INTERRATER RELIABILITY OF RATINGS OF DELUSIONS AND BIZARRE DELUSIONS

Objective: The authors evaluated the interrater reliability of ratings of bizarre delusions, addressing limitations of previous studies. Met hod: Fifty randomly selected psychiatrists rated bizarre delusions in 30 case vignettes adapted from a previous study by Spitzer and associa tes. Estimates of reliability were obtained for definitions of bizarre delusions in the DSM-III, DSM-III-R, and draft DSM-IV criteria for sc hizophrenia and for the clinicians grouped according to their current and previous experience with psychotic patients. Results: The kappas f or ratings of bizarre delusions according to the different definitions and among clinicians with different levels of experience were in the moderate to fair range. Conclusions: The reliability of ratings of biz arre delusions appears to be less than satisfactory for clinical pract ice, and the increased weight given to this symptom in modern diagnost ic systems does not seem justifiable.