Composite International Diagnostic Interview-Short Form Research Articles

Parental Psychopathology and Childhood Atopic Disorders in the Community

To examine the association of parental psychopathology and childhood atopic disorders in the general population. In a sample of 9,240 parent-child dyads drawn from the 1999 US National Health Interview Survey, the association of childhood atopic disorders with parental major depression, generalized anxiety disorder, and panic attacks was examined. Parental DSM-IV psychiatric diagnoses were ascertained by the Composite International Diagnostic Interview, Short-Form (CIDI-SF). Parental major depression and panic attacks were associated with childhood atopic disorders only in biological parent-child dyads (adjusted odds ratios = 1.67 for major depression and 1.46 for panic attacks), and among these more strongly in mother-child dyads. Parental atopic disorders and parental psychopathology had an additive effect on the risk of atopic disorders in the offspring. Findings from this study lend support to the "shared genetic liability" hypothesis for the association of childhood atopic disorders and parental major depression and panic attacks.

Datapoints: Use of Prescription Psychiatric Drugs and Religious Service Attendance

396 O their lifetime, persons with mental disorders seek initial treatment from clergy more frequently than from psychiatrists or general medical doctors, and a majority who seek treatment from clergy do so to the exclusion of other providers (1). However, little is known about the relationship between religion and use of the mental health care system. We examined the use of prescription mental health medications and religious service attendance. Persons who attend more frequently may be more likely to seek help from clergy than from mental health professionals. We focus on medications to reduce ambiguity about the religious affiliation of mental health providers. We used data from the 2003 National Survey on Drug Use and Health (NSDUH) (2). We measured rates of medication use among adults (unweighted N= 10,126) who had one or more symptoms of mental disorders in the past year. Symptoms of mental disorders were measured by using questions adapted from the Composite International Diagnostic Interview–Short Form (3). We estimated that 32 percent of those with a symptom of mental disUse of Prescription Psychiatric Drugs and Religious Service Attendance

Depression and anxiety associated with three pain conditions: results from a nationally representative sample

Investigations of the relationship between pain conditions and psychopathology have largely focused on depression and have been limited by the use of non-representative samples (e.g. clinical samples). The present study utilized data from the Midlife Development in the United States Survey (MIDUS) to investigate associations between three pain conditions and three common psychiatric disorders in a large sample ( N=3032) representative of adults aged 25–74 in the United States population. MIDUS participants provided reports regarding medical conditions experienced over the past year including arthritis, migraine, and back pain. Participants also completed several diagnostic-specific measures from the Composite International Diagnostic Interview-Short Form [Int. J. Methods Psychiatr. Res. 7 (1998) 171], which was based on the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders [American Psychiatric Association 1987]. The diagnoses included were depression, panic attacks, and generalized anxiety disorder. Logistic regression analyses revealed significant positive associations between each pain condition and the psychiatric disorders (Odds Ratios ranged from 1.48 to 3.86). The majority of these associations remained statistically significant after adjusting for demographic variables, the other pain conditions, and other medical conditions. Given the emphasis on depression in the pain literature, it was noteworthy that the associations between the pain conditions and the anxiety disorders were generally larger than those between the pain conditions and depression. These findings add to a growing body of evidence indicating that anxiety disorders warrant further attention in relation to pain. The clinical and research implications of these findings are discussed.

Cognitive deficits and the course of major depression in a cohort of middle-aged and older community-dwelling adults.

