the interview process was estimated using generalisability theory at 0.82-0.87. For both interviewers and interviewees, gender, ethnic background, socio-economic group and type of school attended had no influence on the interview scores awarded or achieved. Staff and student interviewer marks did not differ significantly. Although numbers in each group of staff interviewers were too small for formal statistical analysis, there were no obvious differences in marks awarded between different medical specialties or between interviewers with varying amounts of interviewing experience. Our data provide reassurance that the interview does not seem to be the stage of selection at which some social groups are disadvantaged. These results support the continued involvement of senior medical students in the interview process. Despite the lack of evidence that an interview is useful for predicting future academic or clinical success, most medical schools continue to use interviews as a fundamental component of their selection process. Our study has shown that at least this arguably misplaced reliance upon interviewing is not introducing further social bias into the selection system. © Blackwell Publishing Ltd 2010.

The impact of using peer interviewers in a study of patient empowerment amongst people in cancer follow-up.

PubMed

Jørgensen, Clara R; Eskildsen, Nanna B; Thomsen, Thora G; Nielsen, Inger D; Johnsen, Anna T

2017-12-05

A range of benefits have been reported from engaging peer interviewers in qualitative interviews, but little systematic evaluation exists to assess their impact on both process and outcomes of qualitative interviews in health research. To investigate the impact of involving patient representatives as peer interviewers in a research project on patient empowerment. 18 interviews were carried out as part of the wider study, seven by the academic researcher alone and eleven jointly with a peer interviewer. The interviews were analysed quantitatively and qualitatively to explore potential differences between interviews conducted by the researcher alone and interviews conducted jointly by the researcher and the peer interviewers. A phone evaluation of the peer interviews was carried out with the research participants, and notes were thematically analysed to understand their experiences. Differences were identified between the academic researcher and the peer interviewers in the types of questions they asked and the degree to which personal narrative was used in the interview. Peer interviewers varied significantly in their approach. Research participants were positive about the experience of being interviewed by a peer interviewer. No firm conclusions could be made about impact on outcomes. The uniqueness and complexity of qualitative interviews made it difficult to provide any firm conclusions about the impact of having peer interviewers on the research outcomes, and the benefits identified from the analysis mostly related to the process of the interviews. Benefits from using peer interviewers need to be considered alongside relevant ethical considerations, and available resources for training and support. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

Quality Control for Interviews to Obtain Dietary Recalls from Children for Research Studies

PubMed Central

SHAFFER, NICOLE M.; THOMPSON, WILLIAM O.; BAGLIO, MICHELLE L.; GUINN, CAROLINE H.; FRYE, FRANCESCA H. A.

2005-01-01

Quality control is an important aspect of a study because the quality of data collected provides a foundation for the conclusions drawn from the study. For studies that include interviews, establishing quality control for interviews is critical in ascertaining whether interviews are conducted according to protocol. Despite the importance of quality control for interviews, few studies adequately document the quality control procedures used during data collection. This article reviews quality control for interviews and describes methods and results of quality control for interviews from two of our studies regarding the accuracy of children's dietary recalls; the focus is on quality control regarding interviewer performance during the interview, and examples are provided from studies with children. For our two studies, every interview was audio recorded and transcribed. The audio recording and typed transcript from one interview conducted by each research dietitian either weekly or daily were randomly selected and reviewed by another research dietitian, who completed a standardized quality control for interviews checklist. Major strengths of the methods of quality control for interviews in our two studies include: (a) interviews obtained for data collection were randomly selected for quality control for interviews, and (b) quality control for interviews was assessed on a regular basis throughout data collection. The methods of quality control for interviews described may help researchers design appropriate methods of quality control for interviews for future studies. PMID:15389417

Developmental Differences in the Effects of Repeated Interviews and Interviewer Bias on Young Children's Event Memory and False Reports

ERIC Educational Resources Information Center

Quas, Jodi A.; Malloy, Lindsay C.; Melinder, Annika; Goodman, Gail S.; D'Mello, Michelle; Schaaf, Jennifer

2007-01-01

The present study investigated developmental differences in the effects of repeated interviews and interviewer bias on children's memory and suggestibility. Three- and 5-year-olds were singly or repeatedly interviewed about a play event by a highly biased or control interviewer. Children interviewed once by the biased interviewer after a long…

Diagnostic Utility of the ADI-R and DSM-5 in the Assessment of Latino Children and Adolescents.

PubMed

Magaña, Sandy; Vanegas, Sandra B

2017-05-01

Latino children in the US are systematically underdiagnosed with Autism Spectrum Disorder (ASD); therefore, it is important that recent changes to the diagnostic process do not exacerbate this pattern of under-identification. Previous research has found that the Autism Diagnostic Interview-Revised (ADI-R) algorithm, based on the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition, Text Revision (DSM-IV-TR), has limitations with Latino children of Spanish speaking parents. We evaluated whether an ADI-R algorithm based on the new DSM-5 classification for ASD would be more sensitive in identifying Latino children of Spanish speaking parents who have a clinical diagnosis of ASD. Findings suggest that the DSM-5 algorithm shows better sensitivity than the DSM-IV-TR algorithm for Latino children.

Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey.

