The microcomputerized Diagnostic Interview Schedule: clinical use in an out-patient setting

Area of Science:

• Psychiatry
• Clinical Psychology
• Medical Informatics

Background:

• The validity of the Diagnostic Interview Schedule (DIS) remains debated.
• A microcomputerized version of the DIS offers potential for efficiency and accuracy in data collection.
• Assessing the utility of this new instrument in a clinical psychiatric setting is warranted.

Purpose of the Study:

• To evaluate the use and effectiveness of a microcomputerized Diagnostic Interview Schedule (DIS) in a psychiatric out-patient department.
• To compare the diagnostic yield and patient acceptance of the microcomputerized DIS against a standard non-structured clinical interview (NSI).
• To analyze discrepancies in diagnoses between the two methods and discuss implications for clinical practice.

Main Methods:

• Forty-one psychiatric out-patients were assessed using both the microcomputerized DIS and a standard non-structured clinical interview (NSI).
• Data on interview duration, patient acceptance, and number/type of diagnoses were collected and compared.
• Diagnostic outcomes were analyzed for group differences and individual patient agreement.

Main Results:

• The microcomputerized DIS took an average of 111.6 minutes, with high patient acceptance.
• The DIS yielded a higher mean number of diagnoses per patient (5.5) compared to the NSI (2.56).
• Significant discrepancies were found between the DIS and NSI in diagnoses, particularly for substance abuse, affective, psychosexual, and personality disorders, with limited individual patient agreement.

Conclusions:

• The microcomputerized DIS is a clinically useful adjunct to the diagnostic process in psychiatric out-patient settings.
• Its efficiency and ability to generate a diagnostic profile quickly make it suitable for widespread use.
• Further investigation into the reasons for diagnostic discrepancies between the DIS and NSI is recommended.