To examine associations between cognitive deficits and persistent significant depressive symptoms at baseline and 2- and 4-year follow-ups in a sample of community-dwelling middle-aged and older adults. Prospective cohort study. A U.S. national prospective cohort study of middle-aged and older adults, the Health and Retirement Study. A sample of 661 participants of the 1996 wave of the Health and Retirement Study who met criteria for 12-month Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised major depression (MD). MD was assessed using the World Health Organization Composite International Diagnostic Interview-Short Form. Persistent significant depressive symptoms were assessed using an eight-item version of the Center for Epidemiological Studies Depression scale. Cognitive deficits were associated with persistent significant depressive symptoms at follow-up. In a latent state-trait analysis, two stable and strongly correlated traits best explained variations in cognitive functioning and depressive symptoms across assessment points. Trait-like cognitive deficits commonly complicate the course of MD in community-dwelling middle-aged and older adults and may help to explain the persistent course of depressive symptoms in a large subgroup of adults with MD in this age range.

A longitudinal population-based study of treated and untreated major depression.

Few studies have investigated the factors associated with different outcomes in individuals with major depressive episode (MDE) in relation to mental health service utilization. This study was to, in depressed individuals who used and did not use mental health services, 1) compare the demographic, psychosocial, and clinical characteristics; 2) estimate the risk of MDE in a 6-year follow-up period; and 3) identify the factors associated with the persistence/recurrence of MDE. This was a population- based longitudinal analysis. Participants included the longitudinal cohort of the Canadian National Population Health Survey who reported MDE at the baseline survey (n = 609). MDE was measured by the Composite International Diagnostic Interview-Short Form for Major Depression. In the 6-year follow-up period, 49.8% of participants with treated depression developed subsequent MDE; 28.7% of those with untreated depression reported MDE. Multivariate analyses showed that, among those who reported the use of mental health services, childhood and adulthood traumatic events and functional impairment were related to the recurrence of MDE. Among those who did not use mental health services, reported negative life events and the severity of depressive symptoms were predictive of recurrent MDE. The risk of the recurrence of MDE and associated factors differ in mental health service users and nonusers. Future studies need to confirm these results and to identify service barriers for those who do not use the services and who are at a high risk of MDE.

Screening of psychiatric disorders via the Internet. A pilot study with tinnitus patients

Tinnitus has been associated with psychiatric disorders and more recently diagnostic tools have been used in a systematic manner. In the present study, we administered the World Health Organisation's Composite International Diagnostic Interview – Short form (CIDI-SF) in a computerized Internet-based version to a self-selected sample of tinnitus patients (n=48). Using the cut-off for ‘probable case’ (12-month prevalence), 69% of the tinnitus patients fulfilled the criteria for depression, 60% for generalized anxiety disorder, 83% for specific phobia, 67% for social phobia, 58% for agoraphobia, 21% panic attack, 83% obsessive–compulsive disorder, 2% alcohol dependence and 0% drug dependence. Decreased percentages were found for depression (4%), specific phobia (62%) and social phobia (27%) when applying a more conservative criteria (maximum case criteria). In conclusion, the findings suggest that the Internet version of CIDI-SF can be used as a screening tool for psychiatric disturbance in somatic patients, but that diagnostic criteria need to be adjusted for Internet use.

The difference between single and married mothers in the 12-month prevalence of major depressive syndrome, associated factors and mental health service utilization.

Previous studies suggest that single mothers are at a higher risk of major depression and more likely to use mental health services than are married mothers. The objectives of this analysis were to provide estimates of the prevalence of major depressive syndrome among single and married mothers, to investigate the factors which may affect the difference in the prevalence of major depressive syndrome among single and married mothers and to estimate the health care service utilization by single and married mothers. This was a cross-sectional study using the data from the 1996-97 Canadian National Population Health Survey (NPHS). Major depressive syndrome was evaluated using the Composite International Diagnostic Interview-Short Form for major depression. The prevalence of major depressive syndrome was calculated among 3030 single and 10195 married mothers. The effects of demographic, socioeconomic and biological variables on the association between single-mother status and major depressive syndrome were evaluated by stratified analyses. In the NPHS, the difference between single and married mothers in the prevalence of major depressive syndrome was found among women who were between the ages of 25 and 50. The association in this age group depended on race and on whether they had one or more jobs. Education,problem drinking, daily smoking, having one or more long-term medical illnesses, financial hardship and social support did not affect the association between single-mother status and major depressive syndrome. Single mothers were more likely to visit health professionals for mental problems than were married mothers. The difference between single and married mothers in the prevalence of major depression is age-specific. Single mothers who reported having had one or more jobs and who are non-white had an increased risk of having major depressive syndrome, compared to married mothers. Future studies need to replicate the findings of this analysis and investigate why single mothers with ethnic minority backgrounds and those who are working are at high risk of having depressive disorders.

