Influence of psychoactive substance use on the reliability of psychiatric diagnosis.
The interrater reliability of diagnoses made on the basis of a structured interview for psychiatric patients with and without psychoactive substance use disorders (PSUDs) was examined. Forty-seven pairs of ratings by 9 different clinical interviewers were used. Results supported 3 major findings: (a) The interrater reliability for non-PSUD psychiatric diagnoses is quite high when a subject has no diagnosable PSUD; it is lower, though still substantial, when a PSUD is present. (b) Interviewers are not aware of this and are just as certain of the accuracy of their diagnoses when a PSUD is present as when one is not. (c) Interrater reliability is moderate to substantial as to the judgment of whether, when a non-PSUD diagnosis is present, it is caused by the use of psychoactive substances. The implications of these findings for the appropriate selection of treatments for dually diagnosed patients are discussed.
Corty
E
E
Department of Psychology, Bradley University.
Lehman
A F
AF
Myers
C P
CP
D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D011619:Psychotropic Drugs; D015203:Reproducibility of Results; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology
D011619:Psychotropic Drugs