The acute psychiatric diagnostic interview.

The general outline of a psychiatric diagnostic interview given in Table 1 includes some broad suggestions for the amount of time to spend on each section. As a structured interview based on a symptom checklist questionnaire yields higher frequency of reports of symptoms, it is advisable to follow this type of format rather than a totally unstructured interview technique. Sim recommends a structured format that lends itself to computerization. Griest and colleagues suggest a computer interview, and there are data supporting the diagnostic accuracy of such a system. Within the framework of any diagnostic interview, a thorough exploration of the 10 critical elements listed in Table 5 is essential for accurate diagnosis. This information, which is usually obtainable in about 30 minutes, will enable the clinician to make a preliminary diagnosis, decide upon pharmacotherapy, and determine if hospitalization is warranted. A more intensive but lengthy and time-consuming structured diagnostic interview is the Schedule for Affective Disorders (SADS), which is more appropriate for inpatients or patients being considered for a research protocol.