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An assessment of the Standardized Assessment of Personality as a screening instrument for the International Personality Disorder Examination: a comparison of informant and patient assessment for personality disorder

Published online by Cambridge University Press:  01 July 1999

A. H. MANN ,
P. RAVEN ,
J. PILGRIM ,
S. KHANNA ,
A. VELAYUDHAM ,
K. P. SURESH ,
S. M. CHANNABASAVANNA ,
A. JANCA  and
N. SARTORIUS
A. H. MANN
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
P. RAVEN
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
J. PILGRIM
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
S. KHANNA
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
A. VELAYUDHAM
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
K. P. SURESH
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
S. M. CHANNABASAVANNA
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
A. JANCA
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
N. SARTORIUS
Affiliation:
From the Section of Epidemiology and General Practice, Institute of Psychiatry, London; National Institute of Mental Health and Neurosciences, Bangalore, India; and Departement de Psychiatrie, Hôpitaux Universitaires de Geneve, Switzerland
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Abstract

Background. The International Personality Disorder Examination (IPDE) has been developed as a standardized interview for personality disorders. While it has good psychometric properties, its length makes it difficult to use in the community in population research, particularly outside psychiatric settings. The informant-based Standard Assessment of Personality (SAP), which has been in use since 1981, could serve as a valid screen to detect likely personality disordered individuals who would then receive a definitive diagnosis by IPDE. This study aimed to compare the two instruments in their capacity to detect personality disorder according to ICD-10 taxonomy and to estimate the efficiency of the use of the two together in a case-finding exercise.

Method. Ninety psychiatric out-patients in Bangalore, India, were assessed for personality disorder using the two methods. Assessment was conducted by a pair of trained interviewers in random order and by random allocation to interviewer.

Results. Overall agreement between the two instruments in the detection of ICD-10 personality disorder was modest (kappa = 0·4). The level of agreement varied according to personality category, ranging from kappa 07·66 (dependent) to kappa 0·09 (dyssocial). The SAP proved to have a high negative predictive value (97%) for IPDE as the gold standard, suggesting its potential as a screen in samples where the expected prevalence of personality disorder is low.

Conclusion. A two-stage approach to epidemiological studies of personality disorder may be practicable.

Type
BRIEF COMMUNICATION
Information
Psychological Medicine , Volume 29 , Issue 4 , July 1999 , pp. 985 - 989
Copyright
© 1999 Cambridge University Press

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