Development and Validation of DIS-IV, Korean Version / 신경정신의학

ABSTRACT

OBJECTIVE: Appearance of DSM-IV has influenced greatly on the nosological classification of mental disorder, not considered as revised one of DSM-III-R but a new criteria. DIS-IV has been developed after revision of DIS-III in consideration of various changes in DSM-IV. This study is to develop and validate the DIS-IV, Korean version to activate Korean psychiatric research much more and to modivate more frequent international collaborative study. METHOD: Translation committee produced DIS-IV, Korean version through all the procedures of translation, back-translation, confirmation of retained original meaning of the English version, adaptation to Korean linguistic usage and preliminary study. Four medical students were trained during DIS-IV training course that retained the same contents and methods as of Washington University. Inter-rater reliability was measured by comparison between two diagnoses made from two interviewer who rated one patient at the same time. Procedural validity was measured by comparison between lay-interviewer's diagnosis and psychiatrist's diagnosis which were made after independent DIS-IV using interview. Subjects were 124 patients who were being treated at two University Hospital and National Forensic Psychiatric Hospital between January, 2000 and August, 2000. RESULTS: Average kappa value of inter-rater reliability was 0.74. Diagnoses showing over 0.7 in kappa value were bipolar I disorder, generalized anxiety disorder, depressive disorder, obsessive-compulsive disorder, oppositional defiant disorder, pain disorder, pathological gambling, post-traumatic stress disorder, specific phobia and almost all substance use disorder or substance- related disorder. Procedural validity, that compared lay-interviewer's diagnosis and psychiatrist's diagnosis, were as follows;For all diagnoses, sensitivity, specificity and kappa were 67.6%, 98.3% and 0.69. For diagnoses of substance use disorder or substance- related disorder, sensitivity, specificity and kappa were 79%, 98% and 0.77. For other diagnoses except substance use disorder or substance- related disorder, sensitivity, specificity and kappa were 60.5%, 98% and 0.64. This results are almost at the same level as that of Robins and her colleagues who first reported reliability and validity of DIS. CONCLUSION: We think that DIS-IV, Korean version has higher reliability and validity. It is very important that diagnoses of substance use disorder and substance-related disorder can be made reliably and validly by this instrument. We expect that it can help to improve diagnosability of mental disorder, activate clinical research and increase international scientific communication.