PubMed

Walitt, Brian; Katz, Robert S; Bergman, Martin J; Wolfe, Frederick

2016-01-01

Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). The majority of clinically diagnosed fibromyalgia cases in the US do not reach levels of severity necessary and sufficient for diagnosis. The clinical diagnosis of fibromyalgia is disproportionally dependent on demographic and social factors rather than the symptoms themselves. Diagnostic criteria for fibromyalgia appear to be used as a vague guide by clinicians and patients, and allow for substantial diagnostic expansion of fibromyalgia.

Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey

PubMed Central

Walitt, Brian; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick

2016-01-01

Objectives Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. Methods The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Results Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). Conclusions The majority of clinically diagnosed fibromyalgia cases in the US do not reach levels of severity necessary and sufficient for diagnosis. The clinical diagnosis of fibromyalgia is disproportionally dependent on demographic and social factors rather than the symptoms themselves. Diagnostic criteria for fibromyalgia appear to be used as a vague guide by clinicians and patients, and allow for substantial diagnostic expansion of fibromyalgia. PMID:27281286

The Effects of Respondents’ Consent to be Recorded on Interview Length and Data Quality in a National Panel Study

PubMed Central

McGonagle, Katherine A.; Brown, Charles; Schoeni, Robert F.

2014-01-01

Recording interviews is a key feature of quality control protocols for most survey organizations. We examine the effects on interview length and data quality of a new protocol adopted by a national panel study. The protocol recorded a randomly chosen one-third of all interviews digitally, although all respondents were asked for permission to record their interview, and interviewers were blind to whether or not interviews were recorded. We find that the recording software slowed the interview slightly. Interviewer knowledge that the interview may be recorded improved data quality, but this knowledge also increased the length of the interview. Interviewers with higher education and performance ratings were less reactive to the new recording protocol. Survey managers may face a trade-off between higher data quality and longer interviews when determining recording protocols. PMID:26550000

Comparative Reliability of Structured Versus Unstructured Interviews in the Admission Process of a Residency Program

PubMed Central

Blouin, Danielle; Day, Andrew G.; Pavlov, Andrey

2011-01-01

Background Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. Methods In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Results Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. Conclusions A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains established as essential to succeed in this residency program. PMID:23205201

Comparative reliability of structured versus unstructured interviews in the admission process of a residency program.

PubMed

Blouin, Danielle; Day, Andrew G; Pavlov, Andrey

2011-12-01

Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains established as essential to succeed in this residency program.

Comparison of web-based and face-to-face interviews for application to an anesthesiology training program: a pilot study

PubMed Central

Malkin, Mathew R.; Lenart, John; Stier, Gary R.; Gatling, Jason W.; Applegate II, Richard L.

2016-01-01

Objectives This study compared admission rates to a United States anesthesiology residency program for applicants completing face-to-face versus web-based interviews during the admissions process. We also explored factors driving applicants to select each interview type. Methods The 211 applicants invited to interview for admission to our anesthesiology residency program during the 2014-2015 application cycle were participants in this pilot observational study. Of these, 141 applicants selected face-to-face interviews, 53 applicants selected web-based interviews, and 17 applicants declined to interview. Data regarding applicants' reasons for selecting a particular interview type were gathered using an anonymous online survey after interview completion. Residency program admission rates and survey answers were compared between applicants completing face-to-face versus web-based interviews. Results One hundred twenty-seven (75.1%) applicants completed face-to-face and 42 (24.9%) completed web-based interviews. The admission rate to our residency program was not significantly different between applicants completing face-to-face versus web-based interviews. One hundred eleven applicants completed post-interview surveys. The most common reasons for selecting web-based interviews were conflict of interview dates between programs, travel concerns, or financial limitations. Applicants selected face-to-face interviews due to a desire to interact with current residents, or geographic proximity to the residency program. Conclusions These results suggest that completion of web-based interviews is a viable alternative to completion of face-to-face interviews, and that choice of interview type does not affect the rate of applicant admission to the residency program. Web-based interviews may be of particular interest to applicants applying to a large number of programs, or with financial limitations. PMID:27039029

Selling and Smooth-Talking: Effects of Interviewer Impression Management from a Signaling Perspective.

PubMed

Wilhelmy, Annika; Kleinmann, Martin; Melchers, Klaus G; Götz, Martin

2017-01-01

Prior research suggests that interviewers play an important role in representing their organization and in making the interview a pleasant experience for applicants. This study examined whether impression management used by interviewers (organization-enhancement and applicant-enhancement) is perceived by applicants, and how it influences applicants' attitudes, intentions, and emotions. Adopting a signaling perspective, this article argues that applicants' positive attitudes and intentions toward the organization increase if interviewers not only enhance the organization, but if the signals they sent (i.e., organization-enhancement) are actually received by the applicant. Similarly, applicants' positive emotions should increase if interviewers not only enhance the applicant, but if the signals they send (i.e., applicant-enhancement) are actually received by the applicant. A field study that involved video coding interviewers' impression management behavior during 153 selection interviews and pre- and post-interview applicant surveys showed that the signals sent by interviewers during the interview were received by applicants. In addition, applicants rated the organization's prestige and their own positive affect after the interview more positively when they perceived higher levels of organization-enhancement during the interview. Furthermore, applicants reported more positive affect and interview self-efficacy after the interview when they perceived higher levels of interviewer applicant-enhancement. We also found an indirect effect of interviewers' organization-enhancement on organizational prestige through applicants' perceptions of organization-enhancement as well as indirect effects of interviewers' applicant-enhancement on applicants' positive affect and interview self-efficacy through applicants' perceptions of applicant-enhancement. Our findings contribute to an integrated understanding of the effects of interviewer impression management and point out both risks and chances in selling and smooth-talking toward applicants.