Sociodemographic factors associated with comorbid major depressive episodes and alcohol dependence in the general population.

To estimate the 12-month prevalence of alcohol dependence (AD) among subjects with major depressive episodes (MDEs) and the 12-month prevalence of MDEs among those with AD; to investigate the associations between demographic and socioeconomic characteristics and comorbid MDE and AD, based on established theoretical models; and to compare the rates of mental health service use between groups having high and low risk for comorbid conditions. We used data from the 1996-1997 Canadian National Population Health Survey. MDE and AD were measured using the World Health Organization's Composite International Diagnostic Interview Short Form (CIDI-SF). We calculated the 12-month prevalence of MDEs among participants with AD and of AD among those with MDEs. The associations between demographic and socioeconomic characteristics and comorbidity were investigated. Of participants with MDEs, 8.6% had AD; 19.6% of participants with AD reported having at least 1 MDE in the past 12 months. Being young (aged 12 to 24 years); being divorced, separated, or widowed; and having low family income level were positively associated with MDE, AD, and comorbidity. Among participants with comorbid MDE and AD, those who were aged 12 to 24 years were less likely to have used any mental health services in the past 12 months than were others. Young age, single marital status, and low family income may be potential risk factors for comorbid MDE and AD. Although AD is rare in the general population, public health interventions that target the groups identified as at risk may help to prevent MDE, AD, and comorbidity.

Screening for serious mental illness in the general population.

Public Law 102-321 established a block grant for adults with "serious mental illness" (SMI) and required the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop a method to estimate the prevalence of SMI. Three SMI screening scales were developed for possible use in the SAMHSA National Household Survey on Drug Abuse: the Composite International Diagnostic Interview Short-Form (CIDI-SF) scale, the K10/K6 nonspecific distress scales, and the World Health Organization Disability Assessment Schedule (WHO-DAS). An enriched convenience sample of 155 respondents was administered all screening scales followed by the 12-month Structured Clinical Interview for DSM-IV and the Global Assessment of Functioning (GAF). We defined SMI as any 12-month DSM-IV disorder, other than a substance use disorder, with a GAF score of less than 60. All screening scales were significantly related to SMI. However, neither the CIDI-SF nor the WHO-DAS improved prediction significantly over the K10 or K6 scales. The area under the receiver operating characteristic curve of SMI was 0.854 for K10 and 0.865 for K6. The most efficient screening scale, K6, had a sensitivity (SE) of 0.36 (0.08) and a specificity of 0.96 (0.02) in predicting SMI. The brevity and accuracy of the K6 and K10 scales make them attractive screens for SMI. Routine inclusion of either scale in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.

A national study of the effect of chronic pain on the use of health care by depressed persons.

The objective of this study was to provide national estimates of the impact of common pain conditions such as back pain, chronic headache, self-reported arthritis, and unspecified chronic pain on the use of health services and quality of care among persons with depression. This was a cross-sectional study of data from a U.S. national household survey conducted in 1997-1998. The participants were 1,486 community-dwelling adults who met criteria for major depression or dysthymia according to the Composite International Diagnostic Interview Short-Form. Depressed persons with comorbid pain (N=938) were older, had lower incomes, and reported more severe psychiatric distress than depressed persons who did not have pain. When sociodemographic characteristics and severity of psychological distress were adjusted for, comorbid pain was associated with about 20 percent more visits to medical providers by patients who made at least one visit during a year. However, the patients with comorbid pain were about 20 percent less likely to see a mental health specialist than patients without pain. Pain was also shown to be associated with greater use of complementary or alternative medicine but not with differences in the use of antidepressants. Comorbid pain among persons with depression is associated with more intensive use of general medical services but lower rates of use of mental health services.

