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Structured Clinical Interview for DSM | |
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Purpose | determine major DSM disorders |
The Structured Clinical Interview for DSM (SCID) is a semi-structured interview guide for making diagnoses according to the diagnostic criteria published in the Diagnostic and Statistical Manual of Mental Disorders (DSM). [1] The development of SCID has followed the evolution of the DSM and multiple versions are available for a single edition covering different categories of mental disorders. The first SCID (for DSM-III-R) was released in 1989[ citation needed ], SCID-IV (for DSM-IV) was published in 1994 and the current version, SCID-5 (for DSM-5), is available since 2013. [2]
It is administered by a clinician or trained mental health professional who is familiar with the DSM classification and diagnostic criteria. The interview subjects may be either psychiatric or general medical patients or individuals who do not identify themselves as patients, such as participants in a community survey of mental illness or family members of psychiatric patients. [3] SCID users should have had sufficient clinical experience to be able to perform diagnostic evaluation, however, nonclinicians who have comprehensive diagnostic experience with a particular study population may be trained to administer the SCID. Generally additional training is required for individuals with less clinical experience. [4]
The SCID for the DSM-III-R helped determine Axis I (SCID-I) and Axis II disorders (SCID-II). [5] Separate versions were used to assess psychiatric patients (SCID-P) and to study non-patient populations (SCID-NP). Another form of the SCID-P, SCID-P W/PSY SCREEN, was developed for patients in which psychotic disorders were expected to be rare and only included screening questions for these disorders but not the complex module. Special versions were also created for studying panic disorder, assessing PTSD and combat experience in Vietnam veterans and studying the social and psychiatric consequencies of HIV infection. [6]
The reliability and validity of the SCID for DSM-III-R has been reported in several published studies. With regard to reliability, the range in reliability is enormous, depending on the type of the sample and research methodology (i.e., joint vs. test-retest, multi-site vs. single site with raters who have worked together, etc.)[ citation needed ]
The Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) is used to diagnose dissociative disorders, especially in research settings. It was originally designed for the DSM-III-R but early access to DSM-IV criteria for dissociative disorders allowed them to be incorporated into the SCID-D. [7]
For subjects with non-dissociative disorders administration takes between 30 minutes and 1.5 hours. Subjects with dissociative disorders usually require between 40 minutes to 2.5 hours. These subjects should be given enough time to describe their experiences fully. [8]
The SCID-D has been translated into Dutch and Turkish and is used in the Netherlands and Turkey. [9] [10]
SCID for DSM-IV also follows the multi-axial system, SCID-I for Axis I disorders (major mental disorders) and SCID-II for Axis II disorders (personality disorders).
There are several variants of SCID-I addressed to different audiences. Similarly to the previous edition SCID-I is available for examining psychiatric patients (SCID-I/P) [11] and studying non-patients (SCID-I/NP) [12] and patient populations where psychotic disorders are not expected (SCID-I/P W/ PSY SCREEN). [13] Specific version for clinicians (SCID-CV) [14] and clinical trials (SCID-CT) [15] were also developed. The SCID-II for DSM-IV comes in a single edition. [16]
A variant of the tool (KID-SCID) was developed at York University for generating childhood DSM-IV diagnoses for clinical research studies. [17] In 2015 a study evaluated the psychometric properties of the KID-SCID in a Dutch sample of children and adolescents [18] which later led to the creation of SCID-5-Junior for the DSM-5 (see below).
An Axis I SCID assessment with a psychiatric patient usually takes between 1 and 2 hours, depending on the complexity of the subject's psychiatric history and their ability to clearly describe episodes of current and past symptoms. A SCID with a non-psychiatric patient takes 1⁄2 hour to 1+1⁄2 hours. A SCID-II personality assessment takes about 1⁄2 to 1 hour.[ citation needed ]
There are at least 700 published studies in which the SCID was the diagnostic instrument used.[ citation needed ] Major parts of the SCID have been translated into other languages, including Danish, French, German, Greek, Hebrew, Italian, Portuguese, Spanish, Swedish, Turkish, and Zulu.[ citation needed ]
SCID-5-RV (Research Version) is the most comprehensive version of the SCID-5. It contains more disorders and includes all of the relevant subtypes and severity and course specifiers. An important feature is its customizability, allowing the instrument to be tailored to meet the requirements of a particular study. SCID-5-CV (Clinician Version) is a reformatted version of the SCID-5-RV for use by clinicians. It covers the most common diagnoses seen in clinical settings. Despite the "clinician" designation, it can be used in research as long as the disorders of interest are among those included in this version. SCID-5-CT (Clinical Trials version) is an adaptation of the SCID-5-RV that has been optimized for use in clinical trials.