Selling and Smooth-Talking: Effects of Interviewer Impression Management from a Signaling Perspective

PubMed Central

Wilhelmy, Annika; Kleinmann, Martin; Melchers, Klaus G.; Götz, Martin

2017-01-01

Prior research suggests that interviewers play an important role in representing their organization and in making the interview a pleasant experience for applicants. This study examined whether impression management used by interviewers (organization-enhancement and applicant-enhancement) is perceived by applicants, and how it influences applicants' attitudes, intentions, and emotions. Adopting a signaling perspective, this article argues that applicants' positive attitudes and intentions toward the organization increase if interviewers not only enhance the organization, but if the signals they sent (i.e., organization-enhancement) are actually received by the applicant. Similarly, applicants' positive emotions should increase if interviewers not only enhance the applicant, but if the signals they send (i.e., applicant-enhancement) are actually received by the applicant. A field study that involved video coding interviewers' impression management behavior during 153 selection interviews and pre- and post-interview applicant surveys showed that the signals sent by interviewers during the interview were received by applicants. In addition, applicants rated the organization's prestige and their own positive affect after the interview more positively when they perceived higher levels of organization-enhancement during the interview. Furthermore, applicants reported more positive affect and interview self-efficacy after the interview when they perceived higher levels of interviewer applicant-enhancement. We also found an indirect effect of interviewers' organization-enhancement on organizational prestige through applicants' perceptions of organization-enhancement as well as indirect effects of interviewers' applicant-enhancement on applicants' positive affect and interview self-efficacy through applicants' perceptions of applicant-enhancement. Our findings contribute to an integrated understanding of the effects of interviewer impression management and point out both risks and chances in selling and smooth-talking toward applicants. PMID:28611696

The surgical skills laboratory residency interview: an enjoyable alternative.

PubMed

Dumont, Travis M; Horgan, Michael A

2012-01-01

The authors aimed to trial an alternative interviewing strategy by inviting residency candidates to our surgical anatomy laboratory. Interviews were coincident with surgical dissection. The authors hypothesized that residency candidates hoping to match into a surgical subspecialty might enjoy this unconventional interviewing strategy, which would mimic an operating room experience. On scheduled residency interview dates, formal, unstructured interviews were held with half of the neurosurgical faculty, and unstructured surgical skills laboratory-based interviews were held with the other half of the neurosurgical faculty. Interviews in the skills laboratory featured cases and corresponding surgical dissection guided by faculty. After the interview, the residency candidates were encouraged to complete an optional survey about their interview process. The survey results were pooled for analysis. Of 28 interviewed, 19 individuals responded to the survey. The survey respondents had favorable reviews of the all aspects of the interview process. When asked to report the most enjoyable part of the interview, all respondents listed the surgical skills laboratory. The average respondent scores for importance of the surgical skills laboratory interview (9.5 ± 1.1) compared with conventional interview with faculty (9.2 ± 1.0) or residents (9.1 ± 1.0) was not significantly different (p = 0.50, analysis of variance). The surgical skills laboratory interviews were reviewed favorably by the survey respondents. Nearly all respondents listed the surgical skills interview as the most enjoyable part of the interview experience. The authors advocate this residency interview strategy for surgical subspecialty residencies. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Comparing Lay Community and Academic Survey Center Interviewers in Conducting Household Interviews in Latino Communities.

PubMed

Chan-Golston, Alec M; Friedlander, Scott; Glik, Deborah C; Prelip, Michael L; Belin, Thomas R; Brookmeyer, Ron; Santos, Robert; Chen, Jie; Ortega, Alexander N

2016-01-01

The employment of professional interviewers from academic survey centers to conduct surveys has been standard practice. Because one goal of community-engaged research is to provide professional skills to community residents, this paper considers whether employing locally trained lay interviewers from within the community may be as effective as employing interviewers from an academic survey center with regard to unit and item nonresponse rates and cost. To study a nutrition-focused intervention, 1035 in-person household interviews were conducted in East Los Angeles and Boyle Heights, 503 of which were completed by lay community interviewers. A chi-square test was used to assess differences in unit nonresponse rates between professional and community interviewers and Welch's t tests were used to assess differences in item nonresponse rates. A cost comparison analysis between the two interviewer groups was also conducted. Interviewers from the academic survey center had lower unit nonresponse rates than the lay community interviewers (16.2% vs. 23.3%; p < 0.01). However, the item nonresponse rates were lower for the community interviewers than the professional interviewers (1.4% vs. 3.3%; p < 0.01). Community interviewers cost approximately $415.38 per survey whereas professional interviewers cost approximately $537.29 per survey. With a lower cost per completed survey and lower item nonresponse rates, lay community interviewers are a viable alternative to professional interviewers for fieldwork in community-based research. Additional research is needed to assess other important aspects of data quality interviewer such as interviewer effects and response error.

Use of the Interview in Resident Candidate Selection: A Review of the Literature.

