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A short computer interview for obtaining psychiatric diagnoses

K K Bucholz1, S L Marion, J J Shayka

  • 1Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63108, USA.

Psychiatric Services (Washington, D.C.)
|March 1, 1996
PubMed
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A brief computer interview effectively replaces full diagnostic interviews for most psychiatric conditions, offering faster assessments. However, it may miss some generalized anxiety disorder cases and misdiagnose post-traumatic stress disorder remission.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Health Informatics

Background:

  • Accurate psychiatric diagnosis is crucial for effective treatment.
  • Traditional diagnostic interviews are time-consuming.
  • Computerized assessments offer potential for efficiency.

Purpose of the Study:

  • To evaluate a short computer interview's accuracy against a full diagnostic interview.
  • To assess the sensitivity, specificity, and diagnostic agreement of the computer interview.
  • To determine if the computer interview can replace the full interview for psychiatric diagnoses.

Main Methods:

  • Patients recently discharged from psychiatric services underwent two interviews: a full diagnostic interview and a short computer interview.
  • Diagnoses from both interviews were compared.

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  • Sensitivity, specificity, and kappa values (diagnostic agreement) were calculated.

    • Main Results:

    • The short computer interview demonstrated high sensitivity and specificity for most psychiatric disorders.
    • Excellent diagnostic agreement was observed between the short interview and the full interview.
    • Administration time was significantly reduced with the computer interview.
    • However, the short interview under-identified generalized anxiety disorder and misclassified post-traumatic stress disorder remission.

    Conclusions:

    • The short computer interview is a viable substitute for full diagnostic interviews in many clinical and research settings.
    • Substitution is appropriate when missing active cases is acceptable or detailed symptom counts are unnecessary.
    • Potential applications include study screening and obtaining a broad overview of psychiatric history.