title: Modifying and validating the Composite International Diagnostic Interview (CIDI) for use in Nepal.
abstract: BACKGROUND
  Efforts to develop and validate fully-structured diagnostic interviews of mental disorders in non-Western countries have been largely unsuccessful. However, the principled methods of translation, harmonization, and calibration that have been developed by cross-national survey methodologists have never before been used to guide such development efforts. The current report presents the results of a rigorous program of research using these methods designed to modify and validate the Composite International Diagnostic Interview (CIDI) for an epidemiological survey in Nepal.
  
  
  METHODS
  A five-step process of translation, harmonization, and calibration was used to modify the instrument. A blinded clinical reappraisal design was used to validate the instrument.
  
  
  RESULTS
  Preliminary interviews with local mental health expert led to a focus on major depressive episode, mania/hypomania, panic disorder, post-traumatic stress disorder, generalized anxiety disorder, and intermittent explosive disorder. After an iterative process of multiple translations-revisions guided by the principles developed by cross-national survey methodologists, lifetime DSM-IV diagnoses based on the final Nepali CIDI had excellent concordance with diagnoses based on blinded Structured Clinical Interview for DSM-IV (SCID) clinical reappraisal interviews.
  
  
  CONCLUSIONS
  Valid assessment of mental disorders can be achieved with fully-structured diagnostic interviews even in low-income non-Western settings with rigorous implementation of replicable developmental strategies.
authors.affiliation: Population Studies Center and Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Dirgha J
authors.initials: DJ
authors.lastname: Ghimire
authors.forename: Stephanie
authors.initials: S
authors.lastname: Chardoul
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.forename: William G
authors.initials: WG
authors.lastname: Axinn
authors.forename: Bishnu P
authors.initials: BP
authors.lastname: Adhikari
mesh_terms: D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D009390:Nepal / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D014175:Translating