Independent factors associated with major depressive disorder in a national sample of individuals with diabetes.

To determine whether perceived poor physical health, duration of diabetes, and smoking are associated with major depressive disorder in a national sample of individuals with diabetes. Data on 1,810 individuals with diabetes from the 1999 National Health Interview Survey (NHIS) were analyzed. The Composite International Diagnostic Interview (CIDI) Short-Form (CIDI-SF) developed by the World Health Organization was used to identify individuals with major depressive disorder. Multiple logistic regression was used to determine whether perceived poor physical health, duration of diabetes, and smoking were associated with major depressive disorder. The model controlled for age, sex, race/ethnicity, education, income, employment, marital status, and health status. Other control variables included BMI, smoking, duration of diabetes, presence or absence of major complications, and type of treatment for diabetes. SUDAAN software was used for statistical analyses to account for the complex sampling design of NHIS. Independent factors associated with major depressive disorder were age <64 years, female sex, at least high school education, income <124% of federal poverty level, perceived worsening of health status, and smoking. In addition to other psychosocial factors such as younger age, female sex, lower income, at least high school education, and smoking, perceptions about the effect of diabetes on overall health seems to play an important role in the etiology of depression.

Major depressive episode among young adults: CIDI-SF versus SCAN consensus diagnoses.

We aimed to evaluate the diagnostic accuracy of a highly structured diagnostic interview in relation to a semi-structured diagnostic procedure. We compared the World Health Organization Composite International Diagnostic Interview Short Form (CIDI-SF) in diagnosing major depressive episode (MDE) to consensus diagnoses based on the SCAN interview (Schedules for Clinical Assessment in Neuropsychiatry). Subjects comprised a follow-up sample of 239 20-24-year-old former high-school students who were administered the SCAN and immediately thereafter the CIDI-SF. Concordance was estimated for 12-month MDE, using different cut-points of the CIDI-SF and for any affective disorders. Correspondence between instruments was moderate for MDE (kappa = 0.43, sensitivity 0.71, specificity 0.82), but better for any affective disorder (kappa = 0.60, sensitivity 0.70, specificity 0.90). Most false negatives suffered from their depression as much as those correctly identified by the CIDI-SF. False negativity was mainly due to not endorsing the stem questions of the CIDI-SF. Of the false positives almost half had an affective disorder other than MDE. The CIDI-SF seems to function best in identifying a broader category of affective disorders. It could be useful in large-scale community surveys where more extensive psychiatric interviews are not feasible.

Depression in patients with glaucoma as measured by self-report surveys

Purpose This study aimed to determine whether patients with glaucoma have more depressive symptoms than patients without glaucoma. Design Prospective case-control study. Participants The study population was recruited from two university-based glaucoma clinical practices and a university-based general ophthalmology clinic and consisted of 121 patients with open-angle glaucoma, 42 with diagnoses of suspected glaucoma, and 135 with no chronic ocular conditions except cataract. Intervention The Center for Epidemiologic Studies Depression Scale (CES-D) and Composite International Diagnostic Interview, Short Form (CIDI-SF) questionnaires were administered to all subjects. Demographic information, medical history, and responses to the questionnaires were elicited by an interviewer. Medical record review was performed to obtain clinical examination data and to substantiate the medical and demographic data obtained by the interviewer. Main outcome measures The questionnaire scores by diagnostic group, demographic characteristics, and medical history were examined. Secondary outcome measures were questionnaire scores in patients with glaucoma by visual impairment and glaucoma medication use. Results Depression scores for patients with glaucoma did not differ significantly from scores of control patients. Having past or present mental illness was the only consistent predictor for depression in both questionnaires. Among glaucoma patients, visual acuity level, visual field severity, and use of topical β-blockers were not predictors for depression. Conclusions Patients with glaucoma do not report being more depressed than patients without glaucoma as measured by the CES-D and the CIDI-SF questionnaires.

