Standardized Evaluation in Clinical Practice, Vol. 22

Augmenting the broad information contained in the APA's Handbook of Psychiatric Measures, this in-depth guide examines the real-world issues involved in implementing measures in actual clinical settings. In just five chapters, its 12 distinguished contributors focus on both the uses and limitations of structured diagnostic interviews in clinical practice and on specific measures for assessing two crucially important factors in clinical practice: suicide risk and global functioning.

Standardized Evaluation in Clinical Practice is a groundbreaking guide that details the pros and cons of using structured interviews and rating scales in clinical settings to ensure reliable and valid assessment of diagnoses, symptoms, and outcomes.

American Psychiatric Publishing

In clinical settings clinicians continue to underutilize interviews and rating scales because their benefits are underappreciated and their use is perceived as too costly and time consuming. Augmenting the broad information contained in the APA's Handbook of Psychiatric Measures, this in-depth guide examines the real-world issues involved in implementing measures in actual clinical settings. This book

• Asserts that the use of structured diagnostic interviews in clinical settings is justified, suggesting that it would be most cost-effective to target research assessment toward those groups most difficult to evaluate and most likely to be misdiagnosed, especially those whose misdiagnosis leads to consumption of a greater-than-expected amount of treatment resources
• Focuses on the underrecognition and underreporting of diagnostic comorbidity, discussing the daunting practical issues of using comprehensive structured interviews and suggesting instead that a self-administered questionnaire be used to screen for the most common DSM-IV Axis I disorders
• Considers the use of structured interviews-administered by either lay interviewers or by computer-in the diagnostic assessment of children and adolescents, making a case that using the research model (i.e., reliable measures that can be given to large numbers of subjects) in clinical settings meets the cost-efficiency requirements of understaffed clinical providers
• Discusses the utility and limitations of research instruments for crucially important clinical purposes-determining suicide risk-and presents the inherent difficulties in predicting risk and explore the underlying clinical risk factors based on their proposed stress-diathesis model
• Presents the issues and challenges involved in the U.S. Department of Veteran's Affairs (VA) attempt to implement a national program requiring the routine use of the GAF scale. The authors conclude with a discussion of the reasons why the Global Assessment of Functioning (GAF) scale was chosen, software and procedures, methods to ensure system compliance, and the specific measures taken by two VA networks that helped improve its implementation

It is a groundbreaking guide that details the pros and cons of using structured interviews and rating scales in clinical settings to ensure reliable and valid assessment of diagnoses, symptoms, and outcomes.

Doody Review Services

Reviewer:Michael Purcell, MA(Rush University Medical Center)
Description:Part of the 2003 Review of Psychiatry series, this edited book examines pertinent issues related to the use of standardized assessment tools, ordinarily relegated to research endeavors, in clinical settings. Three chapters focus on using structured diagnostic interviews in clinical practice, while the other two chapters focus on specific types of measures suicide risk and the GAF.
Purpose:The purpose is to explore ways to increase precision and standardization of diagnosis in the clinical setting using assessment tools from the realm of research.
Audience:Practitioners are the primary target, but the book would be useful for students, residents, and any mental health professional involved with clinical assessment of mental illness.
Features:The book contains discussions of structured interviews with adults and children, assessing suicide risk, and the use of the GAF. Tables and flow charts appear quite useful for educational purposes. A suicidal risk worksheet in the appendix of chapter 4 is particularly helpful and practical. All of the chapters do a good job of emphasizing the critical importance of diagnosis. The authors could have addressed perceived limitations of structured methods of diagnosis more fully. Also, more discussion on the use of paper-pencil assessments would have been useful.
Assessment:The accuracy of diagnosis is of prime importance in today's clinical practice as treatments grow increasingly sophisticated, targeting specific forms of mental illness. An accurate diagnosis not only guides treatment but also may aid the practitioner in anticipating the course of illness, the patient's response to treatment, and potential risk factors. This volume, particularly the first chapter written by Monica Ramirez Bosco, PhD, does an excellent job of outlining the current problems with misdiagnosis in clinical settings. Subsequent chapters address ways to remedy the problem using specific assessment tools. Overall, this is an excellent resource for clinicians.

Michael B. First, M.D., is Associate Professor of Clinical Psychiatry at Columbia University, and Research Psychiatrist at the New York Psychiatric Institute in New York, New York.