Missed diagnoses in African Americans with obsessive-compulsive disorder: the structured clinical interview for DSM-IV Axis I disorders (SCID-I)

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Abstract

Background

Research on the utility of structured interviews in assessing OCD is scarce, and even more so, in its use for OCD in African Americans. The purpose of this study was to examine the utility of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) in detecting OCD in African Americans when used by well-trained, culturally competent clinicians.

Methods

Seventy-four African American adults with OCD were assessed with the SCID-I and additional measures of OCD.

Results

Results revealed the poor diagnostic utility of the SCID OCD section (SCID-OCD), with 66.2% ( N = 49) correctly identified and 33.8% ( N = 25) incorrectly diagnosed. Participants receiving the correct diagnosis were more likely to endorse compulsive behaviors, specifically ordering compulsions, and experience greater symptom severity.

Conclusion

The lack of sensitivity for identification of OCD is discussed as the SCID-OCD seems to often miss a true diagnosis of OCD in African Americans.

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Most cited references 42

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The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication.

A M Ruscio, D J Stein, W Chiu … (2010)

Despite significant advances in the study of obsessive-compulsive disorder (OCD), important questions remain about the disorder's public health significance, appropriate diagnostic classification, and clinical heterogeneity. These issues were explored using data from the National Comorbidity Survey Replication, a nationally representative survey of US adults. A subsample of 2073 respondents was assessed for lifetime Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) OCD. More than one quarter of respondents reported experiencing obsessions or compulsions at some time in their lives. While conditional probability of OCD was strongly associated with the number of obsessions and compulsions reported, only small proportions of respondents met full DSM-IV criteria for lifetime (2.3%) or 12-month (1.2%) OCD. OCD is associated with substantial comorbidity, not only with anxiety and mood disorders but also with impulse-control and substance use disorders. Severity of OCD, assessed by an adapted version of the Yale-Brown Obsessive Compulsive Scale, is associated with poor insight, high comorbidity, high role impairment, and high probability of seeking treatment. The high prevalence of subthreshold OCD symptoms may help explain past inconsistencies in prevalence estimates across surveys and suggests that the public health burden of OCD may be greater than its low prevalence implies. Evidence of a preponderance of early onset cases in men, high comorbidity with a wide range of disorders, and reliable associations between disorder severity and key outcomes may have implications for how OCD is classified in DSM-V.

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Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)

(2000)

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Inter-rater reliability of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and Axis II Disorders (SCID II).

Jill Lobbestael, Maartje Leurgans, Arnoud Arntz (2010)

This study simultaneously assessed the inter-rater reliability of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders Axis I (SCID I) and Axis II disorders (SCID II) in a mixed sample of n = 151 inpatients and outpatients, and non-patient controls. Audiotaped interviews were assessed by independent second raters blind for the first raters' scores and diagnoses. Categorical inter-rater reliability was assessed for 12 Axis I disorders of SCID I, while both categorical and dimensional inter-rater reliability was tested for all Axis II disorders. Results revealed moderate to excellent inter-rater agreement of the Axis I disorders, while most categorically and dimensionally measured personality disorders showed excellent inter-rater agreement. Copyright © 2010 John Wiley & Sons, Ltd.

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Author and article information

Contributors

Monnica T. Williams:

ORCID: http://orcid.org/0000-0003-0095-3277

860-486-0919 , monnica.williams@uconn.edu

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 17 July 2017

Publication date PMC-release: 17 July 2017

Publication date Collection: 2017

Volume: 17

Electronic Location Identifier: 258

Affiliations

[1 ]ISNI 0000 0004 1936 7806, GRID grid.62813.3e, Department of Psychology, , Illinois Institute of Technology, ; 3105 S. Dearborn, Chicago, IL 60616 USA

[2 ]ISNI 0000 0001 0860 4915, GRID grid.63054.34, Department of Psychological Sciences, , University of Connecticut, ; 406 Babbidge Road, Unit 1020, Storrs, CT 06269-1020 USA

[3 ]ISNI 0000 0001 2113 1622, GRID grid.266623.5, Center for Mental Health Disparities, Department of Psychological & Brain Sciences, , University of Louisville, ; 2301 South Third Street, Louisville, KY 40292 USA

[4 ]ISNI 0000 0001 2107 308X, GRID grid.412724.6, Department of Psychology, , Spalding University, ; Louisville, KY USA

Author information

Monnica T. Williams http://orcid.org/0000-0003-0095-3277

Article

Publisher ID: 1422

DOI: 10.1186/s12888-017-1422-z

PMC ID: 5514479

SO-VID: fa334f38-416f-4727-8492-a421d3e21232

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 23 July 2016

Date accepted : 5 July 2017

Funding

Funded by: Lindback Career Enhancement Minority Junior Faculty Grant

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ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: obsessive-compulsive disorder,african americans: assessment,race,structured interviews

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ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: obsessive-compulsive disorder, african americans: assessment, race, structured interviews

Missed diagnoses in African Americans with obsessive-compulsive disorder: the structured clinical interview for DSM-IV Axis I disorders (SCID-I)

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Abstract

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Most cited references 42

The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication.

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)

Inter-rater reliability of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and Axis II Disorders (SCID II).

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