Establishing Diagnoses

Establishing an accurate diagnosis is generally done according to criteria from an established classification system—e.g., the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric Association 2000). Criteria can be checked off using an unstructured clinical interview or by using a structured instrument—the Scheduled Clinical Interview for DSM-IV (SCID). The latter is more time-consuming but can offer greater information on diagnoses, particularly in cases of psychiatric comorbidity. Obviously, the use of the SCID requires training and assessment for interrater reliability, as well as monitoring over the course of the trial to prevent "slippage" of diagnostic standards.

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