02 - 2. Diagnostic schedules

2. Diagnostic schedules

© SPMM Course 2. Diagnostic schedules

Scale Mode of administration Features Clinical Interview Schedule (CIS)

Clinician administered – fully structured. A revised version for lay interviewers also available (CIS-R). Used in National Psychiatric Morbidity Surveys of Great Britain. Developed by Goldberg et al. Aims to identify common disorders found in primary care & community settings (focus on neurotic conditions). Composite International Diagnostic Interview (CIDI) Clinician administered CIDI was an improvised schedule that incorporated principles of both PSE and DIS. It was produced by WHO to be used with both ICD and DSM diagnoses. Diagnostic Interview Schedule (DIS) Non-clinicianadministered; fully structured interview. Used in ECA study. Lifetime DSM diagnoses made initially; later a time period can be specified for ‘current diagnoses’. Hopkins Symptom Check List (HSCL) Trained primary care workers (HSCL-25) or self-reported (original) HSCL has a 58 items self-report version that measures ‘neurotic’ symptom distress in outpatients (somatisation, OCD symptoms, interpersonal sensitivity, anxiety and depression) and a 25 item objective version that measures symptoms of anxiety (10 items) and depression (15 items). SCL-90R and Brief Symptom Inventory (BSI) are derivatives of HSCL. Patient Health Questionnaire (PHQ)

Self-report scale It is the self-report version of Primary Care Evaluation of Mental Disorders (PRIME-MD) developed by Spitzer et al. on the basis of DSM-III. Aims to diagnose common neurotic conditions in primary care settings. PHQ-9 is a derivative that focuses on the 9 depression criteria in DSM-IV. GAD-7 on anxiety and PHQ-15 on depression with somatic features. Present State Examination (PSE)

Clinician-administered semi-structured clinical interview Provides clinical diagnoses in the lines of ICD system. CATEGO is the computerize version of PSE schedule. Schedule for Affective Disorders and Schizophrenia (SADS) Clinician-administered semi-structured Covers all major mental illnesses (depression, bipolar disorder, schizophrenia and anxiety disorders). A regular, a lifetime and a change version are available. A children version called Kiddie-SADS is also available. Schedule for Assessment in Neuropsychiatry (SCAN) Semi-structured interview for use by trained clinicians Developed by Wing et al. on the basis of PSE and has replaced PSE at present. Focused on adult psychopathology. Extensive (28 sections and 1872 items in total, but many can be skipped) Structured ClinicalInterview for DSMIV (SCID) Clinicianadministered semistructured To be used for patients in whom a psychiatric diagnosis is suspected. Non-patient version available for epidemiological studies. SCID-II is available for axis 2 disorders.

© SPMM Course Some general observations on diagnostic schedules currently available in psychiatry

1. Most schedules are either DSM or ICD based; only a few cater both simultaneously.
2. A number of primary-care oriented schedules focus largely on nonpsychotic disorders
3. Many schedules have computerized forms; nevertheless a number of them are timeconsuming to complete routinely or during initial clinical contact.
4. Almost all of them are clinician-administered though self-report forms have evolved in recent times.