Psychiatric Diagnosis and Classification - ResearchGate

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CLINICAL ASSESSMENT INSTRUMENTS IN PSYCHIATRY 189 The SCAN glossary is an essential part of SCAN. Rating is done on the basis of matching the answers of the respondent against the differential definitions of the symptoms and signs in the glossary, which is largely based on the phenomenology of Jaspers. The Item Group Checklist IGC) is a list of 59 item groups rated directly, based on information derived from case notes and informants. The Clinical History Schedule CHS) consists of sections on childhood and education to age 16, intellectual level, social roles and performances, overall social handicap disablement), as well as disorders of adult personality and behavior, and physical illnesses or disabilities not entered elsewhere. SCAN exists in the following languages: Chinese, Danish, Dutch, English, French, German, Greek, Italian, Kannada India), Portuguese, Spanish, Turkish, Yoruba Nigeria). Data from all the schedules are coded on a set of scoring sheets. A diagnostic computer program CATEGO-5) is available to process the data and score ICD-10 and DSM-IV diagnoses. A computer-assisted PSE version, called CAPSE-2, assists the interviewer in applying SCAN and allows direct entry of ratings at the time of the interview. The program displays questions and ratings in different windows on the screen and, if needed, SCAN glossary definitions can also be referred to. More recently, WHO developed a computerized version of SCAN 2.1 built on the top of the I-Shell system [37]. This system, which is a ``computer aided personal interviewing tool'' is already used for several other WHO instruments. The SCAN 2.1 for I-Shell contains all of the SCAN text and SCAN glossary as well as ICD-10 and DSM-IV diagnostic algorithms for SCAN. The SCAN program allows an easy and more accurate collection of data with the help of a user-friendly interface which also provides range checking and a context-sensitive SCAN glossary. The algorithms can be run at any time within the interview even with uncompleted data. The program can display extra information about diagnoses such as how they are calculated, which SCAN items are used for which diagnoses, etc. This kind of information is important especially for testing and improving the diagnostic algorithms. The program is available from the WHO SCAN Homepage http://www.who.int/msa/scan) and is provided free of charge to those who have done a SCAN course in a WHO training and research center. The addresses of these centers can also be found on the SCAN Homepage. The training courses last one week and are given by qualified trainers. The set-up is to start with an introductory talk about the ``roots'' of classification, followed by a walkthrough of the various sections of SCAN and the rating scales. Tapes are shown of parts of) a SCAN interview, dealing with the various sections. The participants rate the tape and ratings are discussed. The remainder of the week is mainly spent on interviews by the
190 PSYCHIATRIC DIAGNOSIS AND CLASSIFICATION participants with live patients and brief lectures on the various sections. The format of the training course may vary between centers. Psychometric properties of SCAN 2.1 have been tested and the overall reliability was qualified as moderate to substantial [38]. More information can be found in a reference manual published at Cambridge University Press [39], which can also be used as a companion to the SCAN interview schedule and software. It describes the rationale and development of the system and provides a valuable introduction to its uses. Other Semi-structured Diagnostic Interviews for Axis I Disorders A number of semi-structured diagnostic interviews have been developed for specific Axis I disorders, such as the Eating Disorders Examination [40] or the Yale Brown Obsessive Compulsive Schedule [41]. The DIGS Diagnostic Interview for Genetic Studies) [42] is a clinical interview especially designed by the NIMH Genetics Initiative for the assessment of major mood and psychotic disorders and their spectrum conditions. It has the following features: a) polydiagnostic capacity; b) a detailed assessment of the course of the illness, chronology of psychotic and mood syndromes, and comorbidity; c) additional phenomenological assessments of symptoms; and d) algorithmic scoring capability. A reliability study has been carried out with excellent sensitivity and specificity for DSM-III-R and RDC diagnoses of major depression, bipolar disorder, schizophrenia, and lower diagnostic accuracy for subtypes of schizoaffective disorder [43]. SEMI-STRUCTURED INTERVIEWS FOR PERSONALITY DISORDERS Semi-structured interviews for the assessment of personality disorders provide questions, guidelines and instructions for the assessment of the criteria defining personality disorder in general and specific personality disorders in particular. Some of these interviews are restricted to the assessment of a single personality disorder, while others are constructed for the assessment of all the personality disorders listed in ICD-10 or/and DSM-IV. The Diagnostic Interview for Borderline DIB) The Diagnostic Interview for Borderline DIB) is a semi-structured interview for the assessment of the criteria defining borderline personality disorder.
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PREFACE xi world who are interested
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2 PSYCHIATRIC DIAGNOSIS AND CLASSIF
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10 PSYCHIATRIC DIAGNOSIS AND CLASSI
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IMPLICATIONS OF COMORBIDITY 81 Fina
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IMPLICATIONS OF COMORBIDITY 83 It a
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IMPLICATIONS OF COMORBIDITY 85 leve
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IMPLICATIONS OF COMORBIDITY 87 ledg
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Table 4.2 Matrix of levels and subl
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IMPLICATIONS OF COMORBIDITY 91 unde
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IMPLICATIONS OF COMORBIDITY 93 Tabl
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IMPLICATIONS OF COMORBIDITY 99 Tabl
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IMPLICATIONS OF COMORBIDITY 103 stu
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IMPLICATIONS OF COMORBIDITY 105 52.
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108 PSYCHIATRIC DIAGNOSIS AND CLASS
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PSYCHIATRIC DIAGNOSIS IN DEVELOPING
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282 INDEX AsociacioÂn PsiquiaÂtri
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284 INDEX consciousness in phenomen
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286 INDEX eating disorders 80 Eatin
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288 INDEX India contd) Unani/Arabic
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290 INDEX obsessive-compulsive diso
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292 INDEX St. Louis diagnostic crit
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294 INDEX US Navy classification 49
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