IPDE - Extranet Systems - World Health Organization

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I 45 IPDE iner what he is actually rating. When there is no major difference between an ICD and DSM criterion, they are assessed together by identical questions. This occurs as often as possible to prevent the combined ICD-DSM version of the interview from becoming too long or unwieldy. Some criteria are followed by the designation partial. an indication that the item does not assess the entire criterion. This is done to preserve the topical focus of the interview. For example, it is more appropriate to inquire about an identity disorder in the sexual realm, when the subject of sex is being discussed, than to attempt to cover other manifestations of an identity disorder. such as uncertainty about values or career choice, at the same point in the interview. There appears to be no consensus about how long a behaviour should be present before it can be considered a personality trait. The IPDE has adopted the conservative convention that it should exist for a span of at least five years. Consideration was given to a three-year requirement, but it was decided that might too frequently lead to confounding episodic mental illnesses or responses to unusual or special life sihlations with the more enduring behaviour associated with personality. Some may feel this is too exacting, especially when applied to adolescents. Since users of the IPDE will differ in their predilection for making PD diagnoses in adolescents. those who prefer a three-year requirement may adopt it for that age group. They should specify, however, that they have departed from the standard instructions. The use of anything less than a five-year timeframe with subjects over 20 years of age is discouraged. ICD-10, DSM-IU-R, and DSM-N date the onset of the first manifestations of a PD to childhood, adolescence, or early adulthood. For that reason the IPDE takes the somewhat arbitrary position, that the requirements for at least one criterion of a disorder must have been fulfilled prior to age 25, before that particular disorder can be diagnosed. Age 25 years rather than an earlier age was selected to allow more informed and accurate judgments about many of the adult-oriented PD criteria. Clinical tradition notwithstanding, it is possible that personality transformations may occur in midlife or old age, and that a true PD may emerge de novo at that time. In the absence of empirical data. rather than encourage premature closure on the subject, there is provision in the IPDE for an optional late onset diagnosis. The interview also provides the option of making a past diagnosis in someone who previously met the requirements, but does not evidence the behaviour currently (past 12 months).
46 A. W. Loranger Administration and scoring Much of the behaviour described in the criteria of ICD-10, DSM-HI-R, and DSM-IV exists on a continuum with normality. The IPDE scoring is based on the convention that a behaviour or trait may be absent or normal (O), exaggerated or accentuated (l), and criterion level or pathological (2). A few criteria are not applicable to certain subjects, and are scored 'NA'. A '? scoring category is reserved for those rare occasions when a subject, despite encouragement, refuses to answer a question or states that betshe is unable to do so. It is not used to designate uncertainty on the part of the examiner about rating the item. No single formula was used in developing the guidelines in the scoring manual. They are based on interpretations of the criteria by the author of the instrument, and were revised after discussions with the clinicians who participated in the field trial. Clinical judgement, common sense, and practical experience with the interview shaped the final version of the guidelines. The boxed text contains a sample item from the IPDE demonstrating the format, type of questions, and scoring guidelines. Initial replies of the subject that suggest a positive reply are rarely sufficient for scoring a criterion. They must be supplemented and supported by convincing descriptions or examples. The examiner uses clinical judgement to determine the length of the descriptions and the number of examples. Although there is a standard set of probes, they must be augmented by an adequate clinical examination of the subject. The interviewer scores the IPDE itern-by-item, as he progresses through the interview. The scores are combined for diagnostic purposes at the conclusion of the interview. Although this may be done clerically using a set of step-by-step algorithmic directions, the most efficient method is to use a program especially designed for personal computers. It is written with operator prompts, and the user responds to questions regarding the task to be perFormed and the management of the data, which may be sent to a printer and saved in a disk file. The entire procedure takes 5 to 10 minutes. Scope of the IPDE The IPDE is not designed to survey the entire realm of personality. Its purpose is to identify those traits and behaviours that are relevant to an assessment of the criteria for personality disorders in the ICD-10 and DSM-IV classification systems. It neglects many neutral, positive, and
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Until recently, the standardization
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Assessment and diagnosis of persona
Page 6 and 7: Contents Contributors Preface Annan
Page 8 and 9: Contributors Dr Antonio Andreoli Ho
Page 10 and 11: Preface One of the major goals of t
Page 12 and 13: ... Xlll Acknowledgements The IPDE
Page 14 and 15: Problems in the field of personalit
Page 16 and 17: 5 Problems in the field of PD perso
Page 18 and 19: 7 Problems in the field of PD In DS
Page 20 and 21: 9 Problems in the field of PD cultu
Page 22 and 23: 11 Review of diagnostic instruments
Page 30 and 31: 19 Epidemiology of DSM-Ill PDs in c
Page 32 and 33: Table l. Prevalence rates of specif
Page 35 and 36: 24 1. H. Reich and G. de Girolamo (
Page 37 and 38: 26 .- 5 2 0 W C .- 0 P g F ? g e Q
Page 39 and 40: 28 J. H. Reich and G. de Girolarno
Page 41 and 42: Table 3. Prevalence rates ofpersona
Page 44 and 45: Pfohl etal.. l986 (67) Pilgrim & Ma
Page 46 and 47: 35 Epidemiology of DSM-Ill PDs were
Page 48 and 49: 37 Epidemiology of DSM-Ill PDs migh
Page 50 and 51: 39 Epidemiology of DSM-Ill PDs 23 R
Page 52 and 53: 4 1 Epidemiology of DSM-Ill PDs 55
Page 54 and 55: 43 International personality disord
Page 58 and 59: 47 IPDE Sample of IPDE item The que
Page 60 and 61: 49 IPDE dimensional scores are not
Page 62 and 63: 1 9 IPDE considerable training and
Page 64 and 65: 53 Experiences with IPDE The invest
Page 66 and 67: 55 Experiences with IPDE passive ag
Page 68 and 69: 57 Field Trial
Page 70 and 71: 59 Sampling, inte~iewers, interview
Page 72 and 73: 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
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95 Appendix Table A4 Personality di
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97 Appendix Table A6 Personaliry di
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99 Appendix Table SA Personaliry di
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Table A10 Personality disorder diag
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103 Appendix Table A12 Personality
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Table A13 (con?) Criterion B7 B8 1
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107 Appendix Table A13 (cont) Frequ
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109 Appendix Table A14 (cont.) Freq
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Acknowledgements 113 Manual History
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Manual History of the IPDE One of t
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116 Manual Struchlre of the IPDE Th
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118 Manual that is likely to enhanc
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120 Manual data. If examiners have
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122 Manual Scoring conventions Much
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124 Manual Recording the scores Req
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126 Manual Q. What do you do when s
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128 Manual section, if there are qu
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ICD-10 criteria and corresponding I
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132 ICD-10 criteria and correspondi
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134 IPDE ICD-10 module screening qu
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136 Screening questionnaire 47 1 lo
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I 138 IPDE ICD-10 module* interview
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140 Interview schedule 2. 0 1 2 7 0
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142 Inte~iew schedule 4. O 1 2 I N
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144 Interview schedule 6. O l Z ? 0
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146 Interview schedule 8. 0 1 2 1 0
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148 Interview schedule .10. 0 1 2 ?
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150 Interview schedule 12. 0 1 2 7
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152 lnte~iew schedule 14. 0 1 2 ? 0
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154 Interview schedule 16. 0 1 2 ?
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156 interview schedule 18. 0 1 2 ?
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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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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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