Psychiatric Diagnosis and Classification - ResearchGate

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were withdrawn, PSE-10 the current SCAN 2.1 interview schedule) is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