Factors affecting reliability and confidence of DSM-III-R psychosis-related diagnosis

The relationships between interrater diagnostic reliability, confidence in diagnosis, DSM-III-R criteria ambiguity and case report data quality were e xamined in 20 case vignettes describing psychosis-related symptomatology. E ach of seven diagnosticians made DSM-III-R diagnoses and gave confidence ra tings for those diagnoses, as well as ratings on quality of data presented and clarity of diagnostic criteria for each vignette. As hypothesized, conf idence ratings significantly predicted interrater diagnostic agreement. Cla rity of DSM-III-R criteria positively correlated with both interrater relia bility and confidence. Case report data quality correlated with diagnostic confidence but, contrary to the authors' hypothesis, did not correlate with interrater agreement. The authors conclude that confidence ratings may be useful indices of diagnostic reliability among experienced clinicians and s uggest that the case report method allows fur reliable diagnoses to be made . (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.