IPDE - Extranet Systems - World Health Organization

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Manual History of the IPDE One of the aims of the World Health Organization (WHO) and US National Institutes of Health (NIH) joint program on psychiatric diagn* sis and classification is the development and standardization of diagnostic assessment instruments for use in clinical research around the world.' The IPDE is a semistructured clinical interview developed within that program, and designed to assess the personality disorders in the ICD-10 and DSM-IV classification systems. The IPDE is an outgrowth and modification for international use of the Personality Disorder Examination (PDE).2 To facilitate the development of the IPDE, beginning in 1985 several workshops were convened. At these meetings representatives of the international psychiatric community discussed the format of the interview, the wording of items, and the development of a scoring manual. Translations were undeaaken and frequent revisions made to reflect the experience of interviewers with trial versions. Finally, a field trial was undertaken in 1988 and 1989 at 14 participating centres in 11 countries in North America, Europe, Africa, and Asia.'A In August 1991 the principal investigators in the field trial met at WHO headquarters in Geneva to discuss the results and the experience of the interviewers with the IPDE. This resulted in some minor revisions of existing items. Subsequently additional modifications were made to accommodate the transition from DSM-III-R to DSM-IV. To offset concerns about the length of the interview, and to make it more acceptable to a wider range of clinicians and investigators, it was decided to issue the IPDE in modules. The complete interview would assess all of the disorders in both ICD-10 and DSM-IV. Separate modules would also be available for those who wished to limit the examination to one of the two classification systems.
115 ICD-10 and DSM-IV ICD-10 and DSM-IV DSM-Ns was designed for use in the US and is primarily the product of American psychiatric opinion. ICD-1O6 is intended for use throughout the world and reflects the views and needs of the international psychiatric community. The two are different but overlapping classification systems. There are slight differences in nomenclature: anankasticlobsessive-compulsive, anxioudavoidant, and dissocial/antisocial. In ICD-10, borderline and impulsive are viewed as subtypes of emotionally unstable, schizotypal is located with schizophrenia and delusional disorders, and narcissistic is not included. There are also some differences in the criteria required for various diagnoses. The IPDE field trial demonstrated that there was sufficient disagreement regarding the cases identified as personality disorders in DSM-UI-R and ICD-10 to require the administration of the entire IPDE if one wished to make diagnoses in both systems. Translations of the IPDE Investigators at the various centres involved in the field trial have translated the instrument into the following languages: Dutch, French, German, Hindi, Japanese, Kannada, Norwegian, Swahili, and Tamil. Translations have also been made into other languages, including Danish, Estonian. Greek, Italian, Russian, and Spanish. Additional translations are contemplated. The translations were backtranslated into English by a psychiatrist or psychologist who had not seen the original English version. Variations and problems in the back-translation were then reviewed with those who undertook the original translation, and corrections were made when indicated. Particular pmblems can arise when a semistructured interview like the IPDE is used with subjects who are illiterate and speak a regional or tribal dialect. Since written and spoken language are quite different in such populations, the interviewer must frequently depart fmm the literal text and improvise an equivalent question on the spot, in order to maintain communication with the subject. Although this is a potential source of error variance, the examiner's familiarity with the scope and meaning of the diagnostic criteria and with the intent of the original IPDE question, should keep such error within tolerable limits.
