Skip to main content Accessibility help
×
Home

Procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) in the anxiety disorders

  • Lorna Peters (a1) and Gavin Andrews (a1)

Synopsis

The procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) was examined against the consensus diagnoses of two clinicians for six anxiety disorders (agoraphobia, panic disorder (±agoraphobia), social phobia, simple phobia, obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD) and major depressive episode (MDE)). Clinicians had available to them all data obtained over a 2- to 10-month period. Subjects were 98 patients accepted for treatment at an Anxiety Disorders Clinic, thus, all subjects had at least one of the diagnoses being examined. While the CIDI-Auto detected 88·2% of the clinician diagnoses, it identified twice as many diagnoses as did the clinicians. The sensitivity of the CIDI-Auto was above 0·85 except for GAD, which had a sensitivity of 0·29. The specificity of the CIDI-Auto was lower (range: 0·47–0·99). The agreement between the CIDI-Auto and the clinician diagnoses, as measured by intraclass kappas, ranged from poor (k = 0·02; GAD) to excellent (k = 0·81; OCD), with a fair level of agreement overall (k = 0·40). Canonical correlation analysis suggested that the discrepancies between the CIDI-Auto and clinicians were not due to different diagnostic distinctions being made. It is suggested that the CIDI-Auto may have a lower threshold for diagnosing anxiety disorders than do experienced clinicians. It is concluded that, in a sample where all subjects have at least one anxiety disorder diagnosis, the CIDI-Auto has acceptable validity.

Copyright

Corresponding author

1Address for correspondence: Dr Lorna Peters, Clinical Research Unit for Anxiety Disorders, 299 Forbes Street, Darlinghurst, NSW 2010, Australia.

