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Diagnostic Concordance Of ICD-10 Personality And Comorbid Disorders: A Comparison Of Standard Clinical Assessment And Structured Interviews In A Clinical Setting

Sarah Egan, Paula Nathan, Margaret Lumley

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Objective: The diagnosis of personality disorders is one of the most problematic areas in psychiatric diagnosis. Diagnoses are usually made by standard clinical interview, but they have poor reliability. The aim of this study was to compare the concordance in diagnosis between structured assessment tools and assessment as usual in a clinical setting. Method: Diagnosis of 33 patients on the International Personality Disorder Examination (IPDE) and the Mini International Neuropsychiatric Interview (MINI) was compared to diagnosis made by standard assessment through clinical interview. Results: There was poor concordance between structured measures and standard assessment by clinical interview, and poor levels of diagnostic sensitivity and specificity on standard assessment. Conclusion: Structured measures were more comprehensive, sensitive and specific in diagnosis than standard clinical assessment. Increased diagnostic accuracy is needed for effective understanding and treatment planning for personality disorders.