Reliability of Diagnosis in Older Psychiatric Patients Using the Structured Clinical Interview for DSM-III-R

We conducted one of the few studies that has examined the reliability of the Structured Clinical Interview for DSM-III-R Axis I (SCID-I) with a mixed inpatient and outpatient population of adults 55 years old and over (range, 56--84 years; mean, 67.33 years). All SCID interviews were videotaped or audiotaped and were administered by Master's-level clinicians working toward their doctorate degrees in clinical psychology. Interrater reliability estimates (kappa and percentage agreement) were calculated for current major depressive episode (47% base rate) and the broad diagnostic categories o f anxiety disorders (15% base rate) and somatoform disorders (12% base rate). Kappa values were .70, .77, and 1.0. Respective percentage agreement was 85% for major depression, 94% for anxiety disorders, and 100% for somatoform disorders. Overall percentage agreement was 91%. We conclude that the SCID-I can be effectively administered by relatively inexperienced clinicians to diagnose older psychiatric patients reliably. Directions that future research might take are offered.