PubMed

Stephenson-Famy, Alyssa; Houmard, Brenda S; Oberoi, Sidharth; Manyak, Anton; Chiang, Seine; Kim, Sara

2015-12-01

Although the resident candidate interview is costly and time-consuming for both applicants and programs, it is considered critically important for resident selection. Noncognitive attributes, including communication skills and professionalism, can be assessed by the personal interview. We conducted a review of the literature on the residency interview to identify the interview characteristics used for resident selection and to ascertain to what extent the interview yields information that predicts future performance. We searched PubMed and Scopus using the following search terms: residency, internship, interview, selection, and performance. We extracted information on characteristics of the interview process, including type of interview format, measures taken to minimize bias by interviewers, and testing of other clinical/surgical skills. We identified 104 studies that pertained to the resident selection interview, with highly varied interview formats and assessment tools. A positive correlation was demonstrated between a medical school academic record and the interview, especially for unblinded interview formats. A total of 34 studies attempted to correlate interview score with performance in residency, with mixed results. We also identified a number of studies that included personality testing, clinical skills testing, or surgical skills testing. Our review identified a wide variety of approaches to the selection interview and a range of factors that have been studied to assess its effectiveness. More research needs to be done not only to address and ascertain appropriate interview formats that predict positive performance in residency, but also to determine interview factors that can predict both residents' "success" and program attrition.

Why wait? The social determinants underlying tuberculosis diagnostic delay

PubMed Central

Saunders, Matthew James; Zegarra, Roberto; Evans, Carlton; Alegria-Flores, Kei; Guio, Heinner

2017-01-01

Background Early detection and diagnosis of tuberculosis remain major global priorities for tuberculosis control. Few studies have used a qualitative approach to investigate the social determinants contributing to diagnostic delay and none have compared data collected from individual, community, and health-system levels. We aimed to characterize the social determinants that contribute to diagnostic delay among persons diagnosed with tuberculosis living in resource-constrained settings. Methods/Principle findings Data were collected in public health facilities with high tuberculosis incidence in 19 districts of Lima, Peru. Semi-structured interviews with persons diagnosed with tuberculosis (n = 105) and their family members (n = 63) explored health-seeking behaviours, community perceptions of tuberculosis and socio-demographic circumstances. Focus groups (n = 6) were conducted with health personnel (n = 35) working in the National Tuberculosis Program. All interview data were transcribed and analysed using a grounded theory approach. The median delay between symptom onset and the public health facility visit that led to the first positive diagnostic sample was 57 days (interquartile range 28–126). The great majority of persons diagnosed with tuberculosis distrusted the public health system and sought care at public health facilities only after exhausting other options. It was universally agreed that persons diagnosed with tuberculosis faced discrimination by public and health personnel. Self-medication with medicines bought at local pharmacies was reported as the most common initial health-seeking behaviour due to the speed and low-cost of treatment in pharmacies. Most persons diagnosed with tuberculosis initially perceived their illness as a simple virus. Conclusions Diagnostic delay was common and prolonged. When individuals reached a threshold of symptom severity, they addressed their health with the least time-consuming, most economically feasible, and well-known healthcare option available to them. In high-burden settings, more human and material resources are required to promote tuberculosis case-finding initiatives, reduce tuberculosis associated stigma and address the social determinants underlying diagnostic delay. PMID:28945782

The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer.

PubMed

Hartung, Tim J; Friedrich, Michael; Johansen, Christoffer; Wittchen, Hans-Ulrich; Faller, Herman; Koch, Uwe; Brähler, Elmar; Härter, Martin; Keller, Monika; Schulz, Holger; Wegscheider, Karl; Weis, Joachim; Mehnert, Anja

2017-11-01

Depression screening in patients with cancer is recommended by major clinical guidelines, although the evidence on individual screening tools is limited for this population. Here, the authors assess and compare the diagnostic accuracy of 2 established screening instruments: the depression modules of the 9-item Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS-D), in a representative sample of patients with cancer. This multicenter study was conducted with a proportional, stratified, random sample of 2141 patients with cancer across all major tumor sites and treatment settings. The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic (ROC) curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using the Composite International Diagnostic Interview for Oncology as the criterion standard. The diagnostic accuracy of the PHQ-9 and HADS-D was fair for diagnosing major depressive disorder, with areas under the ROC curves of 0.78 (95% confidence interval, 0.76-0.79) and 0.75 (95% confidence interval, 0.74-0.77), respectively. The 2 questionnaires did not differ significantly in their areas under the ROC curves (P = .15). The PHQ-9 with a cutoff score ≥7 had the best screening performance, with a sensitivity of 83% (95% confidence interval, 78%-89%) and a specificity of 61% (95% confidence interval, 59%-63%). The American Society of Clinical Oncology guideline screening algorithm had a sensitivity of 44% (95% confidence interval, 36%-51%) and a specificity of 84% (95% confidence interval, 83%-85%). In patients with cancer, the screening performance of both the PHQ-9 and the HADS-D was limited compared with a standardized diagnostic interview. Costs and benefits of routinely screening all patients with cancer should be weighed carefully. Cancer 2017;123:4236-4243. © 2017 American Cancer Society. © 2017 American Cancer Society.

Why wait? The social determinants underlying tuberculosis diagnostic delay.

