Psychological Medicine

Original Articles

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

Glyn Lewisa1 c1, Anthony J. Pelosia1, Ricardo Arayaa1 and Graham Dunna1

a1 General Practice Research Unit and Department of Biostatistics and Computing, Institute of Psychiatry; Maudsley Hospital, London

Abstract

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.

Correspondence:

c1 Address for correspondence: Dr Glyn Lewis, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.

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