title: Inter-Rater Reliability of the Diagnoses of Psychosis and Depression in Individuals with Intellectual Disabilities.
abstract: BACKGROUND: There is a history of over-prescription of antipsychotics to individuals with intellectual disability (ID), while antidepressants may be under-prescribed. However, appropriate treatment is best supported when the diagnosis of psychosis or depression is valid and carries good predictive validity. The present authors report a study examining one aspect of validity, namely whether skilled clinicians can agree on whether an individual with an ID is psychotic or depressed. MATERIALS AND METHODS: Pairs of clinicians assessed 52 individuals. Agreement was assessed using Cohen's kappa statistic and agreement proportion. RESULTS: Overall agreement was high for both psychosis and depression. Whether the individual had mild ID or moderate/severe ID did not have a significant impact on agreement. CONCLUSIONS: Experienced clinicians achieved a high level of agreement as to whether a person with ID was psychotic or depressed similar to that found for those without ID. The findings provide some support for treatment interventions based on diagnosis.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney.
authors.forename: S
authors.initials: S
authors.lastname: Einfeld
authors.forename: B
authors.initials: B
authors.lastname: Tonge
authors.forename: L
authors.initials: L
authors.lastname: Chapman
authors.forename: C
authors.initials: C
authors.lastname: Mohr
authors.forename: J
authors.initials: J
authors.lastname: Taffe
authors.forename: S
authors.initials: S
authors.lastname: Horstead