The Collaborative Longitudinal Personality Disorders Study: Reliability of Axis I and II Diagnoses

TLDR

The study assessed the interrater and test‑retest reliability of DSM‑IV Axis I and II disorders using the SCID‑I and DIPD‑IV interviews. Reliability analyses revealed fair‑to‑good interrater κ (.40–.75) for most Axis II disorders (antisocial at 1.0) and similar test‑retest κ, while dimensional ratings were generally excellent (>0.75); Axis I interrater κ were excellent for six of ten disorders, with test‑retest κ slightly lower, yet overall the study confirms that DSM‑IV Axis I and II disorders can be reliably diagnosed using SCID‑I and DIPD‑IV.

Abstract

Both the interrater and test-retest reliability of axis I and axis II disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). Fair-good median interrater κ (.40-.75) were found for all axis II disorders diagnosed five times or more, except antisocial personality disorder (1.0). All of the test-retest κ for axis II disorders, except for narcissistic personality disorder (1.0) and paranoid personality disorder (.39), were also found to be fair-good. Interrater and test-retest dimensional reliability figures for axis II were generally higher than those for their categorical counterparts; most were in the excellent range (>.75). In terms of axis I, excellent median interrater κ were found for six of the 10 disorders diagnosed five times or more, whereas fair-good median interrater κ were found for the other four axis I disorders. In general, test-retest reliability figures for axis I disorders were somewhat lower than the interrater reliability figures. Three test-retest K were in the excellent range, six were in the fair-good range, and one (for dysthymia) was in the poor range (.35). Taken together, the results of this study suggest that both axis I and axis II disorders can be diagnosed reliably when using appropriate semistructured interviews.