The moderating effects of coping strategies on major depression in the general population.

To evaluate the moderating effects of various coping strategies on the association between stressors and the prevalence of major depression in the general population. Subjects from the Alberta buy-in component of the 1994-1995 National Population Health Survey (NPHS) were included in the analysis (n = 1039). Each subject was asked 8 questions about coping strategies that dealt with unexpected stress from family problems and personal crises. Major depression was measured using the World Health Organization's (WHO) Composite International Diagnostic Interview-Short Form (CIDI-SF) for major depression. The impacts of coping strategies in relation to psychological stressors on the prevalence of major depression were determined by examining interactions between coping and life stress on major depression using logistic regression modelling. No robust impact of coping strategies in relation to various categories of stress evaluated in the NPHS was observed. There was evidence that the use of "pray and seek religious help" and "talks to others about the situations" as coping strategies by women moderated the risk of major depression in the presence of financial stress and relationship stress (with a partner). Using emotional expression as a coping strategy by women might decrease the risk of major depression in the presence of 1 or more recent life events, personal stress, relationship stress (with a partner), and environmental stress. Different coping strategies may have a differential impact on the prevalence of major depression in specific circumstances. These findings may be important both to prevent and to treat depressive disorders.

Prospective study of frequent heavy alcohol use and the risk of major depression in the Canadian general population.

The objective of this study was to investigate the effect of persistent alcohol consumption on the risks of major and minor depression. A retrospective cohort study design was used. The data was derived from a large scale longitudinal national health study (Canadian National Population Health Survey). Depression status was evaluated by using the Composite International Diagnostic Interview-Short Form (CIDI-SF) for major depression. Subjects who did not have major depression at baseline were classified into groups according to the persistence of alcohol consumption during the follow-up period. The incidence of major depression in each group was calculated in men and in women separately and were stratified by age. The same procedures were repeated for minor depression. Women who reported having 5+ drinks on one occasion at least once a month were at an elevated risk of major depression. The same pattern was not observed among men in this analysis. However, no difference was found between the groups in terms of the incidence of minor depression. Frequent heavy alcohol use may be a causal factor for major depression among women. Reducing the frequency and quantities of alcohol consumption may offer an opportunity for prevention of major depression among women.

Is the Internet-administered CIDI-SF Equivalent to a Clinician-administered SCID Interview?

The procedural validity of the Composite International Diagnostic Interview - short form (CIDISF) administered via an Internet web-page was examined and compared with an in-person interview (Structured Clinical Interview for DSM-IV Axis I Disorders, research version; SCID) for 7 DSM-IV mental disorders: major depression, generalized anxiety, specific phobia, social phobia, agoraphobia, panic attack and obsessive-compulsive disorder. The 53 participants completed a computerized interview (CIDI-SF) via a web page 2 days before the scheduled in-person interview (SCID). The agreement between CIDI-SF and SCID was generally low (Cohens Kappa <0.40). However, if the panic disorder module from the long version of CIDI is used instead, the Kappa is fair (K = 0.48) with an agreement of 75%. Practical applications and future directions are discussed.

