An Evaluation of a Computer-Based Psychiatric Assessment: Evidence for Expanded Use

Abstract

The purpose of this study was to examine the psychiatric diagnoses of depression made using the structured interview, the Computer-Based Diagnostic Inventory Schedule for Children - Revised (CDISC-R) and diagnoses of depression made by pediatric psychiatrists. One hundred and twenty-two adolescents who were admitted to an inpatient psychiatric treatment unit agreed to participate in the study. All participants completed the CDISC-R structured diagnostic interview and independent measures reflecting depressive symptoms. The admitting pediatric psychiatrists' diagnoses were also recorded. Even though there were more females in the sample, males (n = 38) and females (n = 84) had similar results. The computer-based CDISC-R and physician diagnoses agreed in 76% of the cases. These results were confirmed by the independent measures of depressive symptoms, which were higher for those with diagnoses of depression and lower for those without depression. In the 24% of the cases, where the CDISC-R and physician diagnoses disagreed, the computer-based CDISC-R was more accurate in assigning a diagnosis of depression in terms of the independent measures of depressive symptoms. The CDISC-R, a computer-based diagnostic interview, efficiently and precisely diagnoses depression. This finding indicates that the use of computer-based diagnostic interviews in applied research will provide more objective and precise results, especially in clinical trials. It follows from these findings that computer-based diagnostic interviews could have important clinical applications and play a central role in web-based mental health and Telemedicine by facilitating triage, referral, and monitoring treatment outcomes through remote electronic assessment.