Diagnostic interviews structured

Data Derived From Structured Diagnostic Interviews... 

A comprehensive psychiatric history and psychiatric diagnosis according to a major classification system such as the Diagnostic and Statistical Manual, 4th ed. (DSM-IV) or International Classification of Diseases, 10th ed. (ICD-10) is needed for all patients. A structured diagnostic interview may be helpful for some cases. The mortality rate associated with ECT in adults is approximately the same as that for anesthesia alone, about 1 death per 10,000 patients treated (or per 40,000 ECT treatments). 

Earls, F., Smith, E.M., Reich, W. and Jung, K.G. (1988) Investigating psychopathological consequences of a disaster in children a pilot study incorporating a structured diagnostic interview. J Am Acad Child Adolesc Psychiatry 27 90-95. 

The Mini-International Neuropsychiatric Interview (MINI) is a short structured diagnostic interview for DSM-IV and ICD-10 psychiatric disorders. With an administration time of approximately 15 min, it was designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies, and to be used as a first step in outcome tracking in non-research clinical settings (Sheehan et al.y 1998). 

Structured and semistructured diagnostic interviews are mainly useful for diagnosis, not for monitoring treatment. The following instruments are suitable for monitoring as well as dimensional diagnosis —i.e., quantifying the severity of symptoms and impairment. 

Diagnostic Interview for Children and Adolecents (DICA) (Herjanic and Reich, 1982) Highly structured interview designed to assess DMS-III and III-R diagnoses Available in computerized version Parent Child 6-17... 

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. 

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). 

These are instruments developed to identify specific psychiatric disorders. Most of these scales are based on a structured or semi-structured interview lasting some 60 90 min. Structured interviews contain a mix of open-ended and closed questions. Open-ended questions are essential for the validity of a diagnostic procedure closed questions support the reliability and the standardization of diagnostic tools. The primary goal for the use of diagnostic scales is to reduce the variance within samples caused by diagnostic differences, i.e. to create homogeneous patient populations included in clinical trials. 

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