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Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers

Published online by Cambridge University Press:  09 July 2009

Glyn Lewis ,
Anthony J. Pelosi ,
Ricardo Araya  and
Graham Dunn
Glyn Lewis*
Affiliation:
General Practice Research Unit and Department of Biostatistics and Computing, Institute of Psychiatry; Maudsley Hospital, London
Anthony J. Pelosi
Affiliation:
General Practice Research Unit and Department of Biostatistics and Computing, Institute of Psychiatry; Maudsley Hospital, London
Ricardo Araya
Affiliation:
General Practice Research Unit and Department of Biostatistics and Computing, Institute of Psychiatry; Maudsley Hospital, London
Graham Dunn
Affiliation:
General Practice Research Unit and Department of Biostatistics and Computing, Institute of Psychiatry; Maudsley Hospital, London
*
1Address for correspondence: Dr Glyn Lewis, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
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Synopsis

Many of the standardized interviews currently used in psychiatry require the interviewer to use expert psychiatric judgements in deciding upon the presence or absence of psychopathology. However, when case definitions are standardized it is customary for clinical judgements to be replaced with rules. The Clinical Interview Schedule was therefore revised, in order to increase standardization, and to make it suitable for use by ‘lay’ interviewers in assessing minor psychiatric disorder in community, general hospital, occupational and primary care research.

Two reliability studies of the revised Clinical Interview Schedule (CIS-R) were conducted in primary health care clinics in London and Santiago, Chile. Both studies compared psychiatrically trained interviewer(s) with lay interviewer(s). Estimates of the reliability of the CIS-R compared favourably with the results of studies of other standardized interviews. In addition, the lay interviewers were as reliable as the psychiatrists and did not show any bias in their use of the CIS-R. Confirmatory factor analysis models were also used to estimate the reliabilities of the CIS-R and self-administered questionnaires and indicated that traditional measures of reliability are probably overestimates.

Type
Original Articles
Information
Psychological Medicine , Volume 22 , Issue 2 , May 1992 , pp. 465 - 486
Copyright
Copyright © Cambridge University Press 1992

