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Test-Retest Reliability of Standardized Diagnostic Interviews for Common Adult Psychiatric Disorders: A Systematic
Weiyi Xie1,2, Julie Nordgaard3,4, R Christopher Sheldrick5
1Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
JAMA Network Open
|May 28, 2026
Summary
Standardized diagnostic interviews (SDIs) demonstrate moderate, heterogeneous test-retest reliability for adult psychiatric disorders. Reliability varies by disorder type, suggesting standardization alone is insufficient for consistent diagnosis.
Area of Science:
- Psychiatry and Mental Health
- Clinical Epidemiology
- Diagnostic Assessment
Background:
- Standardized diagnostic interviews (SDIs) aim to enhance diagnostic consistency and reliability in psychiatric assessments.
- The pooled test-retest reliability of SDIs for adult psychiatric disorders has not been previously established.
Purpose of the Study:
- To estimate the test-retest reliability of SDIs for common adult psychiatric disorders.
- To examine variations in reliability across different disorder types.
- To assess factors contributing to heterogeneity in reliability estimates between studies.
Main Methods:
- A systematic review and meta-analysis of studies evaluating SDI test-retest reliability.
- Searched multiple databases (MEDLINE, Embase, PsycINFO, etc.) up to September 2025.
- Utilized multilevel random-effects meta-analysis and meta-regression, adhering to PRISMA guidelines.
Main Results:
- Analyzed 57 studies (46 in meta-analysis, 8146 participants). Pooled SDI test-retest reliability was κ=0.69 (95% CI, 0.66-0.72), with substantial heterogeneity (I²=93%).
- Reliability was higher for substance use disorders (SUDs; κ=0.72) than for mental disorders (κ=0.65).
- Reliability varied significantly among specific disorders, ranging from κ=0.55 (nonaffective psychoses) to κ=0.81 (opioid SUDs).
Conclusions:
- SDIs exhibit moderate and heterogeneous test-retest reliability for adult psychiatric disorders.
- Diagnostic criteria partially explained variability in SUD reliability, but methodological factors did not.
- Structural standardization alone may be insufficient; contextual and phenomenological information is crucial for accurate psychiatric diagnosis.
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