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A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN)

BRUGHA, T. S., JENKINS, R., TAUB, N., MELTZER, H., BEBBINGTON, P. E.·2001·Psychological Medicine

DOI 10.1017/s0033291701004184

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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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Authors: BRUGHA, T. S., JENKINS, R., TAUB, N., MELTZER, H., & BEBBINGTON, P. E.
Affiliations: Office for National Statistics (GB)
ORCID: BRUGHA, T. S.
JENKINS, R.
BEBBINGTON, P. E.
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
DOI: 10.1017/s0033291701004184
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
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Research Portal (King's College London) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › 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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A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN)

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