Brief screening of psychiatric disorders among a national sample of HIV‐positive adults: concordance between the Composite International Diagnostic Interview (CIDI) and the CIDI Short Form (CIDI‐SF)

AbstractObjective:to evaluate the validity of the short form of the Composite International Diagnostic Interview (CIDI‐SF) in a nationally representative sample of persons in care for HIV disease in the US.Methods:in separate interviews, we administered four components of the CIDI‐SF and the full UM CIDI to 1,489 persons ages 18 to 74 receiving ongoing medical care for HIV, and examined the concordance between the two.Results:the CIDI‐SF had lower concordance rates than expected. Results suggest that estimates of mental health disorder based on the CIDI‐SF may be confounded by HIV symptomology.Conclusions:in this population, the CIDI‐SF provided useful information about general mental health but was less accurate for providing disorder‐specific diagnoses than anticipated. The confounding of HIV symptomology and CIDI‐SF disorder raises questions about the accuracy of the CIDI‐SF for studies conducted in HIV and other clinical and specialized subpopulations. Copyright © 2001 Whurr Publishers Ltd.

"Diet pills" and major depression in the Canadian population.

To evaluate epidemiological associations between self-reported diet pill consumption and major depressive episodes (MDEs), using data from a large-scale, cross-sectional survey of the Canadian population. Data from the National Population Health Survey (NPHS) were used in this analysis. The NPHS interview included a brief version of the Composite International Diagnostic Interview (CIDI) depression section, known as the CIDI Short Form for Major Depression (CIDI-SFMD), as well as provision for self-reported medication use. Approximately 0.5% of the population reported the use of diet pills. Diet pill use was more common among women than among men. At the time of data collection (1996-1997), the most commonly used medication was fenfluramine (since withdrawn from the market because of cardiovascular toxicity). The use of these medications was strongly associated with MDE: the annual prevalence among persons reporting use was 17.1% (95% CI, 8.6 to 25.6), approximately 4 times the underlying population rate. Because the NPHS was a general health survey, and because self-reported exposure to these medications was relatively uncommon, the data did not permit a detailed multivariate analysis. These findings, however, indicate that depressive psychopathology is strongly associated with the use of appetite-suppressant medications.

Mode Effects in Self-Reported Mental Health Data

This article analyzes the impact of audio computer-assisted self-interviewing (ACASI) administration on the reporting of mental health syndromes in a general population survey. Estimates of four mental health syndromes (major depressive episode, generalized anxiety disorder, panic attack, and agoraphobia) obtained from an interviewer-administered, paper-and-pencil (I-PAPI) mental health module were compared with those obtained from an ACASI version of the same module implemented in a separate field test. The mental health questions consisted of four scales from the World Health Organization's Composite International Diagnostic Interview Short-Form. Comparisons of ACASI and I-PAPI estimates for each mental health syndrome were made overall and within age, race/ethnicity, gender, educational level, geographic region, and population density subgroups. To assess the likelihood of reporting a mental health syndrome using ACASI versus I-PAPI, logistic regression models were utilized controlling for possible confounding and interaction variables. The results suggest that adult respondents reported more mental health symptoms when interviewed with ACASI than when interviewed with I-PAPI, and the results support the use of ACASI in general population surveys of mental health.

Major depression prevalence in Calgary.

To estimate the 12-month period prevalence of major depression in Calgary. Subjects (n = 2542) were selected using random digit dialing (RDD) and interviewed by telephone using the Composite International Diagnostic Interview-Short Form for Major Depression (CIDI-SFMD). A subset of this sample was recontacted and administered the full mood disorders section of the CIDI. The weighted proportion of the sample scoring in the positive range on the major depression predictor was 14.7%. Validation data determined that approximately three-quarters of these subjects would be expected to have major depression according to the CIDI. Hence, the estimated 12-month period prevalence of major depression was approximately 11.0%. This prevalence estimate is higher than most, but not all, previous Canadian estimates and resembles that of the American National Comorbidity Survey (NCS). Calgary may have a high prevalence of major depression; however, because methodologically comparable studies are not available, to conclude this would be premature. Selection bias due to the RDD sampling (and the associated relatively high rate of nonresponse) may have led to an inflated prevalence estimate. Alternatively, because it allows increased anonymity and emotional "distance" from the nonprofessional interviewers, telephone-based data collection may be more sensitive to psychopathology than face-to-face interviewing.