Inter-Rater Reliability of the Diagnoses of Psychosis and Depression in Individuals with Intellectual Disabilities

• Published in: Journal of applied research in intellectual disabilities Vol. 20; no. 5; pp. 384 - 390
• Main Authors: Einfeld, S., Tonge, B., Chapman, L., Mohr, C., Taffe, J., Horstead, S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2007; Blackwell Publishing; Wiley Subscription Services, Inc
• Subjects: Agreements; Antipsychotics; Clinical Diagnosis; depression; Depression (Psychology); Drug Therapy; Identification; Intellectual disabilities; intellectual disability; inter-rater reliability; Interrater Reliability; Medical diagnosis; Mental Retardation; Physicians; Predictive Validity; Psychiatry; Psychosis
• ISSN: 1360-2322; 1468-3148
• DOI: 10.1111/j.1468-3148.2007.00381.x

Background  There is a history of over‐prescription of antipsychotics to individuals with intellectual disability (ID), while antidepressants may be under‐prescribed. However, appropriate treatment is best supported when the diagnosis of psychosis or depression is valid and carries good predictive validity. The present authors report a study examining one aspect of validity, namely whether skilled clinicians can agree on whether an individual with an ID is psychotic or depressed. Materials and Methods  Pairs of clinicians assessed 52 individuals. Agreement was assessed using Cohen’s kappa statistic and agreement proportion. Results  Overall agreement was high for both psychosis and depression. Whether the individual had mild ID or moderate/severe ID did not have a significant impact on agreement. Conclusions  Experienced clinicians achieved a high level of agreement as to whether a person with ID was psychotic or depressed similar to that found for those without ID. The findings provide some support for treatment interventions based on diagnosis.