PubMed

Bonadonna, Lily Victoria; Saunders, Matthew James; Zegarra, Roberto; Evans, Carlton; Alegria-Flores, Kei; Guio, Heinner

2017-01-01

Early detection and diagnosis of tuberculosis remain major global priorities for tuberculosis control. Few studies have used a qualitative approach to investigate the social determinants contributing to diagnostic delay and none have compared data collected from individual, community, and health-system levels. We aimed to characterize the social determinants that contribute to diagnostic delay among persons diagnosed with tuberculosis living in resource-constrained settings. Data were collected in public health facilities with high tuberculosis incidence in 19 districts of Lima, Peru. Semi-structured interviews with persons diagnosed with tuberculosis (n = 105) and their family members (n = 63) explored health-seeking behaviours, community perceptions of tuberculosis and socio-demographic circumstances. Focus groups (n = 6) were conducted with health personnel (n = 35) working in the National Tuberculosis Program. All interview data were transcribed and analysed using a grounded theory approach. The median delay between symptom onset and the public health facility visit that led to the first positive diagnostic sample was 57 days (interquartile range 28-126). The great majority of persons diagnosed with tuberculosis distrusted the public health system and sought care at public health facilities only after exhausting other options. It was universally agreed that persons diagnosed with tuberculosis faced discrimination by public and health personnel. Self-medication with medicines bought at local pharmacies was reported as the most common initial health-seeking behaviour due to the speed and low-cost of treatment in pharmacies. Most persons diagnosed with tuberculosis initially perceived their illness as a simple virus. Diagnostic delay was common and prolonged. When individuals reached a threshold of symptom severity, they addressed their health with the least time-consuming, most economically feasible, and well-known healthcare option available to them. In high-burden settings, more human and material resources are required to promote tuberculosis case-finding initiatives, reduce tuberculosis associated stigma and address the social determinants underlying diagnostic delay.

An ontology for Autism Spectrum Disorder (ASD) to infer ASD phenotypes from Autism Diagnostic Interview-Revised data.

PubMed

Mugzach, Omri; Peleg, Mor; Bagley, Steven C; Guter, Stephen J; Cook, Edwin H; Altman, Russ B

2015-08-01

Our goal is to create an ontology that will allow data integration and reasoning with subject data to classify subjects, and based on this classification, to infer new knowledge on Autism Spectrum Disorder (ASD) and related neurodevelopmental disorders (NDD). We take a first step toward this goal by extending an existing autism ontology to allow automatic inference of ASD phenotypes and Diagnostic & Statistical Manual of Mental Disorders (DSM) criteria based on subjects' Autism Diagnostic Interview-Revised (ADI-R) assessment data. Knowledge regarding diagnostic instruments, ASD phenotypes and risk factors was added to augment an existing autism ontology via Ontology Web Language class definitions and semantic web rules. We developed a custom Protégé plugin for enumerating combinatorial OWL axioms to support the many-to-many relations of ADI-R items to diagnostic categories in the DSM. We utilized a reasoner to infer whether 2642 subjects, whose data was obtained from the Simons Foundation Autism Research Initiative, meet DSM-IV-TR (DSM-IV) and DSM-5 diagnostic criteria based on their ADI-R data. We extended the ontology by adding 443 classes and 632 rules that represent phenotypes, along with their synonyms, environmental risk factors, and frequency of comorbidities. Applying the rules on the data set showed that the method produced accurate results: the true positive and true negative rates for inferring autistic disorder diagnosis according to DSM-IV criteria were 1 and 0.065, respectively; the true positive rate for inferring ASD based on DSM-5 criteria was 0.94. The ontology allows automatic inference of subjects' disease phenotypes and diagnosis with high accuracy. The ontology may benefit future studies by serving as a knowledge base for ASD. In addition, by adding knowledge of related NDDs, commonalities and differences in manifestations and risk factors could be automatically inferred, contributing to the understanding of ASD pathophysiology. Copyright © 2015 Elsevier Inc. All rights reserved.

DSM-III as a research tool.

PubMed

Treece, C

1982-05-01

The author describes the use of the DSM-III's diagnostic criteria and classification system as a research instrument and discusses some of the advantages and drawbacks of DMS-III for a specific type of study. A rearrangement of the hierarchical order of the DSM-III diagnostic classes is suggested. This rearrangement provides for levels of certainty in analyzing interrater reliability and offers a simplified framework for summarizing group data. When this approach is combined with a structured interview and response format, it provides a flexible way of managing a large classification system for a smaller study without sacrificing standardization.

Developmental Differences in the Effects of Repeated Interviews and Interviewer Bias on Young Children’s Event Memory and False Reports

PubMed Central

Quas, Jodi A.; Malloy, Lindsay C.; Melinder, Annika; Goodman, Gail S.; D’Mello, Michelle; Schaaf, Jennifer

2010-01-01

The present study investigated developmental differences in the effects of repeated interviews and interviewer bias on children’s memory and suggestibility. Three- and 5-year-olds were singly or repeatedly interviewed about a play event by a highly biased or control interviewer. Children interviewed once by the biased interviewer after a long delay made the most errors. Children interviewed repeatedly, regardless of interviewer bias, were more accurate and less likely to falsely claim that they played with a man. In free recall, among children questioned once after a long delay by the biased interviewer, 5-year-olds were more likely than were 3-year-olds to claim falsely that they played with a man. However, in response to direct questions, 3-year-olds were more easily manipulated into implying that they played with him. Findings suggest that interviewer bias is particularly problematic when children’s memory has weakened. In contrast, repeated interviews that occur a short time after a to-be-remembered event do not necessarily increase children’s errors, even when interviews include misleading questions and interviewer bias. Implications for developmental differences in memory and suggestibility are discussed. PMID:17605517

[Simple and useful evaluation of motor difficulty in childhood (9-12 years old children ) by interview score on motor skills and soft neurological signs--aim for the diagnosis of developmental coordination disorder].

