Using consensus OPCRIT diagnoses - An efficient procedure for best-estimate lifetime diagnoses

Background The Operational Criteria Checklist (OPCRIT) generates diagnoses according to 12 operational diagnostic systems (e.g. DSM-III, DSM-III-R, Research Diagnostic Criteria, ICD-10). Aims To examine the agreement between diagnoses generated by the OPCRIT, as completed by the interviewer, with a best-estimate lifetime procedure using the OPCRIT. Method Subjects came from large multi-generational bipolar or schizophrenia pedigrees (n=100), and from a sample of unrelated subjects with schizophrenia (n=40). We analysed the diagnostic agreement between OPCRIT diagnoses generated by the interviewer and our best-estimate OPCRIT diagnoses. according to DSM-III-R and ICD-10, using Cohen kappa statistics. Results Excellent agreement was found between interviewer OPCRIT diagnoses and OPCRIT diagnoses made by the best-estimate lifetime consensus procedure for DSM-III-R (kappa=0.83) and ICD-10 (kappa=0.81). Conclusions Results suggest that this procedure for diagnostic assessment is an efficient alternative to classic best-estimate diagnosis procedures. Declaration of interest Supported by grants from Junta Nacional de Investigacao Cientifica eTechnologia and the US National Institute of Mental Health.