Reliability of psychiatric assessment in older patients.

A number of the causes of psychiatric diagnostic disagreement are discussed in this paper. The use of the Geriatric Mental Status interview to achieve diagnostic reliability is examined in three studies in which U.S.--U.K. Cross-National Project psychiatrists rated and diagnosed thirty-two British and twenty-one American patients. There were no systematic differences between U.S. and U.K. team members in their diagnoses; and agreement on six principal diagnostic categories was achieved in about three-quarters of the cases. The reliability fo the ratings of psychopathology that formed the basis for the diagnoses was satisfactory and is reported in detail.