SCID-5-PD (Personality Disorders version) is used to evaluate the 10 personality disorders. Its name reflects the elimination of the multiaxial system of the SCID-IV. The SCID-5-AMPD (Alternative Model for Personality Disorders) provides dimensional and categorical approaches to personality disorders. Designed for trained clinicians, the modular format allows the researcher or clinician to focus on those aspects of the Alternative Model of most interest. [19]
Various versions of the SCID-5 have been translated to Chinese, Danish, Dutch, German, Greek, Hungarian, Italian, Japanese, Korean, Norwegian, Polish, Portuguese, Romanian, Spanish, Turkish. [20]
As a result of earlier studies conducted on Dutch youth a variant of the tool, SCID-5-Junior, a revision of the KID-SCID, is available in Dutch. [21] [22] There are plans to create a more widely available version for children and adolescents. [23]
The Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria. It is the main book for the diagnosis and treatment of mental disorders in the United States and Australia, while in other countries it may be used in conjunction with other documents. The DSM-5 is considered one of the principal guides of psychiatry, along with the International Classification of Diseases (ICD), Chinese Classification of Mental Disorders (CCMD), and the Psychodynamic Diagnostic Manual. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.
Dissociative identity disorder (DID), also known as multiple personality disorder, split personality disorder, or dissociative personality disorder, is a member of the family of dissociative disorders classified by the DSM-5, DSM-5-TR, ICD-10, ICD-11, and Merck Manual for diagnosis. It remains a controversial diagnosis.
Dissociation is a concept that has been developed over time and which concerns a wide array of experiences, ranging from a mild emotional detachment from the immediate surroundings, to a more severe disconnection from physical and emotional experiences. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a false perception of reality as in psychosis.
Depersonalization-derealization disorder is a mental disorder in which the person has persistent or recurrent feelings of depersonalization and/or derealization. Depersonalization is described as feeling disconnected or detached from one's self. Individuals may report feeling as if they are an outside observer of their own thoughts or body, and often report feeling a loss of control over their thoughts or actions. Derealization is described as detachment from one's surroundings. Individuals experiencing derealization may report perceiving the world around them as foggy, dreamlike, surreal, and/or visually distorted.
Dissociative disorders (DD) are conditions that involve significant disruptions and/or breakdowns "in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior." People with dissociative disorders also use dissociation as a defense mechanism involuntarily. The individual experiences these dissociations to protect themselves from traumatic stress. Some dissociative disorders are triggered by significant psychological trauma, though depersonalization-derealization disorder may be preceded by lesser stress, psychoactive substances, or no identifiable trigger at all.
Robert Leopold Spitzer was a psychiatrist and professor of psychiatry at Columbia University in New York City. He was a major force in the development of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The Shedler-Westen Assessment Procedure (SWAP-200) is a psychological test for personality diagnosis and clinical case formulation, developed by psychologists Jonathan Shedler and Drew Westen. SWAP-200 is completed by a mental health professional based on their observations and knowledge of a patient, client, or assessment subject. The person being assessed does not interact with the test. Because SWAP-200 is completed by the clinician, diagnostic findings do not depend on the accuracy of information people disclose about themselves and test results can not be faked. The SWAP instruments are based on over two decades of empirical research described in more than 100 articles in peer-reviewed scientific journals. SWAP-200 has been translated into fifteen languages. Other SWAP instruments include the revised SWAP-II and the SWAP-II-A for adolescents.
The classification of mental disorders, also known as psychiatric nosology or psychiatric taxonomy, is central to the practice of psychiatry and other mental health professions.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In 2022, a revised version (DSM-5-TR) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has practical importance. However, not all providers rely on the DSM-5 for planning treatment as the ICD's mental disorder diagnoses are used around the world and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions. The DSM-5 is the only DSM to use an Arabic numeral instead of a Roman numeral in its title, as well as the only living document version of a DSM.
Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions vary by source and remain a matter of controversy. Official criteria for diagnosing personality disorders are listed in the sixth chapter of the International Classification of Diseases (ICD) and in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).
