A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN)
Abstract
Background. In psychiatric surveys of the general population, there has been considerable discrepancy between diagnoses obtained by fully structured interviews and those established by systematic semi-structured clinical evaluation. The Composite International Diagnostic Interview (CIDI) is an example of the first type of interview widely used in general population surveys. We compared its performance in diagnosing current depressive and anxiety disorders with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), a semi-structured diagnostic interview administered by clinically trained interviewers. Methods. Household addresses in Leicestershire, UK, were randomly sampled and 860 adults were screened with the Revised Clinical Interview Schedule. Adults with too few symptoms to fulfil diagnostic criteria for study disorders were excluded to increase the proportion re-interviewed who met such criteria. Repeat diagnostic interviews with the CIDI and SCAN, ordered randomly, were sought from eligible screen positive respondents. Recalibrated CIDI prevalence estimates were derived from the SCAN classification using Bayesian statistics. Results. Concordance ranged between ‘poor’ and ‘fair’ across almost all types of study disorders, and for co-morbidity. Concordance was somewhat better for severity of depression and when lower diagnostic thresholds were used for depression. Interview order effects were suggested with lower concordance when CIDI followed SCAN. Recalibration reduced the prevalence of depressive or anxiety disorder from 9·0 to 6·2%. Conclusions. Community psychiatric surveys using structured diagnostic interview data must be interpreted cautiously. They should include an element of clinical re-appraisal so findings can be adjusted for estimation differences between fully structured and clinical assessments.
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Fully structured interviews are intended to increase standardisation, but this could be at the cost of reduced validity.
“By design, fully structured interviews are intended to increase standardisation, but this could be at the cost of reduced validity.39 40 41 42”
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Effect of Age on the Frequency of Anxiety Disorders in Major Depression With Psychotic Features
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Anxiety disorders and comorbid depression in community dwelling older adults
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Can only reversed vegetative symptoms define atypical depression?
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How false are “false” positive psychotic symptoms?
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Self-citationMajor Depressive Disorder with Anger: A Bipolar Spectrum Disorder?
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Factor structure of recalled DSM-IV hypomanic symptoms of bipolar II disorder
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Agitated depression: a valid depression subtype?
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Psychometric delineation of the most discriminant symptoms of depressive mixed states
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Mixed depression: a clinical marker of bipolar-II disorder
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Small Signal, Big Noise: Performance of the CIDI Depression Module
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Agitated Depression: Unipolar? Bipolar? or Both?
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Depressive mixed state: dimensional versus categorical definitions
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RIFD – A brief clinical research interview for functional somatic disorders and health anxiety
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Overtraining syndrome in horses
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Assessing validity of a depression screening instrument in the absence of a gold standard
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Psychiatric epidemiology: Challenges and opportunities
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Mixed states in bipolar II disorder: should full hypomania always be required?
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Should mood reactivity be included in the DSM-IV atypical features specifier?
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The Evaluation of Behavioral Disturbances in Epilepsy
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General Practitioner Recognition of Mental Illness in the Absence of a ‘Gold Standard’
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The end of the beginning: a requiem for the categorization of mental disorder?
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Self-citationIs there a link between atypical and early-onset “unipolar” depression and bipolar II disorder?
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Suicidal ideation and bipolar-II depression symptoms
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Inter‐episode mood lability in mood disorders: residual symptom or natural course of illness?
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Antisocial personality disorder and anxiety disorder: A diagnostic variant?
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Treatment of depression in patients with epilepsy: problems, pitfalls, and some solutions
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Unipolar depression with racing thoughts: A bipolar spectrum disorder?
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The Florence Psychiatric Interview
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Depressive mixed state frequency: Age/gender effects
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A continuity between bipolar II depression and major depressive disorder?
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- Authors
- BRUGHA, T. S., JENKINS, R., TAUB, N., MELTZER, H., & BEBBINGTON, P. E.
- Affiliations
- Office for National Statistics (GB)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2001-07-31
- Volume
- 31
- Issue
- 6
- Pages
- 1001-1013
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2148011850
- Cited by
- 171
- References
- 47
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 1 · 2023: 3 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 3 · 2017: 2 · 2016: 2 · 2015: 4 · 2014: 4 · 2013: 6 · 2012: 1
- FWCI
- 26.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Keywords
- Composite International Diagnostic Interview, depressive disorders, anxiety disorders, psychiatric comorbidity, diagnostic thresholds
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Culture, Depressive Disorder, Female, United Kingdom, Humans, Interview, Psychological, Male, Middle Aged, Population Surveillance, Sensitivity and Specificity, Severity of Illness Index
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