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References

American Psychiatric Association (APA) (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. American Psychiatric Association: Washington, DC.Google Scholar
Anthony, J. C., Folstein, M., Romanowski, A. J., Von Korff, M. R., Nestadt, G. R., Chahal, R., Merchant, A., Brown, C. H., Shapiro, S., Kramer, M. & Gruenberg, E. M. (1985). Comparison of the Lay Diagnostic Interview Schedule and a Standardized Psychiatric Diagnosis Archives of General Psychiatry 42, 667–675.CrossRefGoogle Scholar
Banks, M. H. (1983). Validation of the General Health Questionnaire in a young community sample. Psychological Medicine 13, 349–354.CrossRefGoogle Scholar
Bebbington, P., Hurry, J., Tennant, C., Sturt, E. & Wing, J. K. (1981). Epidemiology of mental disorders in Camberwell. Psychological Medicine 11, 561–579.CrossRefGoogle ScholarPubMed
Bentler, P. M. (1989). EQS Structural Equations Program. Version 3.0. BMDP Statistical Software Inc.: Los Angeles.Google Scholar
Carmines, E. G. & Zeller, R. A. (1979). Reliability and Validity Assessment. SAGE: Beverly Hills.CrossRefGoogle Scholar
Cheng, T. A. (1989). Symptomatology of minor psychiatric morbidity: a cross-cultural comparison. Psychological Medicine 19, 697–708.CrossRefGoogle Scholar
Cooper, J. E., Copeland, J. R. M., Brown, G. W., Harris, T. & Gourlay, A. J. (1977). Further studies on interviewer training and inter-rater reliability of the Present State Examination (PSE). Psychological Medicine 7, 517–523.CrossRefGoogle ScholarPubMed
Cox, B. D., Blaxter, M., Buckle, A. L. J., Fenner, N. P., Golding, J. F., Gore, M., Huppert, F. A., Nickson, J., Roth, M., Stark, J., Wadsworth, M. E. J. & Whichelow, M. (1987). The Health and Lifestyle Survey. Health Promotion Research Trust: Cambridge.Google Scholar
Croft-Jefferys, C. & Wilkinson, G. (1989). Estimated costs of neurotic disorder in UK general practice 1985. Psychological Medicine 19, 549–558.CrossRefGoogle Scholar
Dunn, G. (1989). The Design and Analysis of Reliability Studies. Edward Arnold: London.Google Scholar
Dunn, G., Lewis, G., Pelosi, A. J. & Araya, R. (1991). The use of confirmatory factor analysis in two reliability studies of a standardised interview for psychiatric disorder. (Submitted.)Google Scholar
Eaton, W. W. & Kessler, L. G. (eds) (1985). Epidemiologic Field Methods in Psychiatry: the NIMH Epidemiologic Catchment Area Program. Academic Press: Orlando, Florida.Google Scholar
Feinstein, A. R. (1985). Clinical Epidemiology. The Architecture of Clinical Research. W. B. Saunders & Co: Philadelphia.Google Scholar
Fleiss, J. L. (1970). Estimating the reliability of interview data. Psychometrika 35, 143–162.CrossRefGoogle Scholar
Fleiss, J. L. (1981). Statistical Methods for Rates and Proportions. Wiley and Sons: New York.Google Scholar
GPRU (1970). A Manual for use in Conjunction with the General Practice Research Unit's Standardised Psychiatric Interview 2nd edn. Institute of Psychiatry: London.Google Scholar
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Goldberg, D. & Huxley, P. (1980). Mental Illness in the Community. Tavistock: London.Google Scholar
Goldberg, D. & Williams, P. (1988). The User's Guide to the General Health Questionnaire NFER-Nelson: Windsor.Google Scholar
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardized psychiatric interview for use in community surveys. British Journal of Preventive and Social Medicine 24, 18–23.Google Scholar
Greist, J. H., Klein, M. H., Erdman, H. P., Bires, J. K., Bass, S. M., Machtinger, P. E. & Kresge, D. G. (1987). Comparison of computer- and interviewer-administered versions of the Diagnostic Interview Schedule. Hospital and Community Psychiatry 38, 1304–1311.Google ScholarPubMed
Harding, T. W., De Arango, M. V., Baltazar, J., Climent, C. E., Ibrahim, H. H. A., Ignacio, L. L., Murthy, R. S. & Wig, N. N. (1980). Mental disorders and primary health care: a study of their frequency & diagnosis in four developing countries. Psychological Medicine 10, 231–241.CrossRefGoogle ScholarPubMed
Helzer, J. E., Robins, L. N., McEvoy, L. T., Spitznagel, E. L., Stoltzman, R. K., Farmer, A. & Brockington, I. F. (1985). A comparison of clinical and Diagnostic Interview Schedule Diagnoses. Archives of General Psychiatry 42, 657–666.CrossRefGoogle ScholarPubMed
Jenkins, R. (1985). Minor psychiatric disorder in employed young men and women and its contribution to sickness absence. British Journal of Industrial Medicine 42, 147–154.Google ScholarPubMed
Jenkins, R., Smeeton, N. & Shepherd, M. (1988). Classification of Mental Disorders in Primary Care Settings. Psychological Medicine Monograph Supplement 12. Cambridge University Press: Cambridge.Google Scholar
Joreskog, K. G. & Sorbom, D. (1984). LISREL VI: Analysis of Linear Structural Relationships by the Method of Maximum Likelihood. Scientific Software Ltd: Indiana.Google Scholar
Kagan, A. R. (1965). Interpretation of Electrocardiograms. Milbank Memorial Fund Quarterly 43, 40–48.CrossRefGoogle ScholarPubMed
Kendell, R. E., Everett, B., Cooper, J. E., Sartorius, N. & David, M. E. (1968). The Reliability of the ‘Present State Examination’. Social Psychiatry 3, 123–129.CrossRefGoogle Scholar
Kleinman, A. (1987). Anthropology and psychiatry. The role of culture in cross-cultural research on illness. British Journal of Psychiatry 151, 447–454.CrossRefGoogle ScholarPubMed
Kreitman, N., Sainsbury, P., Morrissey, J., Towers, J. & Scrivener, J. (1961). The reliability of psychiatric assessment analysis. Journal of Mental Science 107, 887–908.CrossRefGoogle Scholar
Last, J. M. (1988). A Dictionary of Epidemiology, 2nd edn.Oxford University Press: New York.Google Scholar
Lewis, G. & Pelosi, A. J. (1990). The case-control study in psychiatry. British Journal of Psychiatry 157, 197–207.CrossRefGoogle ScholarPubMed
