Clinical utility and patient acceptance of the computerized Composite International Diagnostic Interview.

Abstract

The study evaluated the utility to clinicians and the acceptability to patients of the self-administered computerized version of the Composite International Diagnostic Interview (CIDI-Auto) in an acute psychiatric setting. Patients admitted to an acute psychiatric unit completed the CIDI-Auto. Reports of CIDI-Auto diagnoses and symptoms were given to treating psychiatrists, who completed a questionnaire evaluating the accuracy and usefulness of the reports. Patients answered a questionnaire about their attitudes toward computers before completing the CIDI-Auto, and after completing it, they answered a questionnaire about their reactions to the interview. Psychiatrists agreed with only 50 percent of CIDI-Auto current diagnoses and indicated that only 22 percent of CIDI-Auto reports provided useful new diagnoses, although 63 percent helped to clarify diagnoses and 58 percent could save clinicians some time. They endorsed the CIDI-Auto as a possible aid to indirect or remote diagnosis where histories would be taken by nonexpert staff. Ninety-four percent of patients liked the computerized interview, and 83 percent understood the questions without difficulty. Sixty percent felt more comfortable with the computerized interview than with a doctor. Education and previous computer experience promoted positive attitudes and satisfaction with the computerized interview. Psychiatrists considered the current CIDI-Auto completed by patients to be of limited value in diagnosis and history taking. Despite patients' acceptance and positive reactions to the computer interview, satisfactory computerized diagnosis is yet to be attained.