RELIABILITY OF DIAGNOSIS IN OLDER PSYCHIATRIC-PATIENTS USING THE STRUCTURED CLINICAL INTERVIEW FOR DSM-III-R

We conducted one of the few studies that has examined the reliability of the Structured Clinical Interview for DSM-III-R Axis I (SCID-I) wit h a mixed inpatient and outpatient population of adults 55 years old a nd over (range, 56-84 years, mean, 67.33 years). All SCID interviews w ere videotaped or audiotaped and were administered by Master's-level c linicians working toward their doctorate degrees in clinical psycholog y. Interrater reliability estimates (kappa and percentage agreement) w ere calculated for current major depressive episode (47% base rate) an d the broad diagnostic categories of anxiety disorders (15% base rate) and somatoform disorders (12% base rate). Kappa values were .70, .77, and 1.0. Respective percentage agreement was 85% for major depression , 94% for anxiety disorders, and 100% for somatoform disorders. Overal l percentage agreement was 91%. We conclude that the SCID-I can be eff ectively administered by relatively inexperienced clinicians to diagno se older psychiatric patients reliably. Directions that future researc h might take are offered.