The Research Of SCID In Psychological Autopsy

Objective: The reliability, sensitivity and specificity of using psychological autopsies to diagnose a psychiatric disorder are a critical issue. Therefore, the reliability, sensitivity and specificity of the Structured Clinical Interview for DSM-IV Axis I and the usefulness of these instruments for the psychological autopsy method were investigated. In addition, the influencing factors of diagnoses obtained through the best- estimate method using the Structured Clinical Interview for DSM-IV Axis I were discussed.Method: The subjects of the research were the psychiatric patients of the No.7th people's hospital of Dalian and the community persons in the six counties in Liaoning province. Diagnoses by informant's interview were compared with diagnoses generated by a personal interview of 353 persons (209 psychiatric patients and 144 community persons). Inter-rater reliability and test–retest reliability were assessed in 30 and 35 patients and their informants, respectively. Chi-square analysis and kappa were used to determine agreement of diagnoses.Results: Kappa coefficients were above 0.75 for alcohol-related disorders, psychiatric disorders, bipolar disorders and depression disorders for inter-rater and test-retest reliability in personal interview. Kappa coefficients were above 0.75 for alcohol-related disorders, psychiatric disorders, bipolar disorders, depression disorders and anxiety disorders for inter-rater and test–retest reliability in informant's interview. The kappa coefficients of agreement by personal and informant's interview were above 0.65 for most Axis I disorders except alcohol abuse and dysthymia; The specificity of most diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV Axis I was higher than 88%, yet the sensitivity was lower than the specificity especially for the alcohol abuse, dysthymia, major depression and anxiety disorders. The influencing factors of diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV Axis I were category and education of the informants.Conclusion: The reliability, sensitivity and specificity of using psychological autopsies to diagnose a psychiatric disorder were fair to excellent. The influencing factors of diagnoses by informant's interview were category and education of the informants. The Structured Clinical Interview for DSM-IV Axis I can be recommended as a tool for the psychological autopsy research.