Clinical interviews

First MB, Spitzer RL, Gibbon M, et al Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Patient Edition With Psychotic Screen (SCID-I/ P W/ PSY SCREEN) New York, New York State Psychiatric Institute, Biometrics Research, 1997... 

In addition to the clinical interview, psychometric rating instruments allow for rapid and reliable measurement of the nature and severity of depressive and associated symptoms. 

First, M. B., Spitzer, R. L., Gibbon, M., St Williams, J. B. (1994). Structured clinical interview for DSM-1V-patient edition. (SCID-I/P, Version 2.0). New York Biometrics Research Department. 

BEHAVIOURAL MODIFICATION IN DEPRESSED CHILDREN HEAD AND TRUNK MOVEMENTS BEFORE AND AFTER TREATMENT DURING CLINICAL INTERVIEWS... 

There are a number of useful standardized scales to monitor severity and treatment outcomes, (reviewed by Conners [1998] and Barkley [1998]) Because of the overlap with other disorders, an ADHD-specific scale is strongly recommended (such as the Conners, SNAP, Dupaul scales) in which symptom items are based on the DSM criteria and do not include items of other disorders (such as anxiety or mood) or nonspecific functional items. Some ADHD scales provide separate ratings of oppositionality or aggression (SNAP, Conners). It may be helpful to monitor symptoms from non-ADHD conditions as well as functional deficits, and thus a broad-spectrum scale may also be employed but should not be used as the primary measure of ADHD severity or anti-ADHD treatment. Normed rating scales provide comparative information on severity based on age and gender however, such tests are not diagnostic and are not a substitute for the clinical interview. 

It is a truism that no matter how sophisticated the diagnostic instrument, nothing can replace a well-conducted comprehensive clinical interview. It is essential in the assessment of pediatric PTSD that clinicians use multiple informants and take careful histories while searching for complicating comorbid conditions. No single instrument will serve all clinicians. 

The most commonly used semi-structured diagnostic scale is the Structured Clinical Interview for DSM-IV Axis I Disorders (SCI I) First et al., 1997). A clinical version of the SCID (SCID-CV) is designed for use in clinical settings and covers the most commonly seen diagnoses according to DSM-IV. The research version of the SCID includes ratings for different subtypes, severity and course specifiers of mental disorders. The SCLD-CV contains six modules (A) Mood Episodes (B) Psychotic Symptoms (C) Psychotic Disorders (D) Mood Disorders (E) Substance Use Disorders fF) Anxiety and Other Disorders. 

First, MJT, Spitzer, R.L., Gibbon, M., Williams, J.B.W. Structured Clinical Interview for DSM-IY Axis I Disorders. American Psychiatric Press, Washington. DC, 1997. 

In the United States, the Research Diagnostic Criteria (RDC) (19) and the DSM-IV (8) both provide clear inclusion and exclusion criteria for a current episode ( Table 9-2). Evaluation of past episodes can be made using the Schedule for Affective Disorders and Schizophrenia—Lifetime Version (SADS-L) ( 20) or the Structured clinical Interview for DSM (21). In other countries, the Present State Exam (PSE) (22) can reliably distinguish mania from other disorders. Table 9-3 reviews the various clinical presentations of primary bipolar disorder and their related DSM-IV diagnoses ( 23) (see also Appendix A, Appendix G, and Appendix H). 

Spitzer RL, Williams JBW, Gibbon M, et al. The Structured Clinical Interview for DSM-lll-R. I history, rationale and description. Arch Gen Psychiatry 1992 49 624-629. 

Brief clinical interview dealing with anxiety symptoms (Tyrer et al. 1984). 

A brief clinical interview covering the symptoms of depression (Montgomery and Asberg 1979). 

The diagnosis of depression still rests primarily on the clinical interview. Major depressive disorder (MDD) is characterized by depressed mood most of the time for at least 2 weeks and/or loss of interest or pleasure in most activities. In addition, depression is characterized by disturbances in sleep and appetite as well as deficits in cognition and energy. Thoughts of guilt, worthlessness, and suicide are common. Coronary artery disease, diabetes, and stroke appear to be more common in depressed patients, and depression may considerably worsen the prognosis for patients with a variety of comorbid medical conditions. 

Sander AM, Mohan KK, Axelrod BN, Nahhas A, Kapen S. The Epworth Sleepiness Scale an unworthy adversary to clinical interview. Sleep Res 1996 25 355... 

In Germany, Cassel et al. (30) at the same time showed that apneic patients diagnosed by clinical interview and polysomnography were frequently involved in sleep-related accidents (30). 

During the clinical interview Mrs. Urick expressed an interest in knowing more about changes in treatment should her baby have PKU. She was especially curious about tetrahy-drobiopterin (BH4) therapy, which she learned about while searching the Web, where she found several sites indicating that BH4 therapy may be helpful in some patients with PKU. 

The occurrence of psychiatric disorders has been prospectively investigated in 63 patients who received a 6-month course of interferon alfa (9 MU/week) for hepatitis C (379). All were assessed at baseline with the Structured Clinical Interview for DSM-III-R (SCID) and monitored monthly with the Hopkins Symptoms Checklist (SCL-90). Most had a history of alcohol or polysubstance dependence, and 12 had a lifetime diagnosis of major depression. There were no significant changes in the SCL-90 scores during the 6-month period of survey in the 49 patients who completed the study, even in those who had a lifetime history of major depression. At 6 months, there was probable minor depression in eight patients and major depression in one none had attempted suicide. 

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