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July 1985

A Comparison of Clinical and Diagnostic Interview Schedule DiagnosesPhysician Reexamination of Lay-Interviewed Cases in the General Population

Author Affiliations

From the Department of Psychiatry, Washington University School of Medicine, St Louis (Drs Helzer and Robins and Mr McEvoy); the Department of Mathematics and Division of Biostatistics, Washington University, St Louis (Dr Spitznagel); the Institute of Psychiatry, London (Dr Farmer); and the Department of Psychiatry, University of Birmingham (England) (Dr Brockington). Dr Stoltzman is in private practice, Fort Smith, Ark.

Arch Gen Psychiatry. 1985;42(7):657-666. doi:10.1001/archpsyc.1985.01790300019003

• We examined the level of agreement between diagnoses derived from data gathered by lay interviewers using the Diagnostic Interview Schedule (DIS) in a general population survey (the Epidemiologic Catchment Area project) and both DIS and clinical diagnoses made by psychiatrists. Overall percent agreement between the lay DIS and the psychiatrists clinical impression ranged from 79% to 96%. The chancecorrected concordance was .60 or better for eight of the 11 diagnoses. Specificities were all 90% or better. Sensitivities were lower, but lay results showed a bias for only two diagnoses: major depression was significantly underdiagnosed and obsessive illness was overdiagnosed. We compared the present results with those of previous studies from clinical settings. We explored possible reasons for disagreement and discussed the implications of the findings for psychiatric epidemiologic research.