Lewis, G. & Wessely, S. C. (1990). Comparison of the General Health Questionnaire and the Hospital Anxiety and Depression Scale. British Journal of Psychiatry 157, 860–865.CrossRefGoogle ScholarPubMed
Lewis, G. & Williams, P. (1989). Clinical judgement and the standardized interview in psychiatry. Psychological Medicine 19, 971–980.CrossRefGoogle ScholarPubMed
Lewis, G., Pelosi, A. J., Glover, E., Wilkinson, G., Stansfeld, S. A., Williams, P. & Shepherd, M. (1988). The development of a computerized assessment for minor psychiatric disorder. Psychological Medicine 18, 737–745.CrossRefGoogle ScholarPubMed
Lord, F. M. & Novick, M. R. (1968). Statistical Theories of Mental Test Scores. Addison-Wesley: Reading, MA.Google Scholar
Mari, J. J. & Williams, P. (1985). A comparison of the validity of two psychiatric screening questionnaires (GHQ-12 and SRQ-20) in Brazil, using Relative Operating Characteristic (ROC) analysis. Psychological Medicine 15, 651–659.CrossRefGoogle ScholarPubMed
Metz, C. E., Wang, P.-L. & Kronman, H. B. (1984). ROCFIT. Department of Radiology and the Franklin McLean Memorial Research Institute: University of Chicago.Google Scholar
Myers, J. K., Weissman, M., Tischler, G., Holzer, C., Leaf, P., Orvaschel, H., Anthony, J., Boyd, J., Burke, J., Kramer, M. & Stoltzman, R. (1984). Six-month prevalence of psychiatric disorder in three communities. Archives of General Psychiatry 41, 959–967.CrossRefGoogle ScholarPubMed
Robins, L. N. (1985). Epidemiology: reflections on testing the validity of psychiatric interviews. Archives of General Psychiatry 42, 918–924.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule; its history, characteristics and validity. Archives of General Psychiatry 38, 381–389.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Ratcliff, K. S. & Seyfried, W. (1982). Validity of the Diagnostic Interview Schedule. Psychological Medicine 12, 855–870.CrossRefGoogle ScholarPubMed
Robins, L. N., Wing, J. K., Wittchen, H. U., Helzer, J. E., Babor, T. F., Burke, J., Farmer, A., Jablenski, A., Pickens, R., Regier, D. A., Sartorius, N. & Towle, L. H. (1988). The composite international diagnostic interview: an epidemiological instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Archives of General Psychiatry 45, 1069–1077.CrossRefGoogle ScholarPubMed
Rodgers, B. & Mann, S. A. (1986). The reliability and validity of PSE assessments by lay interviewers: a national population survey. Psychological Medicine 16, 689–700.CrossRefGoogle ScholarPubMed
Rose, G. A. (1965). Chest pain questionnaire. Milbank Memorial Fund Quarterly 43, 32–39.CrossRefGoogle ScholarPubMed
Rose, G. (1989). The mental health of populations. In The Scope of Epidemiological Psychiatry (ed. Williams, P., Wilkinson, G. and Rawnsley, K.), pp. 77–85. Routledge: London.Google Scholar
Sackett, D. L., Haynes, R. B. & Tugwell, P. (1985). Clinical Epidemiology: A Basic Science for Clinical Medicine. Little, Brown: Boston.Google Scholar
SAS Institute Inc. (1985). SAS User's Guide: Basics. Version 5. SAS Institute Inc: Cary, NC.Google Scholar
Sen, B. & Mari, J. J. (1986). Psychiatric research instruments in the transcultural setting: experiences in India and Brazil. Social Science and Medicine 23, 277–281.CrossRefGoogle ScholarPubMed
Shepherd, M. & Clare, A. C. (1981). Addendum to Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. Psychiatric Illness in General Practice, 2nd edn.Oxford University Press: Oxford.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. (1966). Psychiatric Illness in General Practice, 2nd edn.Oxford University Press: Oxford.Google Scholar
Shepherd, M., Brooke, E. M., Cooper, J. E. & Lin, T. (1968). An experimental approach to psychiatric diagnosis. Acta Psychiatrica Scandinavica Suppl. 201.Google Scholar
Spitzer, R. L. (1983). Psychiatric diagnosis: are clinicians still necessary? Comprehensive Psychiatry 24, 399–411.CrossRefGoogle ScholarPubMed
Spitzer, R. L. & Endicott, J. (1977). Schedule for Affective Disorders and Schizophrenia. New York State Psychiatric Institute: New York.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1975). Research Diagnostic Criteria. New York: Biometrics Research, New York State Psychiatric Institute.Google ScholarPubMed
Stavrakaki, C. & Vargo, B. (1986). The relationship of anxiety and depression. A review of the literature. British Journal of Psychiatry 149, 7–16.CrossRefGoogle ScholarPubMed
Sturt, E., Bebbington, P., Hurry, J. & Tennant, C. (1981). The present state examination used by interviewers from a survey agency: report from the MRC Camberwell Community survey. Psychological Medicine 11, 185–192.CrossRefGoogle ScholarPubMed
Sturt, E., Wykes, T. & Creer, C. (1982). A survey of long-term users of community psychiatric services in Camberwell. I. Demographic, social and clinical characteristics of the sample. In Long-term community care: experience in a London Borough. Psychological Medicine Monograph Supplement 2 (ed. Wing, J. K.).Google Scholar
Tessler, R., Mechanic, D. & Dimond, M. (1976). The effect of psychological distress on physician utilization: a prospective study. Journal of Health and Social Behaviour 17, 353–364.CrossRefGoogle ScholarPubMed
Torres, P. & Alvarez, V. (1987). Validez de un cuestionario para detectar desordenes emocionales (GHQ-12) en estudiantes universitarios. Revista Psiquiatria IV, 255–264.Google Scholar
Tyrer, P. (1989). Classification of Neurosis. John Wiley: Chichester.Google Scholar
Williams, P., Tarnopolsky, A., Hand, D. & Shepherd, M. (1986). Minor psychiatric morbidity and general practice consultations: the West London Survey. Psychological Medicine Monograph Supplement 9.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wing, J. K., Nixon, J. M., Mann, S. A. & Leff, J. P. (1977). Reliability of the PSE (ninth edition) used in a population study. Psychological Medicine 7, 505–516.CrossRefGoogle ScholarPubMed
Zigmond, A. S. & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361–370.CrossRefGoogle ScholarPubMed