Psychiatric Diagnosis and Classification - ResearchGate
Psychiatric Diagnosis and Classification - ResearchGate
Psychiatric Diagnosis and Classification - ResearchGate
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188 PSYCHIATRIC DIAGNOSIS AND CLASSIFICATION<br />
of the questions. It is therefore very suitable for patients who are difficult to<br />
interview. The interviewer decides what to rate on the basis of the subject's<br />
information, always bearing the definitions <strong>and</strong> rating rules in mind. Each<br />
symptom is assessed in its own right, thus allowing comparisons of psychiatric<br />
diagnoses to be made across the world, based on the current ICD-10<br />
<strong>and</strong> DSM-IV systems or other diagnostic systems that may develop in the<br />
future.<br />
SCAN has four components: a semi-structured clinical interview schedule<br />
i.e. the tenth edition of the Present State Examination PSE-10) for SCAN<br />
version 2.1), a glossary of differential definitions, an Item Group Checklist<br />
IGC); <strong>and</strong> a Clinical History Schedule CHS).<br />
The SCAN core component is the Present State Examination PSE), which is<br />
a guide to structuring a clinical interview. There are nine earlier versions of the<br />
PSE tested globally during the past four decades. The ninth edition PSE-9),<br />
translated into more than 35 languages, was the first of the series to be<br />
published [36]. It consisted of only 140 items, compared to the 500±600 of<br />
PSE-7 <strong>and</strong> PSE-8. Since many users regretted that the longer preceding versions<br />
were withdrawn, PSE-10 the current SCAN 2.1 interview schedule) is<br />
now offering them a choice. PSE-10/SCAN builds on the experience of extensive<br />
tests using PSE-9. It retains the main features of PSE-9 <strong>and</strong> links together<br />
the latest two international classification systems ICD-10 <strong>and</strong> DSM-IV).<br />
PSE-10 itself has two main parts: Part 1 covers non-psychotic sections,<br />
such as physical health, worrying, tension, panic, anxiety <strong>and</strong> phobias,<br />
obsessional symptoms, depressed mood <strong>and</strong> ideation, impaired thinking,<br />
concentration, energy, interests, bodily functions, weight, sleep, eating disorders,<br />
alcohol <strong>and</strong> drug abuse. Part 2 covers the assessment of psychotic<br />
<strong>and</strong> cognitive disorders <strong>and</strong> abnormalities of behavior, speech <strong>and</strong> affect<br />
Table 8.3).<br />
Table<br />
8.3 Example of a question from the Schedules for Clinical Assessment<br />
in Neuropsychiatry SCAN)<br />
3.00 Worrying<br />
Have you worried a great deal during [PERIOD]<br />
± What is it like when you worry<br />
± Do unpleasant thoughts go round <strong>and</strong> round in your mind<br />
± Do you worry more than is necessary, given the problem<br />
± What happens when you try to turn your attention to something else<br />
± Can you stop worrying by looking at TV or reading or thinking about<br />
something you usually enjoy<br />
A round of painful thought which cannot be stopped <strong>and</strong> is out of<br />
proportion to the topic of worry. Worries ``too much'' but only in relation to<br />
real problems ˆ mild.