Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI).

The structure and content of the Munich-Composite International Diagnostic Interview (M-CIDI) for the assessment of DSM-IV symptoms, syndromes, and diagnoses is described along with findings from a test-retest reliability study. A sample of 60 community respondents were interviewed twice independently by trained interviewers with an average time interval of 38 days between investigations. Test-retest reliability was good for almost all specific DSM-IV core symptom questions and disorders examined, with kappa values ranging from fair for two diagnoses--bulimia (kappa 0.55) and generalized anxiety disorder (kappa 0.45)--to excellent (kappa above 0.72) for all other anxiety disorders and alcohol use disorders. Test-retest reliability for age of onset and time-related questions was fairly consistently high (intra-class correlation values of 0.79 or above), with one notable exception: the assessment of disorders with onset before puberty. We concluded that the M-CIDI is acceptable for respondents, efficient in terms of time needed for and ease of administration, and reliable in terms of consistency of findings over time periods of at least 1 month.

Early developmental stages of psychopathology study (EDSP): objectives and design.

The primary and secondary objectives of the Early Developmental Stages of Substance Abuse Study (EDSP) are described along with a detailed description of the overall design, special design features and instruments used. The EDSP is a 5-year prospective study with three waves of assessments. Special design features are the linkages with family genetic investigations as well as neuroendocrinological stress tests in high-risk subjects. Overall, 3,021 adolescents and young adults aged 14-24 years are included. The response rate for the baseline investigation was 71%. Diagnostic assessments were made by using a modified lifetime (baseline) and 12-month change version of the WHO-CIDI, adjusted for DSM-IV. Modifications refer to a more detailed quantitative assessment of symptoms and substance use variables as well as the inclusion of questions to assess course of disorders and subthreshold diagnostic conditions.

Structure, content and reliability of the Munich-Composite International Diagnostic Interview (M-CIDI) substance use sections.

After reviewing currently available diagnostic assessment instruments for substance use disorders this paper describes the format and structure of the Munich-Composite International Diagnostic Interview (M-CIDI) substance disorder section. In addition, the test-retest reliability of diagnoses and criteria for nicotine, alcohol, illegal and prescription drugs, is reported. Findings obtained in community sample of adolescents and young adults indicate that the substance section is acceptable for almost all types of respondents, efficient in terms of time and ease of administration as well as reliable in terms of consistency of findings over time. The test-retest reliability over a period of an average of 1 month, as examined by two independent interviewers indicates good-to-excellent kappa values for all substance disorders assessed, with significant kappa values ranging between 0.55 for drug abuse and 0.83 for alcohol abuse. There was also fairly consistently high agreement for the assessment of single DSM-IV diagnostic criteria for abuse and dependence as well as the M-CIDI quantity-frequency and time-related questions. To conclude, although - unlike previous studies - this study was conducted in a community sample and not in patients and used considerably longer time intervals of more than a month between investigations, our M-CIDI reliability findings are at least as high as those from previous studies.

Prevalence of mental disorders and psychosocial impairments in adolescents and young adults.

BACKGROUND: As part of a longitudinal study, prevalence findings of DSM-IV disorders are presented for a random sample of 3021 respondents aged 14 to 24, with response rate 71%. METHOD: Assessment included various subtypes of disorders, subthreshold conditions and disorders that have only rarely been studied in other epidemiological surveys. The computer-assisted Munich-Composite International Diagnostic Interview (M-CIDI) was used to derive DSM-IV diagnoses. RESULTS: Substance disorders were the most frequent (lifetime 17.7%; 12-month 11.4%), with abuse being considerably more frequent than dependence. Other mental disorders had a lifetime prevalence of 27.5% (12-month, 17.5%) with depressive disorders (16.8%) being more frequent than anxiety disorders (14.4%). Eating disorders (3.0%) and threshold somatoform disorders (1.2%) were rare disorders. Subthreshold anxiety and somatoform disorders, however, were more frequent than threshold disorders. Prevalence of disorders was equally high for males and females, although specific disorder prevalence varied significantly by gender. The co-occurrence of disorders (co-morbidity) was substantial and was significantly related to greater reductions in work productivity and increased rates of professional helpseeking behaviour. CONCLUSIONS: Findings underline that mental disorders in young adults are frequent and impairing, limiting work and education ability and social interaction. Given the fact that adolescents and young adults are in a key phase of socialization in terms of professional career and interpersonal relationships, our findings indicate a considerable risk potential for an accumulation of complicating factors and future chronicity. This paper is the first report of this ongoing longitudinal study about early developmental conditions of mental disorders.

Differentiation of dementia and depression by memory tests. A meta-analysis.

The many tasks used for clinical memory assessment have not been compared systematically for their usefulness in differentiating dementia and depression in old age. The aim of this meta-analysis was to identify those attributes of memory tasks that show high discriminative power. Eighty-nine effect-sizes were calculated out of 16 publications directly comparing demented and depressed patients. Outliers in the effect-size distribution (5% of the highest values) were excluded. The groups could be significantly better differentiated by delayed retrieval tasks rather than immediate retrieval tasks. Tasks with distraction before retrieval reached higher effect sizes than retrieval tasks without distraction. Tasks of high-capacity demand differentiated the groups significantly better than tasks of moderate and low demand. Effect-size magnitude was not influenced by patient characteristics except severity of dementia. Thus, demented and depressed patients may best be differentiated by a memory task that uses delayed retrieval with distraction.

Verbal memory tests in the differential diagnosis of depression and dementia: discriminative power of seven test variations.

The many tasks for the assessment of verbal memory differ widely in features of presentation and retrieval. In this study, seven common memory tasks (immediate and delayed free recall, randomized presentation, selective reminding, serial recall, recognition after short and long delay) were compared for their discriminative power between depressed, demented, and healthy elderly subjects. Tasks that require little cognitive capacity were hypothesized to be particularly useful to differentiate the patient groups. Demented and depressed patients demonstrated deficits on all tests, the demented being more severe. Only recognition after long and short delay, and delayed recall distinguished demented from depressed patients. Delayed retrieval tasks were more useful to discriminate patient groups than tasks that require little cognitive capacity.