Showing papers by "Janet B. W. Williams published in 1982"

Research diagnostic criteria and DSM-III: an annotated comparison.

Abstract: • For several years the Research Diagnostic Criteria (RDC) have been used widely by investigators to select and describe research subjects. These criteria were used as the initial basis for the specified diagnostic criteria for the major diagnostic categories of DSM-III . With the availability of DSM-III in early 1980, research investigators involved in ongoing studies using the RDC and those planning future studies need to understand the relationship between these two systems so that they can make an informed decision about the use of these systems in their work. We compared each of the RDC categories with the corresponding DSM-III categories and determined major differences in the way the systems define many of the categories and the reasons for these differences. We delineated some of the issues that need to be considered when making decisions about which sets of criteria to use in research studies.

Diagnostic criteria for schizophrenia: reliabilities and agreement between systems.

Abstract: • We compared the joint frequencies and reliabilities of the following sets of criteria for the diagnosis of schizophrenia: the New Haven Schizophrenia Index; the Carpenter, Strauss, Bartko (4-, 5-, 6-, and 7-item) system; DSM-III ; Research Diagnostic Criteria (RDC; full and chronic); the Feighner system; and the 1975 criteria of Taylor and Abrams. The systems, of essentially equal reliability, varied sevenfold in their rates of diagnosing schizophrenia. Patients in whom schizophrenia was diagnosed by the lower-rate systems were likely to receive the same diagnosis by the higher-rate systems. This tends not to be the case when an affective syndrome is present.

Reliability in the DSM-III Field Trials: Interview v Case Summary

Abstract: • A study compared the reliability of psychiatric diagnoses obtained from live interviews and from case summaries, on the same patients, by the same clinicians, using the same DSM-III diagnostic criteria. The results showed that the reliability of the major diagnostic classes of DSM-III was higher when diagnoses were made from live interviews than when they were made from case summaries. We conclude that diagnoses based on information contained in traditionally prepared case summaries may lead to an underestimation of the reliability of diagnoses made based on information collected during a “live” interview.

Supervising intake diagnosis. A psychiatric 'Rashomon'.

Abstract: • Psychiatric diagnoses based on data collected during routine clinical intake evaluations done by trainees are often later used in research studies and in program evaluation. It is commonly assumed that the supervisory process can effectively overcome errors that trainees make in diagnosis. We designed a study to assess the adequacy of patient-in-absentia supervision for ensuring accurate psychiatric diagnoses. In 30% of the cases there were major diagnostic disagreements between the supervised diagnoses and consensus diagnoses based on information provided by both the trainee and an experienced clinician who sat in on the trainee's initial interview. These findings have implications for clinical care, training, and research.