Diagnostic agreement between a doctor and a nurse for psychiatric disorders: a pilot study

The objective of the study was to examine inter-rater agreement for psychiatric disorders by means of a structured interview performed by a psychiatrist and a nurse. Sixteen psychiatric inpatients with a mean age of 38.9+/-12.9 years were assessed independently by a psychiatrist and a nurse using a structured psychiatric interview, Strukturert Psykiatrisk Intervju for Allmennpraksis (SPIFA). For most diagnoses, agreement was substantial to perfect (kappa = 1 for the diagnoses major depression, generalized anxiety disorder, obsessive-compulsive disorder and substance abuse). Fair to moderate kappa values were found for personality disturbances and dysthymia. The results of this study indicate that after adequate training nurses can perform structured psychiatric interviews with a high inter-rater agreement.