title: Validity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis.
abstract: Psychological autopsies are an important research tool in establishing risk factors associated with suicide. We report the results of a validity study comparing psychological autopsy-generated DSM-III-R diagnoses in suicides and non-suicides with chart diagnoses generated by clinicians who had treated the subjects prior to death. The Structured Clinical Interview for DSM-III-R Disorders (SCID-P) and the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) were used to make independent post-mortem diagnoses. Comparison of research diagnoses with clinician ante-mortem diagnoses generated kappa coefficients of 0.85 for Axis I diagnoses and 0.65 for Axis II conditions. These kappa coefficients compare favourably with direct patient interview reliability studies. This provides evidence for the validity of the psychological autopsy as a method of determining psychiatric diagnosis.
authors.affiliation: Mental Health Clinical Research Center for the Study of Suicidal Behavior, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Kelly
authors.forename: J J
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000059:Accidents / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D003645:Death, Sudden; D005260:Female; D006708:Homicide / Q000523:psychology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D015588:Observer Variation; D010348:Patient Care Team; D010554:Personality Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013405:Suicide / Q000523:psychology*