COMPARISON OF DSM-III-R SYMPTOMS FOR ALCOHOL DEPENDENCE BETWEEN PATIENT SELF-REPORT AND CLINICIAN INTERVIEW OR THE STRUCTURED CLINICAL INTERVIEW FOR DSM-III-R

This study sought to determine which Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), symptoms of alcohol dependence were most sensitive to under-reporting by 78 inpati ents from alcohol treatment programs. We hypothesized that patients wo uld be more reluctant to report social/behavioral symptoms (lost time, hazardous behavior or major role interference, and reduced activities ) than psychological or physiological symptoms. Patient endorsement of symptoms on a self-administered diagnostic questionnaire was compared with parallel items on the Structured Clinical Interview for DSM-III- R (SCID) and clinician interview. Bias and Prevalence Adjusted Kappas for individual symptom agreement ranged from -.02 to .87. Subjects end orsed fewer symptoms per category than either the SCID or clinician in terview. Using a Student-Newman-Kuels post-hoc analysis at the p < .05 level, we found that mean agreement for the social/behavioral categor y was significantly lower than mean agreement for the other categories .