Screening and Assessment of Co-Occurring Disorders in the Justice ...

Appendix M: Instruments for Diagnosis ofCo-Occurring DisordersThe Composite International Diagnostic Interview (CIDI)The CIDI is a structured comprehensive interview developed by the World HealthOrganization (WHO) for epidemiological surveys to assess mental disordersaccording to the definitions and criteria of the International Classification ofDisease (ICD, ICD-10) and the DSM (DSM-IV). The CIDI is one of the mostwidely used structured diagnostic interviews in the world, as it was developedspecifically for use for different cultures and settings. The instrument wasderived from the Diagnostic Interview Schedule (DIS; Robins, Helzer, Croughan,& Ratcliff, 1981) and accommodates diagnoses based on the definitions andcriteria of the ICD and DSM. The CIDI was first used in 1990, and was revisedand expanded in 1998 by the WHO World Mental Health (WMH) initiative toaddress subthreshold impairment, symptom severity and persistence, risk factors,internal and external (global) impairment, consequences, patterns of treatment,and treatment adequacy, in addition to diagnosis of mental disorders (Kessler &Ustun, 2004). The WMH-CIDI contains 22 diagnostic sections (including anxiety,mood, and eating disorders, tobacco and substance use, ADHD, conduct disorder,psychosis, and personality disorders), four sections assessing functioning andphysical comorbidity, two sections assessing treatment, seven sections assessingsociodemographics, and two sections assessing methodological factors (e.g.,interviewer observations).Positive Features•y The CIDI provides both ICD-10 and DSM-IV diagnoses•y A diverse sample was used to develop the instrument, including individualswith a broad range of alcohol and drug use severity•y A computerized version of the CIDI is available, which contains a scoringalgorithm to provide a diagnosis. The computerized version has theability to handle more elaborate “skip” patterns, while covering the sameinformation as the paper and pencil version (Andrews & Peters, 2003)•y The WMH-CIDI has been translated into several languages using thestandard WHO translation and back-translation protocol•y Administration of the CIDI does not require use of mental healthprofessionals or those with significant clinical training•y The CIDI diagnoses for alcohol and drug dependence have been found tobe reliable, although reliability is generally poor for corresponding harmfuluse and abuse diagnoses (Kessler et al., 1998; Ustun et al., 1997)97