Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers

• Published in: Psychological medicine Vol. 22; no. 2; p. 465
• Main Authors: Lewis, G, Pelosi, A J, Araya, R, Dunn, G
• Format: Journal Article
• Language: English
• Published: England 01.05.1992
• Subjects: Adult; Cross-Sectional Studies; England - epidemiology; Female; Humans; Incidence; Interview, Psychological; Male; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - psychology; Observer Variation; Patient Care Team; Personality Assessment - statistics & numerical data; Psychometrics; Psychosocial Deprivation; Reproducibility of Results; Research Design; Risk Factors; England
• DOI: 10.1017/S0033291700030415
• ISSN: 0033-2917

Many of the standardized interviews currently used in psychiatry require the interviewer to use expert psychiatric judgements in deciding upon the presence or absence of psychopathology. However, when case definitions are standardized it is customary for clinical judgements to be replaced with rules. The Clinical Interview Schedule was therefore revised, in order to increase standardization, and to make it suitable for use by 'lay' interviewers in assessing minor psychiatric disorder in community, general hospital, occupational and primary care research. Two reliability studies of the revised Clinical Interview Schedule (CIS-R) were conducted in primary health care clinics in London and Santiago, Chile. Both studies compared psychiatrically trained interviewer(s) with lay interviewer(s). Estimates of the reliability of the CIS-R compared favourably with the results of studies of other standardized interviews. In addition, the lay interviewers were as reliable as the psychiatrists and did not show any bias in their use of the CIS-R. Confirmatory factor analysis models were also used to estimate the reliabilities of the CIS-R and self-administered questionnaires and indicated that traditional measures of reliability are probably overestimates.