An applied study of a modified semi-structured clinical interview in the diagnosis of bipolar disorder
10.3760/cma.j.cn113661-20220816-00224
- VernacularTitle:改良半结构式临床访谈在双相障碍诊断中的应用研究
- Author:
Zhaoyu GAN
1
;
Xiaolin LIANG
1
;
Ting YANG
1
;
Xiuhua WU
1
;
Qi ZHU
1
;
Haining HE
1
Author Information
1. 中山大学附属第三医院精神科，广州510630
- Publication Type:Journal Article
- Keywords:
Bipolar disorder;
Diagnosis;
Structured clinical interview;
Semi-structured clinical interview;
32-item Hypomania Checklist
- From:
Chinese Journal of Psychiatry
2023;56(2):114-121
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study explores the diagnostic efficiency of a modified semi-structured clinical interview (MSCI) based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) for bipolar disorder (BD) by comparing MSCI with a traditionally structured interview and a self-reported diagnostic scale.Methods:MSCI, Structured Clinical Interview for DSM Axis Ⅰ Disorders-Patient Edition (SCID-Ⅰ/P), and 32-item hypomania checklist (HCL-32) were simultaneously administered in 445 outpatients with major depressive disorder ( n=100) or BD ( n=345). All patients were followed up for at least half a year and at least three times to confirm the diagnosis based on the clinical data, follow-up evaluation, and treatment efficacy. The sensitivity and specificity of the three diagnostic strategies were compared using the chi-square test. Results:The sensitivity of MSCI was significantly higher than that of SCID-Ⅰ/P (0.67 vs. 0.32, χ 2=82.10, P<0.001) but was similar to that of HCL-32 (0.67 vs. 0.70, χ 2=2.22, P=0.136). MSCI presented significantly lower specificity than SCID-Ⅰ/P (0.96 vs.1.0, χ 2=4.08, P=0.043) but significantly higher specificity than HCL-32 (0.96 vs.0.67, χ 2=27.89, P<0.001). For the diagnosis of bipolar Ⅰ disorder, no significant difference was found between the sensitivity of MSCI (1.0) and SCID-Ⅰ/P (0.73) (χ 2=3.47, P=0.062) and between the sensitivity of MSCI and HCL-32 (0.73) (χ 2=3.47, P=0.062). For bipolar Ⅱ disorder, the sensitivity of MSCI (0.90) was significantly higher than that of SCID-Ⅰ/P (0.41) (χ 2=92.49, P<0.001) and that of HCL-32 (0.66) (χ 2=22.51, P<0.001). For BD with mixed features, the sensitivity of MSCI (0.37) was significantly higher than that of SCID-Ⅰ/P (0.19) (χ 2=10.85, P<0.001) but lower than that of HCL-32 (0.80) (χ 2=49.40, P<0.001). For other specified bipolar and related disorders, the sensitivity of MSCI (0.41) did not significantly differ from that of SCID-Ⅰ/P (0.18) (χ 2=2.73, P=0.100) but was significantly lower than that of HCL-32 (0.70) (χ 2=4.53, P=0.033). Conclusion:Compared to SCID-Ⅰ/P and HCL-32, MSCI has better diagnostic efficiency for BD.
