This study examines the feasibility and differential inter-rater reliability of Operationalized Psychodynamic Diagnosis 3 (OPD-3) for patients experiencing psychosis.

We conducted OPD interviews with n₁ = 40 patients with SCID-diagnosed nonpsychotic disorders and n₂ = 40 patients with non-affective or affective psychoses. Each patient's video-recorded interview was independently rated by two trained OPD-3 raters, selected from a rater pool of five. We assessed feasibility based on extensive rater discussions and consultations with expert practitioners.

OPD-based diagnostic assessment of individual psychodynamic patient characteristics with OPD-3 has proven feasible for patients with psychosis. Due to particularities of this patient group, some aspects of the rating necessitate specific attention during rater training. OPD-3 shows moderate to excellent inter-rater reliabilities for patients with psychosis with only minor differences to patients without psychosis.

OPD-3 is a clinically applicable and reliable instrument for psychodynamic diagnosis in patients with psychosis.