Personality disorder not otherwise specified (PD-NOS) is a subclinical diagnostic classification for some DSM-IV Axis II personality disorders not listed in DSM-IV.
The Schedule for Affective Disorders and Schizophrenia (SADS) is a collection of psychiatric diagnostic criteria and symptom rating scales originally published in 1978. It is organized as a semi-structured diagnostic interview. The structured aspect is that every interview asks screening questions about the same set of disorders regardless of the presenting problem; and positive screens get explored with a consistent set of symptoms. These features increase the sensitivity of the interview and the inter-rater reliability of the resulting diagnoses. The SADS also allows more flexibility than fully structured interviews: Interviewers can use their own words and rephrase questions, and some clinical judgment is used to score responses. There are three versions of the schedule, the regular SADS, the lifetime version (SADS-L) and a version for measuring the change in symptomology (SADS-C). Although largely replaced by more structured interviews that follow diagnostic criteria such as DSM-IV and DSM-5, and specific mood rating scales, versions of the SADS are still used in some research papers today.
The Eating Disorder Diagnostic Scale (EDDS) is a self-report questionnaire that assesses the presence of three eating disorders; anorexia nervosa, bulimia nervosa and binge eating disorder. It was adapted by Stice et al. in 2000 from the validated structured psychiatric interview: The Eating Disorder Examination (EDE) and the eating disorder module of the Structured Clinical Interview for DSM-IV (SCID)16.
Michael B. First is an American psychiatrist who focuses on diagnostic criteria for mental disorders. He is Professor of Clinical Psychiatry at Columbia University. First was one of the editors of DSM-IV-TR, the Editor of Text and Criteria for the DSM-IV, and the editor of the Structured Clinical Interview for DSM-IV. He also served as consultant to the World Health Organization for the revision of ICD-11.
The nine-item Patient Health Questionnaire (PHQ-9) is a depressive symptom scale and diagnostic tool introduced in 2001 to screen adult patients in primary care settings. The instrument assesses for the presence and severity of depressive symptoms and a possible depressive disorder. The PHQ-9 is a component of the larger self-administered Patient Health Questionnaire (PHQ), but can be used as a stand-alone instrument. The PHQ is part of Pfizer's larger suite of trademarked products, called the Primary Care Evaluation of Mental Disorders (PRIME-MD). The PHQ-9 takes less than three minutes to complete. It is scored by simply adding up the individual items' scores. Each of the nine items reflects a DSM-5 symptom of depression. Primary care providers can use the PHQ-9 to screen for possible depression in patients.
Janet B. W. Williams is an American social worker who focuses on the diagnosis and assessment of mental disorders. She is Professor Emerita of Clinical Psychiatric Social Work at Columbia University. She was a major force in writing the PHQ-9, a 9-question instrument given to patients in a primary care setting to screen for the presence and severity of depression.
Other specified dissociative disorder (OSDD) is a mental health diagnosis for pathological dissociation that matches the DSM-5 criteria for a dissociative disorder, but does not fit the full criteria for any of the specifically identified subtypes, which include dissociative identity disorder, dissociative amnesia, and depersonalization/derealization disorder, and the reasons why the previous diagnoses were not met are specified. "Unspecified dissociative disorder" is given when the clinician does not give a reason. The International Statistical Classification of Diseases and Related Health Problems (ICD-10) refers to the diagnosis as "Other dissociative and conversion disorders". Under the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), it was known as "Dissociative disorder not otherwise specified" (DDNOS).
The NetSCID-5 is an online version of the Structured Clinical Interview for DSM-5, developed and marketed in consultation with the SCID-5 authors by TeleSage, Inc. in Chapel Hill, North Carolina.
The Hierarchical Taxonomy Of Psychopathology (HiTOP) consortium was formed in 2015 as a grassroots effort to articulate a classification of mental health problems based on recent scientific findings on how the components of mental disorders fit together. The consortium is developing the HiTOP model, a classification system, or taxonomy, of mental disorders, or psychopathology, aiming to prioritize scientific results over convention and clinical opinion. The motives for proposing this classification were to aid clinical practice and mental health research. The consortium was organized by Drs. Roman Kotov, Robert Krueger, and David Watson. At inception it included 40 psychologists and psychiatrists, who had a record of scientific contributions to classification of psychopathology The HiTOP model aims to address limitations of traditional classification systems for mental illness, such as the DSM-5 and ICD-10, by organizing psychopathology according to evidence from research on observable patterns of mental health problems.