SPIFA-A presentation of the Structured Psychiatric Interview for General Practice.
BACKGROUND
The diagnostic ability of general practitioners (GPs) concerning mental disorders is not optimal, and could be improved by structured diagnostic interviews. Various aspects of the Structured Psychiatric Interview for General Practice (SPIFA) are examined.


OBJECTIVE
The inter-rater reliability of the SPIFA, the time used by GPs and specialists and the GPs satisfaction are examined. The properties of the SPIFA are compared with those of the Prime-MD and the MINI schedules.


METHODS
Inter-rater reliability of the SPIFA was tested in 336 patients in general practice. The patients were randomized to two interview strategies. Either both GPs and psychiatrists used the SPIFA, or GPs used the SPIFA and psychiatrists a modified version of the SCID for Axis I disorders. The satisfaction was investigated by a questionnaire sent to 1000 GPs who had SPIFA training.


RESULTS
The SPIFA showed adequate inter-rater reliability for depression, anxiety disorders and increased suicidal risk for both interview strategies. In patients with more than two co-morbid disorders, the inter-rater reliability was poor. The mean duration of SPIFA was 21 min for SPIFA screening and 22 min for SPIFA manual. The 192 GPs responding to the questionnaire were mostly satisfied with the SPIFA.


CONCLUSIONS
The SPIFA seems to be a reliable, valid and helpful instrument for GPs making diagnoses of mental disorders in their patients. Compared with the Prime MD and the MINI, the SPIFA seemed to have comparable psychometric properties but better feasibility in primary care.
Department of Clinical Cancer Research, The Norwegian Radiumhospital, Rikshospitalet University Hospital, Oslo, Norway. alvd@ulrik.uio.no
Alv A
AA
Dahl
Marit Bjartveit
MB
Krüger
Nils Håvard
NH
Dahl
Hasse
H
Karlsson
Lars
L
Von Knorring
Eystein
E
Stordal
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001291:Attitude of Health Personnel; D015897:Comorbidity; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D058006:General Practice; D006801:Humans; D033183:Interdisciplinary Communication; D007406:Interview, Psychological / Q000379:methods*; D008403:Mass Screening / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D015588:Observer Variation; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires