TY - JOUR
T1 - Comparison of the Lay Diagnostic Interview Schedule and a Standardized Psychiatric Diagnosis
T2 - Experience in Eastern Baltimore
AU - Anthony, James C.
AU - Folstein, Marshal
AU - Romanoski, Alan J.
AU - Von Korff, Michael R.
AU - Nestadt, Gerald R.
AU - Chahal, Raman
AU - Merchant, Altaf
AU - Brown, C. Hendricks
AU - Shapiro, Sam
AU - Kramer, Morton
AU - Gruenberg, Ernest M.
PY - 1985/7
Y1 - 1985/7
N2 - We studied DSM-III diagnoses made by the lay Diagnostic Interview Schedule (DIS) method in relation to a standardized DSM-III diagnosis by psychiatrists in the two-stage Baltimore Epidemiologic Catchment Area mental morbidity survey. Generally, prevalence estimates based on the DIS one-month diagnoses were significantly different from those based on the psychiatric diagnoses. Subjects identified as cases by each method were often different subjects. Measured in terms of K, the chance-corrected degree of agreement between the DIS and psychiatrists' one-month diagnoses was moderate for DSM-III alcohol-use disorder (abuse and dependence combined), and lower for other mental disorder categories. The unreliability of either the DIS or psychiatric diagnoses is one potential explanation for the observed disagreements. Others include the following: (1) insufficient or inadequate information (on which to base a diagnosis); (2) recency of disorder; (3) incomplete criterion coverage; (4) overinclusive DIS questions; and (5) degree of reliance on subject symptom reports. Further study of the nature and sources of these discrepancies is underway. This work should produce a more complete understanding of obstacles to mental disorder case ascertainment by lay interview and clinical examination methods in the context of a field survey.
AB - We studied DSM-III diagnoses made by the lay Diagnostic Interview Schedule (DIS) method in relation to a standardized DSM-III diagnosis by psychiatrists in the two-stage Baltimore Epidemiologic Catchment Area mental morbidity survey. Generally, prevalence estimates based on the DIS one-month diagnoses were significantly different from those based on the psychiatric diagnoses. Subjects identified as cases by each method were often different subjects. Measured in terms of K, the chance-corrected degree of agreement between the DIS and psychiatrists' one-month diagnoses was moderate for DSM-III alcohol-use disorder (abuse and dependence combined), and lower for other mental disorder categories. The unreliability of either the DIS or psychiatric diagnoses is one potential explanation for the observed disagreements. Others include the following: (1) insufficient or inadequate information (on which to base a diagnosis); (2) recency of disorder; (3) incomplete criterion coverage; (4) overinclusive DIS questions; and (5) degree of reliance on subject symptom reports. Further study of the nature and sources of these discrepancies is underway. This work should produce a more complete understanding of obstacles to mental disorder case ascertainment by lay interview and clinical examination methods in the context of a field survey.
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U2 - 10.1001/archpsyc.1985.01790300029004
DO - 10.1001/archpsyc.1985.01790300029004
M3 - Article
C2 - 4015308
AN - SCOPUS:0021869044
SN - 0003-990X
VL - 42
SP - 667
EP - 675
JO - Archives of general psychiatry
JF - Archives of general psychiatry
IS - 7
ER -