Literatura científica selecionada sobre o tema "Diagnostic interview"

Department of Health (2010) guidelines highlight the importance of diagnosis for adults with autism spectrum disorders (ASD) who have not previously had their condition recognised. Reliable, valid and user-friendly diagnostic tools must therefore be available. Part 1: This section critically appraises and systematically reviews 12 studies examining the NICE (2012) recommended adult ASD diagnostic tools. It concludes that there is good evidence to support the use of the Ritvo Asperger Diagnostic Scale-Revised(RAADS-R) and Autism Diagnostic Observation Schedule (ADOS), with some support for the use of the Autism Diagnostic Interview-Revised (ADI-R). However the Adult Asperger Assessment (AAA), Asperger Syndrome Diagnostic Interview (ASDI) and Diagnostic Interview for Social and Communication Disorders (DISCO) appear to have insufficient evidence at present. Further research is indicated for all the instruments. Part 2: This section presents a study of a new informant report diagnostic tool, the Developmental, Diagnostic and Dimensional Interview - Short Form Adult Version (3Di-sva). The 3Di-sva interview was completed with an informant for 27 ASD and 27 non-clinical comparison participants. It demonstrated good psychometric properties, including good internal consistency and inter-rater reliability, and strong sensitivity and specificity. The 3Di-sva is a time and cost-efficient tool, which could be suitable for use as part of a multi-dimensional adult ASD assessment. The study was completed as part of a joint project with McKenner (2015), who examined the 3Di-sva when used in a clinical comparison population. Part 3: This section is a critical appraisal which reflects upon areas relevant to both the literature review and empirical paper. The main focus of the discussion is upon on the idea of ideal versus achievable research and upon my learning process about research within NHS settings.

The World Health Organization-Composite International Diagnostic Interview (WHO-CIDI) is a highly structured interview for the assessment of mental disorders, based on the definitions and criteria of the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Over the past decade it has become evident that the CIDI does not sufficiently address the assessment needs of women. Women are affected by most mental disorders, particularly mood and anxiety disorders, approximately twice as frequently as men. Women-specific disorders, such as Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), psychiatric disorders during pregnancy and postpartum as well as during the perimenopause, menopause and beyond are not addressed by the standard CIDI diagnostic modules. In addition, the CIDI in its current form does not address the potential effect that female reproductive milestones may have on diagnosis, treatment and prevention of mental disorders in women. Our aim was to develop a new women specific platform (CIDI-VENUS; CIDI-V) to be embedded in the existing CIDI that will address the above mentioned current deficiencies. Guided by a team of experts in the field of Women’s Mental Health from Canada and Germany the following modules were developed: 1) A complete menstrual history and comprehensive contraceptive history with a link to the Premenstrual Symptoms Screening Tool (PSST). 2) A complete perinatal history of pregnancies, miscarriages, terminations, still births, death of a child, with details of current pregnancy including gestation and expected date of confinement, labour history and breastfeeding, history of tobacco, alcohol, and other substance use including prescription drugs during pregnancy and postpartum, a section on specific phobias and on recurrent obsessive/compulsive thoughts/behaviours (OCD) related to the baby with a link to the Perinatal Obsessive-Compulsive Scale (POCS), as well as a link to the Edinburgh Postnatal Depression Scale (EPDS). 3). A detailed history of use of hormone therapy (e.g. pills, patches, implants, etc.) with a focus on (peri-) menopausal women, differentiating between physical and psychological symptoms with a link to the Menopause Visual Analogue Scales (M-VAS) and to the Greene Climacteric Scale. 4) An iterative module concluding each CIDI section to specify the course of mental disorders during the reproductive stages and menopausal transition. While retaining core diagnostic sections and diagnostic algorithms, the CIDI-V is enriched by women-specific diagnostic modules, providing a wealth of clinically relevant information about women’s mental health, not available anywhere else in our current psychiatric diagnostic instruments.

