Method of diagnosis

For a number of years the generally accepted method for research diagnoses of psychiatric disorders has been to conduct a structured or semi-structured mental status interview to elicit the presence and duration of symptoms of the disorder and apply these to Diagnostic and Statistical Manual (DSM) or International Classification of Diseases (ICD) criteria for that disorder. The current DSM-IV TR (American Psychiatric Association 2000) has identified a category of disorders which are judged by the clinician to be the consequence of a general medical condition. The DSM-IV diagnostic criteria for mood disorders due to stroke or other medical disorders are shown in Table 5.1. At the present time, although there is some debate in the literature as to the most appropriate way to diagnose depression in patients with brain injury, this is the accepted criteria and method for diagnosis in psychiatry.

There are a number of structured and semi-structured interviews for diagnosis in psychiatry and investigators of poststroke depression have utilized a wide variety of these instruments. Eastwood et al. and we have recently used the Schedule for Affective Disorders and Schizophrenia (SADS) (Eastwood et al. 1989; Robinson 2000). Morris et al. (1990) used the Composite Index of Diagnostic Interviews (CIDI).