PubMed

Kashiwagi, Mitsuru; Suzuki, Shuhei

2009-09-01

Many children with developmental disorders are known to have motor impairment such as clumsiness and poor physical ability;however, the objective evaluation of such difficulties is not easy in routine clinical practice. In this study, we aimed to establish a simple method for evaluating motor difficulty of childhood. This method employs a scored interview and examination for detecting soft neurological signs (SNSs). After a preliminary survey with 22 normal children, we set the items and the cutoffs for the interview and SNSs. The interview consisted of questions pertaining to 12 items related to a child's motor skills in his/her past and current life, such as skipping, jumping a rope, ball sports, origami, and using chopsticks. The SNS evaluation included 5 tests, namely, standing on one leg with eyes closed, diadochokinesia, associated movements during diadochokinesia, finger opposition test, and laterally fixed gaze. We applied this method to 43 children, including 25 cases of developmental disorders. Children showing significantly high scores in both the interview and SNS were assigned to the "with motor difficulty" group, while those with low scores in both the tests were assigned to the "without motor difficulty" group. The remaining children were assigned to the "with suspicious motor difficulty" group. More than 90% of the children in the "with motor difficulty" group had high impairment scores in Movement Assessment Battery for Children (M-ABC), a standardized motor test, whereas 82% of the children in the "without motor difficulty" group revealed no motor impairment. Thus, we conclude that our simple method and criteria would be useful for the evaluation of motor difficulty of childhood. Further, we have discussed the diagnostic process for developmental coordination disorder using our evaluation method.

Help-seeking for psychiatric disorders.

PubMed

Bland, R C; Newman, S C; Orn, H

1997-11-01

To examine demographic and clinical determinants of seeking help for mental or emotional problems. To determine the proportion of those people with a disorder who sought help. To determine what categories of professionals are sought by those who get care. A 2-stage random sample of 3956 adult residents of Edmonton, Alberta, Canada was interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS) (73% completion rate). An average of 2.8 years later, a systematic random sample of 1964 subjects was reinterviewed (an 86% completion rate) using the DIS and a health care utilization questionnaire. After adjusting for age and sex, the reinterview sample was representative of those with and without a diagnosis at the first interview. Of the 1964 subjects, 570 (31%) met criteria for a DIS/DSM-III diagnosis in the year preceding the interview (one-year prevalence rate). These diagnoses included generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). For those with a diagnosis, sex, age, marital status, education, employment, and income were examined as determinants of help-seeking. Only sex (female) and age (under 45) were significant predictors. Comorbidity was highly significant: the help-seeking rate for those with one diagnosis was 20.3%; for those with more than one diagnosis, the rate was 42.8% (OR = 2.94, chi 2 = 31.4, df = 1, P < 0.001). Just over 28% of those with a diagnosis saw any health care professional, and 7.7% of those without a diagnosis sought help for a mental or emotional problem. A specific diagnosis made a difference: 46.7% of those with a major depressive episode sought help, but only 16.0% of those with alcohol abuse or dependence sought care. Major determinants of help-seeking are sex (female), age (under 45), severity of the illness, and comorbidity. A surprisingly high proportion of those with a disorder (72%) do not seek help, and over one-third of those seeking help do not have a current DIS/DSM-III disorder.

OMICS and 21st century brain surgery from education to practice: James Rutka of the University of Toronto interviewed by Joseph B. Martin (Boston) and Türker Kılıç (İstanbul).

PubMed

Rutka, James; Martin, Joseph; Kılıç, Türker

2014-12-01

The Science-in-Backstage interviews aim to share experiences by global medical and life sciences thought leaders on emergent technologies and novel scientific, medical, and educational practices, situating them in both a historical and contemporary science context so as to "look into the biotechnology and innovation futures" reflexively and intelligently. OMICS systems diagnostics and personalized medicine are greatly impacting brain surgery, not to forget the training of the next generation of neurosurgeons. What do the futures hold for the practice of, and education in 21(st) century brain surgery in the age of OMICS systems science, personalized medicine, and the use of simulation in surgeon training? James Rutka is a clinician scientist and a world leader in diagnosis and treatment of brain tumors. He is Professor and Chair of the Department of Surgery at the Faculty of Medicine, University of Toronto, a President Emeritus of the American Association of Neurological Surgeons, and Editor-in-Chief of the Journal of Neurosurgery. Professor Rutka was interviewed for the global medical, biotechnology, and life sciences readership of the OMICS: A Journal of Integrative Biology to speak on these pressing questions in his personal capacity as an independent senior scholar. The issues debated in the present interview are of broad relevance for 21(st) century surgery and postgenomics medicine. The interviewers were Professor Joseph B. Martin, Harvard Medical School Dean Emeritus in Boston and Joint Dean of Medicine at Bahçeşehir University in İstanbul, and the author of "Alfalfa to Ivy: Memoir of a Harvard Medical School Dean," and Professor Türker Kılıç, Dean of Medicine at Bahçeşehir University in İstanbul, and an elected member of the Turkish Academy of Sciences.