The World Health Organization-Composite International Diagnostic Interview (WHO-CIDI) is a highly structured interview for the assessment of mental disorders, based on the definitions and criteria of the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Over the past decade it has become evident that the CIDI does not sufficiently address the assessment needs of women. Women are affected by most mental disorders, particularly mood and anxiety disorders, approximately twice as frequently as men. Women-specific disorders, such as Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), psychiatric disorders during pregnancy and postpartum as well as during the perimenopause, menopause and beyond are not addressed by the standard CIDI diagnostic modules. In addition, the CIDI in its current form does not address the potential effect that female reproductive milestones may have on diagnosis, treatment and prevention of mental disorders in women. Our aim was to develop a new women specific platform (CIDI-VENUS; CIDI-V) to be embedded in the existing CIDI that will address the above mentioned current deficiencies. Guided by a team of experts in the field of Women’s Mental Health from Canada and Germany the following modules were developed: 1) A complete menstrual history and comprehensive contraceptive history with a link to the Premenstrual Symptoms Screening Tool (PSST). 2) A complete perinatal history of pregnancies, miscarriages, terminations, still births, death of a child, with details of current pregnancy including gestation and expected date of confinement, labour history and breastfeeding, history of tobacco, alcohol, and other substance use including prescription drugs during pregnancy and postpartum, a section on specific phobias and on recurrent obsessive/compulsive thoughts/behaviours (OCD) related to the baby with a link to the Perinatal Obsessive-Compulsive Scale (POCS), as well as a link to the Edinburgh Postnatal Depression Scale (EPDS). 3). A detailed history of use of hormone therapy (e.g. pills, patches, implants, etc.) with a focus on (peri-) menopausal women, differentiating between physical and psychological symptoms with a link to the Menopause Visual Analogue Scales (M-VAS) and to the Greene Climacteric Scale. 4) An iterative module concluding each CIDI section to specify the course of mental disorders during the reproductive stages and menopausal transition. While retaining core diagnostic sections and diagnostic algorithms, the CIDI-V is enriched by women-specific diagnostic modules, providing a wealth of clinically relevant information about women’s mental health, not available anywhere else in our current psychiatric diagnostic instruments.

After reviewing currently available diagnostic assessment instruments for substance use disorders this paper describes the format and structure of the Munich-Composite International Diagnostic Interview (M-CIDI) substance disorder section. In addition, the test-retest reliability of diagnoses and criteria for nicotine, alcohol, illegal and prescription drugs, is reported. Findings obtained in community sample of adolescents and young adults indicate that the substance section is acceptable for almost all types of respondents, efficient in terms of time and ease of administration as well as reliable in terms of consistency of findings over time. The test-retest reliability over a period of an average of 1 month, as examined by two independent interviewers indicates good-to-excellent kappa values for all substance disorders assessed, with significant kappa values ranging between 0.55 for drug abuse and 0.83 for alcohol abuse. There was also fairly consistently high agreement for the assessment of single DSM-IV diagnostic criteria for abuse and dependence as well as the M-CIDI quantity-frequency and time-related questions. To conclude, although – unlike previous studies – this study was conducted in a community sample and not in patients and used considerably longer time intervals of more than a month between investigations, our M-CIDI reliability findings are at least as high as those from previous studies.

After reviewing currently available diagnostic assessment instruments for substance use disorders this paper describes the format and structure of the Munich-Composite International Diagnostic Interview (M-CIDI) substance disorder section. In addition, the test-retest reliability of diagnoses and criteria for nicotine, alcohol, illegal and prescription drugs, is reported. Findings obtained in community sample of adolescents and young adults indicate that the substance section is acceptable for almost all types of respondents, efficient in terms of time and ease of administration as well as reliable in terms of consistency of findings over time. The test-retest reliability over a period of an average of 1 month, as examined by two independent interviewers indicates good-to-excellent kappa values for all substance disorders assessed, with significant kappa values ranging between 0.55 for drug abuse and 0.83 for alcohol abuse. There was also fairly consistently high agreement for the assessment of single DSM-IV diagnostic criteria for abuse and dependence as well as the M-CIDI quantity-frequency and time-related questions. To conclude, although – unlike previous studies – this study was conducted in a community sample and not in patients and used considerably longer time intervals of more than a month between investigations, our M-CIDI reliability findings are at least as high as those from previous studies.