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Until recently, the standardization
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Assessment and diagnosis of persona
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Contents Contributors Preface Annan
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Contributors Dr Antonio Andreoli Ho
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Preface One of the major goals of t
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... Xlll Acknowledgements The IPDE
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Problems in the field of personalit
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5 Problems in the field of PD perso
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7 Problems in the field of PD In DS
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9 Problems in the field of PD cultu
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11 Review of diagnostic instruments
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19 Epidemiology of DSM-Ill PDs in c
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Table l. Prevalence rates of specif
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24 1. H. Reich and G. de Girolamo (
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26 .- 5 2 0 W C .- 0 P g F ? g e Q
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28 J. H. Reich and G. de Girolarno
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Table 3. Prevalence rates ofpersona
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Pfohl etal.. l986 (67) Pilgrim & Ma
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35 Epidemiology of DSM-Ill PDs were
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37 Epidemiology of DSM-Ill PDs migh
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39 Epidemiology of DSM-Ill PDs 23 R
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4 1 Epidemiology of DSM-Ill PDs 55
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43 International personality disord
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I 45 IPDE iner what he is actually
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47 IPDE Sample of IPDE item The que
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49 IPDE dimensional scores are not
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1 9 IPDE considerable training and
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53 Experiences with IPDE The invest
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55 Experiences with IPDE passive ag
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57 Field Trial
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59 Sampling, inte~iewers, interview
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Description of centres participatin
Page 74 and 75: 63 Centres participating in IPDE fi
Page 82 and 83: P- P Table 1. Sample sizes and IPDE
Page 84 and 85: 73 Results Table 3. ICD-I0 Disorder
Page 86 and 87: 75 Results Table 5. Frequency of CO
Page 88 and 89: 77 Results Table 8. Interrater reli
Page 90 and 91: Discussion and conclusions Armand W
Page 92 and 93: 8 1 Discussion and Conclusions stab
Page 94 and 95: 83 Discussion and Conclusions Repet
Page 96 and 97: Discussion and Conclusions of princ
Page 98 and 99: 87 Discussion and Conclusions Frequ
Page 100 and 101: 89 Discussion and Conclusions emoti
Page 102 and 103: 9 1 Discussion and Conclusions inte
Page 104 and 105: 93 Appendix Table A2 Persomlity dis
Page 106 and 107: 95 Appendix Table A4 Personality di
Page 108 and 109: 97 Appendix Table A6 Personaliry di
Page 110 and 111: 99 Appendix Table SA Personaliry di
Page 112 and 113: Table A10 Personality disorder diag
Page 114 and 115: 103 Appendix Table A12 Personality
Page 116 and 117: Table A13 (con?) Criterion B7 B8 1
Page 118 and 119: 107 Appendix Table A13 (cont) Frequ
Page 120 and 121: 109 Appendix Table A14 (cont.) Freq
Page 122 and 123: Acknowledgements 113 Manual History
Page 126 and 127: 116 Manual Struchlre of the IPDE Th
Page 128 and 129: 118 Manual that is likely to enhanc
Page 130 and 131: 120 Manual data. If examiners have
Page 132 and 133: 122 Manual Scoring conventions Much
Page 134 and 135: 124 Manual Recording the scores Req
Page 136 and 137: 126 Manual Q. What do you do when s
Page 138 and 139: 128 Manual section, if there are qu
Page 140 and 141: ICD-10 criteria and corresponding I
Page 142 and 143: 132 ICD-10 criteria and correspondi
Page 144 and 145: 134 IPDE ICD-10 module screening qu
Page 146 and 147: 136 Screening questionnaire 47 1 lo
Page 148 and 149: I 138 IPDE ICD-10 module* interview
Page 150 and 151: 140 Interview schedule 2. 0 1 2 7 0
Page 152 and 153: 142 Inte~iew schedule 4. O 1 2 I N
Page 154 and 155: 144 Interview schedule 6. O l Z ? 0
Page 156 and 157: 146 Interview schedule 8. 0 1 2 1 0
Page 158 and 159: 148 Interview schedule .10. 0 1 2 ?
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Page 162 and 163: 152 lnte~iew schedule 14. 0 1 2 ? 0
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Page 168 and 169: 158 Interview schedule 20. O 1 2 N
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164 Interview schedule *26. 0 1 2 ?
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166 lntewiew schedule 28. 0 1 2 ? 0
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168 Interview schedule 30. 0 1 2 ?
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170 lnte~iew schedule 32. O 1 2 7 N
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174 lntewiew schedule 36. 0 1 2 ? 0
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176 lnterv~ew schedule 38. 0 1 2 ?
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184 lnte~iew schedule 46. 0 1 2 7 0
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~ 186 Interview schedule 48. 0 1 2
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194 Interview schedule 56. 0 1 2 1
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196 Interview schedule VI. IMPULSE
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200 Interview schedule Have you eve
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202 Interview schedule 1 63. 0 1 2
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204 Intewiew schedule Rate the foll
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206 IPDE ICD-10 module handscoring
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+ 39+44=4, 208 Handscoring algorith
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210 Handscoring algorithms and summ
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IPDE ICD-10 module summary scoreshe
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224 Index paranoid 108 schizoid 108
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226 Index Personalily Assessment Sc
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IPDE - Extranet Systems - World Health Organization

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