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Related Experiment Videos

Diagnosing comorbidity in substance abusers. Computer assessment and clinical validation

H E Ross1, R Swinson, E J Larkin

  • 1Addiction Research Foundation, Toronto, Ontario, Canada.

The Journal of Nervous and Mental Disease
|October 1, 1994
PubMed
Summary

The Computerized Diagnostic Interview Schedule (C-DIS) showed poor agreement with clinician diagnoses for substance abusers. While C-DIS identified many Axis I disorders, it frequently overdiagnosed comorbid conditions.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Health Informatics

Background:

  • Accurate diagnosis of substance use disorders and comorbid conditions is crucial for effective treatment.
  • Automated diagnostic tools are being developed to aid clinical assessment.
  • The Computerized Diagnostic Interview Schedule (C-DIS) is one such tool for diagnosing mental health conditions.

Purpose of the Study:

  • To compare the diagnostic accuracy of the C-DIS with clinician-based diagnoses for substance abusers.
  • To evaluate the C-DIS as a potential screening instrument for Axis I disorders and comorbid conditions.

Main Methods:

  • 173 substance abusers in treatment were interviewed using the C-DIS.
  • Clinicians conducted Structured Clinical Interviews for DSM-III-R (SCID) and reviewed patient charts.

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  • Consensus diagnoses were established using all available information, including a second SCID in a subset of patients.

    • Main Results:

    • The C-DIS demonstrated poor diagnostic agreement with SCID diagnoses, except for antisocial personality disorder and most psychoactive substance use disorders.
    • C-DIS showed potential as a screening tool, identifying most subjects with Axis I (nondrug) disorders but with a high rate of false positives.
    • A negative C-DIS result for comorbid disorders was highly reliable, confirmed in 90% of cases.

    Conclusions:

    • The C-DIS, in its current form, has limited utility for definitive diagnosis in substance abusers compared to structured clinical interviews.
    • The C-DIS may serve as a screening tool for Axis I disorders, but its overdiagnosis rate requires careful clinical interpretation.
    • The C-DIS shows promise for ruling out comorbid disorders when results are negative.