Little is known about how psychotherapy patients perceive and evaluate computer-assisted diagnostic interviews for mental disorders. Using the World Health Organization's Composite International Diagnostic Interview in its computer-administered form, psychologists interviewed 236 psychotherapy patients, who evaluated the interview with regard to content, comprehensibility, and acceptance. More than 87% of patients evaluated the interview positively. Higher symptom severity and comorbidity, but not depression, were associated with a slightly lower but still favorable appraisal. The results indicate that the use of computerized clinical diagnostic interviews, previously usually restricted to research, seems to be a time-efficient, economical, and acceptable approach for the diagnostic phase of psychotherapy. The indications of diminished acceptability among multimorbid and severely disturbed patients warrant further study. Implications for quality assurance and practice research networks are discussed<br>Wir wissen wenig darüber, wie Psychotherapiepatienten computergestützte Interviews für psychische Störungen erleben und bewerten. Trainierte Psychologen untersuchten 236 konsekutive Patienten einer Psychotherapieambulanz mit dem Composite International Diagnostic Interview (CIDI) in seiner computergestützen Version.. Danach beurteilten die befragten Patienten das Interview auf der Basis einer 15 Items umfassenden Liste hinsichtlich Inhalt, Verständlichkeit und Akzeptanz. 87% der Patienten bewerteten das Interview positiv, und gaben z.B. an froh zu sein, dass “die Befragung so genau und ausführlich war”. Größere Symptombelastung und höhere Komorbidität, nicht aber das Ausmaß an Depression, waren mit einer etwas schlechteren, absolut gesehen aber immer noch guten Bewertung des Interviews assoziiert. Die Ergebnisse zeigen, dass computergestützte Interviews, die bisher fast nur im Forschungsbereich eingesetzt wurden, eine zeit- und kosteneffiziente sowie für den Patienten akzeptable Möglichkeit für die Eingangsdiagnostik psychotherapeutischer Behandlungen darstellen. Die Hinweise auf eine geringere Akzeptanz bei multi-morbiden und stärker beeinträchtigten Patienten sollten weiter untersucht werden. Implikationen für die Qualitätssicherung und Praxisforschungsnetzwerke werden diskutiert

Little is known about how psychotherapy patients perceive and evaluate computer-assisted diagnostic interviews for mental disorders. Using the World Health Organization's Composite International Diagnostic Interview in its computer-administered form, psychologists interviewed 236 psychotherapy patients, who evaluated the interview with regard to content, comprehensibility, and acceptance. More than 87% of patients evaluated the interview positively. Higher symptom severity and comorbidity, but not depression, were associated with a slightly lower but still favorable appraisal. The results indicate that the use of computerized clinical diagnostic interviews, previously usually restricted to research, seems to be a time-efficient, economical, and acceptable approach for the diagnostic phase of psychotherapy. The indications of diminished acceptability among multimorbid and severely disturbed patients warrant further study. Implications for quality assurance and practice research networks are discussed.<br>Wir wissen wenig darüber, wie Psychotherapiepatienten computergestützte Interviews für psychische Störungen erleben und bewerten. Trainierte Psychologen untersuchten 236 konsekutive Patienten einer Psychotherapieambulanz mit dem Composite International Diagnostic Interview (CIDI) in seiner computergestützen Version.. Danach beurteilten die befragten Patienten das Interview auf der Basis einer 15 Items umfassenden Liste hinsichtlich Inhalt, Verständlichkeit und Akzeptanz. 87% der Patienten bewerteten das Interview positiv, und gaben z.B. an froh zu sein, dass “die Befragung so genau und ausführlich war”. Größere Symptombelastung und höhere Komorbidität, nicht aber das Ausmaß an Depression, waren mit einer etwas schlechteren, absolut gesehen aber immer noch guten Bewertung des Interviews assoziiert. Die Ergebnisse zeigen, dass computergestützte Interviews, die bisher fast nur im Forschungsbereich eingesetzt wurden, eine zeit- und kosteneffiziente sowie für den Patienten akzeptable Möglichkeit für die Eingangsdiagnostik psychotherapeutischer Behandlungen darstellen. Die Hinweise auf eine geringere Akzeptanz bei multi-morbiden und stärker beeinträchtigten Patienten sollten weiter untersucht werden. Implikationen für die Qualitätssicherung und Praxisforschungsnetzwerke werden diskutiert.