References

Hide All
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd edn.). APA: Washington, DC.
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd edn.—Revised). APA: Washington, DC.
Andrews, G., Peters, L., Guzman, A.-M. & Bird, K. (1995). A comparison of two structured diagnostic interviews: CIDI and SCAN. Australian and New Zealand Journal of Psychiatry. 29, 124132.
Bird, K. D. (1994). A Kappa Coefficient for Non-exclusive Categories. Working Paper 94/1. School of Psychology, University of New South Wales: Sydney.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement 20, 3746.
Cottler, L. B., Robins, L. N., Grant, B. F., Blaine, J., Towle, L. H., Wittchen, H.-U., Sartorius, N. and the participants in the WHO/ADAHMA Field Trial (1991). The CIDI-Core substance abuse and dependence questions: cross-cultural and nosological issues. British Journal of Psychiatry 159, 653658.
Farmer, A. E., Katz, R., McGriffin, P. & Bebbington, P. (1987). A comparison between the Present State Exam and the Composite International Diagnostic Interview. Archives of General Psychiatry 44, 10641068.
Fleiss, J. (1971). Measuring nominal scale agreement among many raters. Psychological Bulletin 76, 378382.
Harris, R. J. (1985). A Primer of Multivariate Statistics. Academic Press: Orlando, Florida.
Hasin, D. S. & Skodol, A. E. (1989). Standardized diagnostic interviews for psychiatric research. In The Instruments of Psychiatric Research (ed. Thompson, C.), pp. 1951. John Wiley & Sons: Chichester.
Helzer, J. E., Robins, L. N., McEvoy, L. T., Spitznagel, E. L., Stolzman, R. K., Farmer, A. E. & Brockington, I. F. (1985). A comparison of clinical and Diagnostic Interview Schedule diagnoses. Archives of General Psychiatry 42, 657666.
Hunt, C. & Andrews, G. (1993). Drop-out as a performance indicator in psychotherapy. Acta Psychiatrica Scandinavica 85, 275278.
Hunt, C. & Andrews, G. (1995). Unravelling Comorbidity: The Life-Chart Approach. Journal of Psychiatric Research (in the press).
Janca, A., Robins, L. N., Cottler, L. B. & Early, T. S. (1992). Clinical observation of assessment using the Composite International Diagnostic Interview (CIDI): an analysis of the CIDI Field Trials–Wave II at the St Louis site. British Journal of Psychiatry 160, 815818.
Kraemer, H. C. (1980). Extension of the kappa coefficient. Biometrics 36, 207216.
Kraemer, H. C. & Bloch, D. A. (1988). Kappa coefficients in epidemiology: an appraisal of a reappraisal. Journal of Clinical Epidemiology 41, 959968.
Kranzler, H. R., Rounsaville, B. J., Kadden, R. M. & Babor, T. F. (1994). Use of the ‘LEAD’ procedure for psychiatric diagnosis in patients with psychoactive substance use disorders. Journal of Nervous and Mental Disease 182, 277283.
Leitmeyer, P. (1990). Zür Symptomerfässung mit demstandardisierten Interview CIDI in der Allgemeinpraxis. Unpublished dissertation. University of Mannheim.
Marascuilo, L. A. & Levin, J. R. (1988). Multivariate Statistics in the Social Sciences: A Researcher's Guide. Brooks/Cole: Monterey.
Pilkonis, P. A., Heape, C. L., Ruddy, J. & Serrao, P. (1991). Validity in the diagnosis of personality disorders: the use of the LEAD standard. Psychological Assessment: A Journal of Consulting and Clinical Psychology 3, 4654.
Robins, L. N. (1989). Diagnostic grammar and assessment: translating criteria into questions. Psychological Medicine 19, 5768.
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, S. (1981). National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Archives of General Psychiatry 38, 381390.
Semler, G., Wittchen, H.-U., Joschke, K., Zaudig, M., von Geiso, T., Kaiser, S., von Cranach, M. & Pfister, H. (1987). Test–retest reliability of a standardized psychiatric interview (DIS/CIDI). European Archives of Psychiatry and Neurological Sciences 236, 214222.
Spitzer, R. L. (1983). Psychiatric diagnosis: are clinicians still necessary? Comprehensive Psychiatry 24, 399411.
Spitzer, R. L. & Williams, J. B. W. (1980). Classification in psychiatry. In Comprehensive Textbook of Psychiatry (ed. Kaplan, H. I., Freedman, A. M. and Sadock, B. J.), pp. 10351050. Williams & Wilkins: Baltimore.
Spitzer, R. L., Williams, J. B. W., Gibbon, M. & First, M. (1990). Structured Clinical Interview for DSM-III-R. American Psychiatric Press: Washington, DC.
Spitznagel, E. L. & Helzer, J. E. (1985). A proposed solution to the base rate problem in the kappa statistic. Archives of General Psychiatry 42, 725728.
Williams, J. B. W., Gibbon, M., First, M. B., Spitzer, R. L., Davies, M., Borus, J., Howes, M. J., Kane, J., Pope, H. G., Rounsaville, B. & Wittchen, H.-U. (1992). The structured clinical interview for DSM-III-R (SCID): II. Multisite test–retest reliability. Archives of General Psychiatry 49, 630636.
Wittchen, H.-U. (1994). Reliability and validity studies of the WHO Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research 28, 5784.
Wittchen, H.-U., Robins, L. N., Cottler, L. B., Sartorius, N., Burke, J. D., Regier, D. & participants in the multicentre WHO/ADAMHA field trials. (1991). Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). British Journal of Psychiatry 159, 645653.
Wittchen, H.-U., Essau, C. A., Rief, W. & Fichter, M. M. (1993). Assessment of somatoform disorders and comorbidity pattern with the CIDI: findings in psychosomatic patients. International Journal of Methods in Psychiatric Research 3, 87100.
World Health Organization. (1990). CIDI Core Computer Manual for Data Entry and Diagnostic Programs for the CIDI. (Version 1.0, Rev. 4). WHO: Geneva.
World Health Organization. (1992). Schedules for Clinical Assessment in Neuropsychiatry. WHO: Geneva.
World Health Organization. (1993 a). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: WHO.
World Health Organization. (1993 b). CIDI-Auto Version 1.0: Administrator's Guide. Training and Reference Centre for WHO CIDI: Sydney.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed