Aim: The Structured Clinical Interview for the DSM is one of the most used diagnostic instruments in clinical research worldwide. The current Clinician Version of the instrument (SCID-5-CV) has not yet been assessed in respect to its psychometric qualities. We aimed to assess the clinical validity and different reliability indicators (interrater test-retest, joint interview, face-to-face vs telephone application) of the SCID-5-CV in a large sample of 180 non-prototypical and psychiatric patients based on interviews conducted by raters with different levels of clinical experience.Methods: The SCID-5-CV was administered face-to-face and by telephone by 12 psychiatrists/psychologists who took turns as raters and observers. Clinical diagnoses were established according to DSM-5 criteria and the longitudinal, expert, all data (LEAD) procedure. We calculated the percentage of agreement, diagnostic sensitivity and specificity, and the level of agreement (kappa) for diagnostic categories and specific diagnoses.Results: The percentage of positive agreement between the interview and clinical diagnoses ranged between 73% and 97% and the diagnostic sensitivity/specificity were >0.70. In the joint interview, the levels of positive agreement were high (>75%) and kappa levels were >0.70 for most diagnoses. The values were less expressive, but still adequate, for interrater test-retest interviews. Conclusion:The SCID-5-CV presented excellent reliability and high specificity as assessed with different methods. The clinical validity of the instrument was also confirmed, which supports its use in daily clinical practice. We highlight the adequacy of the instrument to be used via telephone and the need for careful use by professionals with little experience in psychiatric clinical practice.
This systematic review and meta-analysis examines whether physician depressive symptoms are associated with the risk for perceived or observed medical errors.
Background: With the release of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), the Posttraumatic Stress Disorder Checklist (PCL) has been updated to meet the revisions of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD). However, the diagnostic utility and reliability of a Brazilian version of the new Posttraumatic Stress Disorder Checklist (PCL-5) have not been investigated yet. Objective: To investigate the internal consistency, test-retest reliability, and diagnostic utility of the complete version (21-item) and two abbreviated (8-item and 4-item) versions of the Brazilian PCL-5. Methods: A total of 85 individuals with a history of exposure to at least one traumatic event underwent a diagnostic interview using the Structured Clinical Interview for DSM-5 (SCID-5-CV) and completed the Brazilian version of the PCL-5. Moreover, participants were invited to complete the checklist for a second time 10-30 days after the first assessment. Results: Both the complete and abbreviated versions of the Brazilian PCL-5 showed good internal consistency (complete PCL-5, α = .96; 8-item, α = .93; 4-item, α = .85) and test-retest reliability (complete PCL-5, ICC .87 [95% CI, 0.65-0.95]; 8-item, ICC .84 [95% CI, 0.60-0.94]; 4-item, ICC .84 [95% CI, 0.58-0.94]). Diagnostic utility analyses using the Structured Clinical Interview for DSM-5 (SCID-5-CV) revealed that a cutoff point of 36 presented the higher overall efficiency for predicting a PTSD diagnosis Overall Efficiency (OE, .80) and corresponded to Youden's index J (.65). For the 8-item version, a cutoff point of 13 corresponded to Youden's index J (.61), while scores of 21 or more were associated with the highest OE (.78). For the 4-item PCL-5, scores > 7 presented the highest OE (.77) and corresponded to Youden's index J (.59). Conclusions: Overall, the findings provide relevant evidence regarding the high reliability and diagnostic utility of this Brazilian version of the PCL-5. Propiedades psicométricas y utilidad diagnóstica de una versión brasileña del PCL-5 (versiones completa y abreviadas) Antecedentes: con la publicación de la quinta edición del Manual de Diagnóstico y Estadístico para los Trastornos Mentales (DSM-5), el Cuestionario para el Trastorno de Estrés Postraumático (PCL) se ha actualizado para cumplir con las revisiones de los criterios de diagnósticos del trastorno de estrés postraumático (TEPT). Sin embargo, la utilidad diagnóstica y la confiabilidad de una versión brasileña del nuevo cuestionario de trastorno de estrés postraumático (PCL-5) aún no se ha investigado. Objetivo: investigar la consistencia interna, la confiabilidad test-retest y la utilidad diagnóstica de la versión completa (21 ítems) y dos versiones abreviadas (8 y 4 ítems) del PCL-5 brasileño. Métodos: Un total de 85 individuos con antecedentes de exposición, al menos, a un evento traumático se sometieron a una entrevista diagnóstica utilizando la entrevista clínica estructurada para el DSM-5 (SCID-5-CV) y completaron la versión br...
RESUMOObjetivo: Realizar uma revisão sistemática sobre as características psicométricas de instrumentos breves para rastreamento de múltiplos transtornos mentais em cuidados primários de saúde. Métodos: Revisão sistemática da literatura nas bases de dados PubMed, Lilacs, SciELO e ISI, de artigos publicados até abril de 2014, utilizando descritores sobre rastreamento breve de múltiplos transtornos mentais em cuidados primários de saúde. Resultados: Foram obtidos 277 estudos e selecionados 15 após a aplicação dos critérios de inclusão e exclusão. Oito estudos analisaram confiabilidade e/ou consistência interna e os resultados mostraram índices bastante satisfatórios. Nos artigos selecionados, estavam presentes as análises das validades preditiva, concorrente e discriminante. Conclusão: As escalas de rastreamento são úteis para a triagem de pacientes com possíveis transtornos mentais, e o uso desses instrumentos melhoraria a capacidade de detecção desses transtornos em cuidados primários de saúde. ABSTRACTObjective: Conduct a systematic literature review about psychometric characteristics of brief tools used for screening multiple mental disorders in primary health care. Methods: Systematic literature review on PubMed, Lilacs, SciELO and ISI databases until April 2014 using key words related to brief screening of multiple mental disorders in primary health care. Results: Were obtained 277 articles; 15 articles were selected after considering inclusion and exclusion criteria. Eight articles assessed reliability and/or internal consistency and results showed satisfactory indices. In the selected articles, were present analyzes of predictive validity, concurrent and discriminant. Results ranged from moderate to good. Conclusion: Screening scales are useful to identify patients with possible mental disorders and they increase chances of detecting such disorders in primary health care.
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