title: The Reliability of Psychiatric Diagnosis Revisited: The Clinician's Guide to Improve the Reliability of Psychiatric Diagnosis.
abstract: BACKGROUND
  The authors reviewed the topic of reliability of psychiatric diagnosis from the turn of the 20th century to present. The objectives of this paper are to explore the reasons of unreliability of psychiatric diagnosis and propose ways to improve the reliability of psychiatric diagnosis.
  
  
  METHODS
  The authors reviewed the literature on the concept of reliability of psychiatric diagnosis with emphasis on the impact of interviewing skills, use of diagnostic criteria, and structured interviews on the reliability of psychiatric diagnosis.
  
  
  RESULTS
  Causes of diagnostic unreliability are attributed to the patient, the clinician and psychiatric nomenclature. The reliability of psychiatric diagnosis can be enhanced by using diagnostic criteria, defining psychiatric symptoms and structuring the interviews.
  
  
  CONCLUSIONS
  The authors propose the acronym 'DR.SED,' which stands for diagnostic criteria, reference definitions, structuring the interview, clinical experience, and data. The authors recommend that clinicians use the DR.SED paradigm to improve the reliability of psychiatric diagnoses.
authors.affiliation: All from Department of Behavioral Medicine and Psychiatry, Robert C. Byrd Health Sciences Center of West Virginia University, Morgantown, West Virginia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Aboraya
authors.forename: Eric
authors.initials: E
authors.lastname: Rankin
authors.forename: Cheryl
authors.initials: C
authors.lastname: France
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Missiry
authors.forename: Collin
authors.initials: C
authors.lastname: John