P-1054 - Reliability of the assessment of subjective experience and of mental status

Abstract

Background The contemporary methodology in obtaining psychopathological information relies almost exclusively on the use of structured questionnaires and interview schedules. These interviews yield high interrater reliability and reduce cost. The assessments of anomalous self-experience and of mental status (disorders of experience and expression) are often considered as “soft”, “subjective” and hence unreliable. In spite of the advantages of the structured interviews, concerns have been raised about the epistemiological coherence and the validity of the structured interviews. Aim To examine the interrater reliability between experienced clinicians with a semistructured, phenomenologically-oriented psychopathological interview assessing anomalous self-experience and mental status. Methods Seventeen inpatients were interviewed by one of the raters, with both raters were present. The interview comprised of a thorough psycho-social history and the EASE-scale. Results The interater-reliability for the total EASE-scale showed nearly perfect agreement with kappa = 0.94. The interrater agreement for the MSE assessment showed substantial to complete agreement with kappas above 0.81, except for four items: “Withdrawn/shy” (kappa = 0.77), “Suspicious, guarded and hostile” (kappa = 0.77), “Raport insecure and anxious” (kappa = 0.76), “Restless” (kappa = 0.64). Conclusion High interrater-reliability can be achieved for the asssessment of anomalous self-experience and mental status in the context of conversational, phenomenological-oriented, semi-structured interview. This is an important finding because these dimensions of descriptive psychopathology are often considered unreliable, and therefore rarely studied.