He. Ross et al., DIAGNOSING COMORBIDITY IN SUBSTANCE-ABUSERS - A COMPARISON OF THE TEST-RETEST RELIABILITY OF 2 INTERVIEWS, The American journal of drug and alcohol abuse, 21(2), 1995, pp. 167-185
This study examines the test-retest reliability of two interview sched
ules (computer- and clinician-administered) in diagnosing lifetime com
orbidity in treated substance abusers. The Computerized Diagnostic Int
erview Schedule (C-DIS) and the Structured Clinical Interview for DSM-
III-R (SCID) were both administered to 173 substance abusers after ran
dom assignment to one of two groups. Within 1 to 2 weeks, subjects in
the first group repeated the C-DIS and subjects in the second group we
re reinterviewed by a different clinician, blind to the results of the
initial SCID. Both instruments showed good to excellent reliability f
or DSM-III-R psychoactive substance use disorders with kappas ranging
from .50 to .89 for individual disorders. However, the reliability of
comorbid other mental disorders was substantially poorer on both instr
uments, particularly the SCID. C-DIS kappas ranged from -.05 for gener
alized anxiety to .70 for simple phobia. SCID kappas ranged from .31 f
or panic disorder to .83 for antisocial personality disorder. Anxiety
disorders as a category, some phobic disorders, and antisocial persona
lity disorder showed acceptable levels of test-retest reliability on b
oth instruments. There was a trend for borderline or threshold cases t
o account for some of the disagreement on the C-DIS. Differences of op
inion between clinicians on organicity accounted for some of the disag
reements on panic disorder and major depression. The C-DIS, unlike the
SCID, tended to diagnose more disorders at initial interview, perhaps
a result of its tedious probe structure. Neither instrument should be
administered only once to provide a reliable lifetime diagnostic prof
ile of comorbidity in substance abusers.