Description

The Structured Clinical Interview for DSM-III-R (SCID) is a standardized diagnostic interview developed by Spitzer, Williams, Gibbon, and First (1986) based on the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition – Revised (DSM-III-R).

The instrument was designed to provide a systematic and reliable approach for the assessment and diagnosis of psychiatric disorders by applying standardized clinical criteria. It allows clinicians and researchers to evaluate the presence of specific psychiatric conditions through a structured interview process.

The Greek adaptation of the Σύνθετης Κλινικής Εξέτασης Ψυχικής Υγείας (ΣΚΕΨΗ) was based on the revised versions of 1986 and 1988, with the final form corresponding to the 1990 edition.

Objective

The primary objective of the SCID is to support the accurate identification and diagnosis of psychiatric disorders according to internationally established diagnostic criteria.

The instrument aims to:

Assess the presence of psychiatric disorders based on DSM criteria.

Provide a standardized diagnostic procedure for clinical and research settings.

Improve diagnostic reliability between different evaluators.

Evaluate psychopathological conditions and overall psychological functioning.

The SCID includes assessment of:

  • Axis I disorders, including major psychiatric conditions.
  • Axis II disorders, focusing on personality disorders through the SCID-II.
  • Axis V functioning, providing an overall evaluation of psychosocial functioning.

Structure and Content

The SCID is organized as a structured clinical interview covering diagnostic categories defined by DSM-III-R.

The instrument includes:

SCID-I, which evaluates major clinical disorders of Axis I.

SCID-II, which assesses personality disorders.

Global Functioning Assessment, which evaluates overall functional impairment.

The interview format combines standardized questions with clinical judgment, allowing the examiner to determine whether diagnostic criteria are fulfilled.

Scoring Method

The diagnosis and classification of psychiatric disorders are based on whether the individual meets predefined DSM-III-R criteria.

Each symptom is evaluated according to its presence and clinical significance:

1 = Symptom absent

2 = Symptom partially present or uncertain

3 = Symptom present according to diagnostic criteria

The final diagnostic decision is based on the overall pattern of symptoms and the fulfilment of DSM-III-R criteria.

Data Analysis and Use

The SCID provides structured diagnostic information that can be used in clinical assessment and psychiatric research.

The results may be used for:

Diagnostic classification of psychiatric disorders.

Assessment of symptom profiles.

Research studies investigating prevalence, comorbidity, and treatment outcomes.

Evaluation of changes in psychopathology following therapeutic interventions.

The structured nature of the interview allows comparisons between different populations and research settings.

Validity and Reliability

The SCID demonstrates high levels of diagnostic agreement between evaluators.

Reported inter-rater agreement includes:

  • 91% agreement for schizophrenia diagnosis
    (κ = 0.88, p < 0.001)
  • 90% agreement for mood disorders
    (κ = 0.88, p < 0.001)
  • 67% agreement for somatoform disorders
    (κ = 0.58, p < 0.001)

Overall diagnostic agreement reached:

84% agreement (κ = 0.73, p < 0.001).

Test–retest evaluation among 58 psychiatric patients demonstrated substantial diagnostic stability, with agreement rates ranging from:

89% for substance-related disorders

to

75% for other psychiatric disorders.

The identification of healthy individuals among a community sample of 360 participants showed an agreement rate of:

86.9%.

These findings support the reliability and clinical usefulness of the SCID as a structured diagnostic instrument.

Applications

The SCID can be applied in:

Clinical psychiatric assessment.

Mental health research.

Epidemiological studies.

Clinical trials evaluating psychiatric treatments.

Assessment of comorbidity and diagnostic profiles.

Training and standardization of psychiatric diagnosis.

References

Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1992). The Structured Clinical Interview for DSM-III-R (SCID): I: History, rationale, and description. Archives of General Psychiatry, 49(8), 624–629.

Yilmaz, N., Kugu, N., Kavakci, O., & Dogan, O. (2018). Psychopathology and sociodemographic characteristics in suicide attempters: A single center study. Cumhuriyet Medical Journal, 40(3), 215–225.