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A comparison of two structured diagnostic interviews: CIDI and SCAN
G Andrews1, L Peters, A M Guzman
1Clinical Research Unit for Anxiety Disorders, University of New South Wales at St. Vincent's Hospital, Darlinghurst.
The Australian and New Zealand Journal of Psychiatry
|March 1, 1995
Summary
This study compared the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) for diagnosing anxiety and depressive disorders. The CIDI demonstrated perfect inter-rater reliability, while the SCAN showed good reliability, with both instruments achieving moderate diagnostic agreement.
Area of Science:
- Psychiatry
- Clinical Psychology
- Epidemiology
Background:
- Accurate diagnosis of anxiety and depressive disorders is crucial for effective treatment.
- Standardized diagnostic interviews are essential tools in clinical practice and research.
- Comparing the reliability and concordance of different diagnostic instruments is vital for clinical utility.
Purpose of the Study:
- To explore the relationship and inter-rater reliability of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN).
- To assess the diagnostic agreement between CIDI and SCAN for anxiety and depressive disorders.
- To compare the inter-rater reliability of CIDI and SCAN.
Main Methods:
- 101 patients from an Anxiety Disorders Clinic were assessed using CIDI and SCAN in a counterbalanced order.
- A subsample of 29 patients underwent observed interviews to determine inter-rater reliability.
- Canonical correlation analysis was used to measure concordance between instruments.
Main Results:
- Moderate concordance was found between CIDI and SCAN for current (r = 0.69) and lifetime (r = 0.66) diagnoses.
- The CIDI demonstrated perfect inter-rater reliability (overall intraclass kappa = 1.00).
- The SCAN showed good inter-rater reliability (overall intraclass kappa = 0.67).
Conclusions:
- Both CIDI and SCAN achieve moderate diagnostic distinctions for anxiety and depressive disorders.
- The CIDI exhibits superior inter-rater reliability compared to the SCAN.
- The clinical judgment inherent in SCAN administration may contribute to lower interviewer-observer agreement than the more structured CIDI.