Structured clinical interview for DSM-IV

The Structured Clinical Interview for DSM-IV (SCID) is a common method for the diagnosis of mental disorders after the classification system of psychiatric DSM-IV (Diagnostic Manual Diagnostic and Statistical Manual of Mental Disorders) .

Multiaxial diagnosis system of the DSM-IV

The DSM, published by the American Psychiatric Society , represents - in addition to the ICD - an international classification system for mental illnesses used in research and clinical diagnostics . The DSM-IV version was in force from 1994 to 2013.

The DSM-IV is a multiaxial system that systematically records and describes psychiatric diagnoses in five so-called axes. The axes relate to the following diagnostic assessment criteria:

Axis I: Clinical disorders and other clinically relevant problems. Mainly condition disorders , severe mental disorders and learning disabilities (examples: schizophrenia , anxiety disorders, impulse control disorders, eating disorders ).
Axis II: personality disorders (examples: borderline personality disorder , schizoid or paranoid personality disorders , antisocial personality disorder ) and intellectual disabilities .
Axis III: Medical Disease Factors. This axis included physical problems that can be significant for the mental disorder .
Axis IV: Psychosocial and environmental problems (examples: housing problems, professional problems, problems in the social environment)
Axis V: Global assessment of the functional level using the GAF scale .

Structured clinical interview for DSM-IV (SKID)

The SKID for the diagnosis of mental disorders according to DSM-IV is available in two separate versions:

SKID-I: for mental disorders ( axis I disorders of the DSM-IV)
SKID-II: for personality disorders ( axis II disorders of the DSM-IV)

Procedure of the SKID-I

From a technical point of view, the SKID-I is a guided interview: the interviewer asks certain questions and codes the answers in order to be able to make a differential diagnosis at the end. However, if necessary, standardized survey instruments (e.g. questionnaires such as the Beck Depression Inventory , BDI) can be added.

The SKID-I is used to record and diagnose selected psychological syndromes and disorders of outpatient or inpatient patients, as defined in the DSM-IV on axis I (“ clinical syndrome ”).

The SKID-I begins with a poorly structured anamnesis section, in which, using a short exploration guide, biosocial data and general information about the patient and his or her current and previous complaints and symptoms ( axis III and axis IV ) are collected, as well as observations on axis V ( psychosocial functional level).

In the subsequent, structured interview, the following symptoms or disorders of axis I of the DSM-IV (" axis I disorders ") are recorded according to clearly formulated diagnostic criteria in 10 sections (section A - section J) :

A - Affective symptoms (e.g. major depression , mania , dysthymia )
B - Psychotic Symptoms
C - differential diagnosis of psychotic disorders (e.g., schizophrenia , schizoaffective disorder , delusion )
D - differential diagnosis of mood disorders
E - abuse and dependence on psychotropic substances
F - Anxiety Disorders (e.g., Panic Disorder , Agoraphobia , Social Phobia , Generalized Anxiety Disorder , Obsessive Compulsive Disorder )
G - Somatoform disorders (e.g. somatization disorder , hypochondria , pain disorder , body awareness disorder )

H - eating disorders (e.g. anorexia nervosa , bulimia nervosa )

I - adjustment disorders (e.g. depressive mood , anxious inhibition , behavior disorder )

J - Optional disorders (e.g., stress disorders , manic episode )

The answers to the questions are coded by the interviewer, depending on the extent to which a diagnostic criterion is met or not:

? = unsure / too little information
1 = no / not available
2 = available, but not in accordance with the criteria
3 = certainly available and in accordance with the criteria

Coding options are also offered for assessing axis III (physical disorders) and axis V (psychosocial functional level). All diagnoses are recorded in longitudinal and cross-section as well as with additional information about the beginning and course.

The SKID-I takes around 100 minutes to complete for inpatient psychiatric patients.

Procedure of the SKID-II

The SKID-II can be used to diagnose the ten personality disorders on axis II and the two personality disorders listed in the appendix to DSM-IV (" axis II disorders "). This is a two-stage process, consisting of a questionnaire for self-assessment and a subsequent interview. The questionnaire is used to screen for the characteristics of the eleven recorded personality disorders. In the following interview, only those questions need to be asked for which a “yes” answer was ticked in the questionnaire. This procedure reduces the implementation time.

The implementation time of the SKID-II is estimated at around 30 minutes.

literature

Hans-Ulrich Wittchen, Michael Zaudig , Thomas Fydrich: Structured clinical interview for DSM-IV. Hogrefe, Göttingen 1997.
Stephan Doering , Susanne Hörz: Handbook of structural diagnostics: concepts, instruments, practice. Schattauer Verlag (April 3, 2012), ISBN 3-794-52793-3 .
John F. Clarkin, Eve Caligor, Barry Stern, Otto F. Kernberg: Structured Interview for Personality Organization (STIPO). Personality Disorders Institute, Weill Medical College of Cornell University, New York, 2004. (German translation: Structured interview on personality organization - German version - STIPO-D. Archive )

Individual evidence

↑ Henning Saß , Isabel Houben: DSM-IV. Hogrefe Verlag, Göttingen 1996, ISBN 978-3-8017-0810-8 .
↑ ^a ^b ^c ^d Hans-Ulrich Wittchen, Michael Zaudig , Thomas Fydrich: Structured clinical interview for DSM-IV. Hogrefe, Göttingen 1997.
^ Stephan Doering , Susanne Hörz: Manual of structural diagnostics: concepts, instruments, practice. Schattauer Verlag (April 3, 2012), ISBN 3-794-52793-3 .
↑ Questionnaire to record DSM-IV personality disorders (ADP-IV) for the standardized interview system SKID-II. (Archive) - Diagnosis of Personality Disorder. Homepage of the University of Vienna. (Archive)
↑ John F. Clarkin, Eve Caligor, Barry Stern, Otto F. Kernberg: Structured Interview for Personality Organization (STIPO). Personality Disorders Institute, Weill Medical College of Cornell University, New York, 2004. (German translation: Structured interview on personality organization - German version - STIPO-D. Archive )

[1] Henning Saß , Isabel Houben: DSM-IV. Hogrefe Verlag, Göttingen 1996, ISBN 978-3-8017-0810-8 .

[:0-2] Hans-Ulrich Wittchen, Michael Zaudig , Thomas Fydrich: Structured clinical interview for DSM-IV. Hogrefe, Göttingen 1997.

[3] Stephan Doering , Susanne Hörz: Manual of structural diagnostics: concepts, instruments, practice. Schattauer Verlag (April 3, 2012), ISBN 3-794-52793-3 .

[4] Questionnaire to record DSM-IV personality disorders (ADP-IV) for the standardized interview system SKID-II. (Archive) - Diagnosis of Personality Disorder. Homepage of the University of Vienna. (Archive)

[5] John F. Clarkin, Eve Caligor, Barry Stern, Otto F. Kernberg: Structured Interview for Personality Organization (STIPO). Personality Disorders Institute, Weill Medical College of Cornell University, New York, 2004. (German translation: Structured interview on personality organization - German version - STIPO-D. Archive )