Comparing appropriateness and equivalence of email interviews to phone interviews in qualitative research on reproductive decisions.

PubMed

Hershberger, Patricia E; Kavanaugh, Karen

2017-10-01

Despite an increasing use of qualitative email interviews by nurse researchers, there is little understanding about the appropriateness and equivalence of email interviews to other qualitative data collection methods, especially on sensitive topics research. The purpose is to describe our procedures for completing asynchronous, email interviews and to evaluate the appropriateness and equivalency of email interviews to phone interviews in two qualitative research studies that examined reproductive decisions. Content analysis guided the methodological appraisal of appropriateness and equivalency of in-depth, asynchronous email interviews to single phone interviews. Appropriateness was determined by: (a) participants' willingness to engage in email or phone interviews, (b) completing data collection in a timely period, and (c) participants' satisfaction with the interview. Equivalency was evaluated by: (a) completeness of the interview data, and (b) insight obtained from the data. Of the combined sample in the two studies (N=71), 31% of participants chose to participate via an email interview over a phone interview. The time needed to complete the email interviews averaged 27 to 28days and the number of investigator probe-participant response interchanges was 4 to 5cycles on average. In contrast, the phone interviews averaged 59 to 61min in duration. Most participants in both the email and phone interviews reported they were satisfied or very satisfied with their ability to express their true feelings throughout the interview. Regarding equivalence, 100% of the email and phone interviews provided insight into decision processes. Although insightful, two of the email and one phone interview had short answers or, at times, underdeveloped responses. Participants' quotes and behaviors cited within four published articles, a novel evaluation of equivalency, revealed that 20% to 37.5% of the citations about decision processes were from email participants, which is consistent with the percent of email participants. In-depth, asynchronous email interviews were appropriate and garnered rich, insightful data that augmented the phone interviews. Awareness of the procedures, appropriateness, and nuances when carrying out email interviews on sensitive topics may provide nurse researchers with the ability to obtain thick, rich data that can best advance clinical practice and direct future research. Copyright © 2017 Elsevier Inc. All rights reserved.

Patient Health Questionnaire-9 versus Edinburgh Postnatal Depression Scale in screening for major depressive episodes: a cross-sectional population-based study.

PubMed

Santos, Iná S; Tavares, Beatriz Franck; Munhoz, Tiago N; Manzolli, Patricia; de Ávila, Gisele Bartz; Jannke, Eduardo; Matijasevich, Alicia

2017-01-21

Major depressive episodes (MDE) are frequent at the population level and are generally associated with severe symptoms that impair performance of activities of daily living of individuals suffering from this condition. The aim of this study was to compare the accuracy of two tests that separately showed suitable properties in screening for MDE: the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS). In a previous study, the sensitivity and specificity of the PHQ-9 and the EPDS in screening for MDE were compared with a structured diagnostic interview conducted by psychiatrics and psychologists using the Mini International Neuropsychiatric Interview as the gold standard. In a sample of adults living in the community in Pelotas, Brazil, the PHQ-9 and EPDS were applied at the same interview and the gold standard on a median of 17 days later. The interviews were carried out at the participant's home. 447 Individuals (191 men and 256 women) were assessed. The PHQ-9 and the EPDS results were concordant in 87.5% of the respondents, with a moderate agreement beyond what was expected by chance alone (kappa = 0.61). The areas below the ROC curves were not statistically different (82.1% for PHQ-9 and 83.5% for EPDS) (p = 0.291), thus indicating that the two tests had similar moderate accuracy. PHQ-9 and EPDS may be applied with equal confidence in screening for MDE in the community.

User-Centered Design of the eyeGuide, a Tailored Glaucoma Behavior Change Program

PubMed Central

Killeen, Olivia; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P.; Newman-Casey, Paula Anne

2016-01-01

PURPOSE We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. PATIENTS Glaucoma patients ≥ age 40 prescribed ≥1 glaucoma medication were included. METHODS The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semi-structured diagnostic and pre-testing interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audio recorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook and identified key themes using NVivo 10.0 to further refine the eyeGuide. RESULTS Twenty-one glaucoma patients were interviewed; mean age 72 ± 12.4 years, five (24%) African-Americans, nine (43%) with poor self-reported adherence, ten (47.6%) ≥ age 75, ten (47.6%) with poor vision and nine (42.9%) women. Qualitative analysis identified five important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients’ beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a web-based module. Participant feedback resulted in revised content. CONCLUSIONS User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content. PMID:27096721

User-centered Design of the eyeGuide: A Tailored Glaucoma Behavior Change Program.

PubMed

Killeen, Olivia J; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P; Newman-Casey, Paula Anne

2016-10-01

We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. Glaucoma patients age 40 years and above prescribed ≥1 glaucoma medication were included. The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semistructured diagnostic and pretesting interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audiorecorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook, and identified key themes using NVivo 10.0 to further refine the eyeGuide. Twenty-one glaucoma patients were interviewed; mean age 72±12.4 years, 5 (24%) African Americans, 9 (43%) with poor self-reported adherence, 10 (47.6%) age 75 years and above, 10 (47.6%) with poor vision, and 9 (42.9%) women. Qualitative analysis identified 5 important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients' beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a Web-based module. Participant feedback resulted in revised content. User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content.

