Diagnostic concordance of ICD-10 personality and comorbid disorders: a comparison of standard clinical assessment and structured interviews in a clinical setting.
OBJECTIVE
The diagnosis of personality disorders is one of the most problematic areas in psychiatric diagnosis. Diagnoses are usually made by standard clinical interview, but they have poor reliability. The aim of this study was to compare the concordance in diagnosis between structured assessment tools and assessment as usual in a clinical setting.


METHODS
Diagnosis of 33 patients on the International Personality Disorder Examination (IPDE) and the Mini International Neuropsychiatric Interview (MINI) was compared to diagnosis made by standard assessment through clinical interview.


RESULTS
There was poor concordance between structured measures and standard assessment by clinical interview, and poor levels of diagnostic sensitivity and specificity on standard assessment.


CONCLUSIONS
Structured measures were more comprehensive, sensitive and specific in diagnosis than standard clinical assessment. Increased diagnostic accuracy is needed for effective understanding and treatment planning for personality disorders.
Egan
Sarah
S
School of Psychology, Curtin University of Technology, Perth, Australia. s.egan@curtin.edu.au
Nathan
Paula
P
Lumley
Margaret
M
D000328:Adult; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007406:Interview, Psychological / Q000592:standards*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D010552:Personality Assessment / Q000592:standards*; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology; D010556:Personality Tests / Q000592:standards*; D012680:Sensitivity and Specificity