IPDE - Extranet Systems - World Health Organization

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1 9 IPDE considerable training and experience in making psychiatric diagnoses. Like other semistructured clinical interviews, its reliability and validity are inseparable fmm the qualifications and training of the person using it. It is designed for experienced psychiatrists, clinical psychologists, and those with comparable training, who are capable of making independent psychiatric diagnoses without a semistructured interview. It is not intended for use by clinicians in the early phase of their training, or by research assistants, nurses, and medical or graduate students. Most clinicians feel comfortable with the IPDE and achieve a basic pmficiency after giving about 10 interviews. Those who wish to obtain the optimal training are encouraged tn enrol1 in the course offered at the worldwide WHO training centres. References 1. Jablensky, A., Sartorius, N., Hirschfeld, R. & Pardes, H. Diagnosis and classification of mental disorders and alcohol- and drug-related problems: a research agenda for the 1980s. PsychologicalMedicine, 1983: 13: 907-21. 2. World Health Organization. The ICD-l0 Classification of Mental and Behavioural Disorders, Diagnostic Crire~ for Research. Geneva: World Health Organization, 1993. 3. American Psychiatric Association. Diagnostic and Starisricd Manual of Menral Disorders, revised 3rd edn. Washington, DC: American Psychiatric Association. 1987. 4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, revised 4th edn. Washington, DC: American Psychiatric Association, 1994. 5. Loranger, A.W. Personaliry Disorder Examination (PDE) Manual. Yonkers: DV Communications. 1988.
Experiences with the IPDE Alv A. Dahl and Antonio Andreoli Personality disorders (PDs) have been considered among the least reliable diagnoses in psychiatry. When DSM-I11 PD diagnoses are made by clinicians, their reliability has proved to be rather poor.' The develop ment of struchued interviews for PD was, therefore. the natural next step in an effoa to improve reliability. Loranger et a1 .2.3 developed the Personality Disorder Examination (PDE) to fill that need. The IPDE evolved from the PDE, and includes the PDs in both ICD-10 and DSM- 111-R. Its features are described elsewhere in this monograph. After the completion of the International Pilot Study of Personality Disorders (IPSPD), the interviewers completed a questionnaire about their experiences with the IPDE.4 At a meeting of investigators in Geneva in 1991, considerable time was devoted to issues raised by responses to the questionnaire. We will present the main findings and solutions chosen, since they reflect the dynamic process involved in the development of the final version of the IPDE. Some centres sent a common reply to the questionnaire, while others provided the responses of the individual interviewers. They revealed a variety of experiences and attitudes towards the inst~ument and the problems in diagnosing PDs. They are reviewedquestion by question. What is your general impression of the IPDE? The overwhelming majority of the respondents found the IPDE to be a useful instrument for diagnosing PDs. One could perhaps argue that this was inflated, because they had a major investment in the instrument. But many of the sites had also tried other ways of diagnosing PDs in the ICD- 9 and DSM-III classification systems, and they might simply have found the IPDE an effective way of doing it. Only minor modifications were suggested. In the IPSPD the mean time of the interviews was two hours and twenty minutes. About half of the participants found that it took too long.
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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
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 56 and 57: I 45 IPDE iner what he is actually
Page 58 and 59: 47 IPDE Sample of IPDE item The que
Page 60 and 61: 49 IPDE dimensional scores are not
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
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
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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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