A dissertation submitted to the Faculty of Arts in partial fulfilment of the requirements for the Degree of Master of Arts (Clinical Psychology) in the Department of Psychology at the University of Zululand, South Africa, 2015<br>This is a case study for the three categories of psychology: clinical, counselling and educational, and focuses on evaluating the diagnostic interview styles that clinical, counselling and educational psychologists employ when seeing their patients/clients.I t also aims to check consistency in the diagnostic interviewing styles they employ to formulate diagnoses and treatment plans for their patients/clients. The study indicates that psychologists undergo similar training and are regulated by the same professional board (HPCSA), though their scope of practice is not the same. However, the clinical/diagnostic interview is common among all psychologists. If they employ a diagnostic interviewing style that is not appropriate to the client’s/patient’s needs and problems, accurate diagnosis will not be achieved, and proper treatment or intervention will not be possible. This study is unique because it evaluates psychologists’ interviewing styles.

Background Lack of coordination between screening studies for common mental disorders in primary care and community epidemiological samples impedes progress in clinical epidemiology. Short screening scales based on the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), the diagnostic interview used in community epidemiological surveys throughout the world, were developed to address this problem. Method Expert reviews and cognitive interviews generated CIDI screening scale (CIDI-SC) item pools for 30-day DSM-IV-TR major depressive episode (MDE), generalized anxiety disorder (GAD), panic disorder (PD) and bipolar disorder (BPD). These items were administered to 3058 unselected patients in 29 US primary care offices. Blinded SCID clinical reinterviews were administered to 206 of these patients, oversampling screened positives. Results Stepwise regression selected optimal screening items to predict clinical diagnoses. Excellent concordance [area under the receiver operating characteristic curve (AUC)] was found between continuous CIDI-SC and DSM-IV/SCID diagnoses of 30-day MDE (0.93), GAD (0.88), PD (0.90) and BPD (0.97), with only 9–38 questions needed to administer all scales. CIDI-SC versus SCID prevalence differences are insignificant at the optimal CIDI-SC diagnostic thresholds (χ2 1 = 0.0–2.9, p = 0.09–0.94). Individual-level diagnostic concordance at these thresholds is substantial (AUC 0.81–0.86, sensitivity 68.0–80.2%, specificity 90.1–98.8%). Likelihood ratio positive (LR+) exceeds 10 and LR− is 0.1 or less at informative thresholds for all diagnoses. Conclusions CIDI-SC operating characteristics are equivalent (MDE, GAD) or superior (PD, BPD) to those of the best alternative screening scales. CIDI-SC results can be compared directly to general population CIDI survey results or used to target and streamline second-stage CIDIs.

Background Lack of coordination between screening studies for common mental disorders in primary care and community epidemiological samples impedes progress in clinical epidemiology. Short screening scales based on the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), the diagnostic interview used in community epidemiological surveys throughout the world, were developed to address this problem. Method Expert reviews and cognitive interviews generated CIDI screening scale (CIDI-SC) item pools for 30-day DSM-IV-TR major depressive episode (MDE), generalized anxiety disorder (GAD), panic disorder (PD) and bipolar disorder (BPD). These items were administered to 3058 unselected patients in 29 US primary care offices. Blinded SCID clinical reinterviews were administered to 206 of these patients, oversampling screened positives. Results Stepwise regression selected optimal screening items to predict clinical diagnoses. Excellent concordance [area under the receiver operating characteristic curve (AUC)] was found between continuous CIDI-SC and DSM-IV/SCID diagnoses of 30-day MDE (0.93), GAD (0.88), PD (0.90) and BPD (0.97), with only 9–38 questions needed to administer all scales. CIDI-SC versus SCID prevalence differences are insignificant at the optimal CIDI-SC diagnostic thresholds (χ2 1 = 0.0–2.9, p = 0.09–0.94). Individual-level diagnostic concordance at these thresholds is substantial (AUC 0.81–0.86, sensitivity 68.0–80.2%, specificity 90.1–98.8%). Likelihood ratio positive (LR+) exceeds 10 and LR− is 0.1 or less at informative thresholds for all diagnoses. Conclusions CIDI-SC operating characteristics are equivalent (MDE, GAD) or superior (PD, BPD) to those of the best alternative screening scales. CIDI-SC results can be compared directly to general population CIDI survey results or used to target and streamline second-stage CIDIs.