Patient health questionnaire-9 versus Edinburgh postnatal depression scale in screening for major depressive episodes: a cross-sectional population-based study.

PubMed

Santos, Iná S; Tavares, Beatriz Franck; Munhoz, Tiago N; Manzolli, Patricia; de Ávila, Gisele Bartz; Jannke, Eduardo; Matijasevich, Alicia

2016-09-27

Major depressive episodes (MDE) are frequent at the population level and are generally associated with severe symptoms that impair performance of activities of daily living of individuals suffering from this condition. The aim of this study was to compare the accuracy of two tests that separately showed suitable properties in screening for MDE: the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh postnatal depression scale (EPDS). In a previous study, the sensitivity and specificity of the PHQ-9 and the EPDS in screening for MDE were compared with a structured diagnostic interview conducted by psychiatrics and psychologists using the Mini International Neuropsychiatric Interview as the gold standard. In a sample of adults living in the community in Pelotas, Brazil, the PHQ-9 and EPDS were applied at the same interview and the gold standard on a median of 17 days later. The interviews were carried out at the participant's home. 447 individuals (191 men and 256 women) were assessed. The PHQ-9 and the EPDS results were concordant in 87.5 % of the respondents, with a moderate agreement beyond what was expected by chance alone (kappa = 0.61). The areas below the ROC curves were not statistically different (82.1 % for PHQ-9 and 83.5 % for EPDS) (p = 0.291), thus indicating that the two tests had similar moderate accuracy. PHQ-9 and EPDS may be applied with equal confidence in screening for MDE in the community.

Treatment Seeking and Self-Constructed Explanations of Pain and Pain Management Strategies Among Adolescents with Temporomandibular Disorder Pain.

PubMed

Nilsson, Ing-Marie; Willman, Ania

2016-01-01

To explore adolescents' explanations of their temporomandibular disorder (TMD) pain, their pain management strategies for TMD pain, and their treatment-seeking behavior. One-on-one interviews were conducted with 21 adolescents aged 15 to 19 years who had TMD pain and followed a semistructured interview guide. Subjects were strategically selected from patients referred to an orofacial pain clinic. All participants had been examined and received a pain diagnosis based on the Research Diagnostic Criteria for TMD. The interviews focused on the adolescents' experiences of TMD pain, their strategies for handling pain, and how they seek care. The interviews were recorded, transcribed verbatim, and analyzed using qualitative manifest content analysis. Qualitative manifest content analysis revealed two categories: (1) self-constructed explanations, with three subcategories (situation-based explanatory model, physical/biologic model, and psychological explanatory model); and (2) pain management strategies, with four subcategories (social support, treatment, relaxation/rest, and psychological strategies). Adolescents used physical activities and psychological and pharmacologic treatment to manage pain. Reasons for seeking treatment were to be cured, to obtain an explanation for their pain, and because their symptoms bother others. Adolescents living with TMD pain develop self-constructed explanations and pain management strategies. With access to these descriptions, dentists can be better prepared to have a dialogue with their adolescent patients about their own explanations of pain, the nature of pain, and in which situations the pain appears. Dentists can also explore adolescent patients' pain management strategies and perhaps also suggest new treatment strategies at an earlier stage.

The Structured Interview and Interviewer Training in the Admissions Process

PubMed Central

Cox, Wendy C.; White-Harris, Carla; Blalock, Susan J.

2007-01-01

Objectives To determine the extent to which the structured interview is used in the PharmD admissions process in US colleges and schools of pharmacy, and the prevalence and content of interviewer training. Methods A survey instrument consisting of 7 questions regarding interviews and interviewer training was sent to 92 colleges and schools of pharmacy in the United States that were accredited or seeking accreditation. Results Sixty survey instruments (65% response rate) were returned. The majority of the schools that responded (80%) used interviews as part of the PharmD admissions process. Of the schools that used an interview as part of the admissions process, 86% provided some type of interviewer training and 13% used a set of predefined questions in admissions interviews. Conclusions Most colleges and schools of pharmacy use some components of the structured interview in the PharmD admissions process; however, training for interviewers varies widely among colleges and schools of pharmacy. PMID:17998980

Reducing misinformation effects in older adults with cognitive interview mnemonics.

PubMed

Holliday, Robyn E; Humphries, Joyce E; Milne, Rebecca; Memon, Amina; Houlder, Lucy; Lyons, Amy; Bull, Ray

2012-12-01

We examined the effect of a prior Modified Cognitive Interview on young and older adults' recall of a short film of a staged crime and subsequent reporting of misinformation. Participants viewed the film followed the next day by misinformation presented in a postevent summary. They were then interviewed with either a Modified Cognitive Interview or a control interview followed by a recognition memory test. A Modified Cognitive Interview elicited more correct details and improved overall accuracy compared to a control interview in both age groups, although the young adults recollected three times more correct information in a Modified Cognitive Interview than the older adults. In both age groups, correct recollections of person and action details were higher in a Modified Cognitive Interview than a control interview. Importantly, older adults who were interviewed with a Modified Cognitive Interview were not susceptible to misinformation effects. 2013 APA, all rights reserved