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One-hundred 9 through 12-year-old children and their mothers who had been previously interviewed with the Diagnostic Interview Schedule for Children (DISC) were selected for a clinical diagnostic reassessment. The families, who were reinterviewed after 3 to 4 months, were part of a larger geographically based epidemiological sample. Reinterviews were conducted by child clinicians, using a modified version of the Kiddie-Schedule for Affective Disorder and Schizophrenia (K-SADS). The prevalences of each of the mental disorders as estimated by each interview were compared. Agreement on diagnoses based on these interviews was found to be moderate, although generally statistically significant. Study design issues that account in part for these findings are discussed.

A series of developments in psychiatry have led to the increasing use of computer algorithms to produce psychiatric diagnoses from coded interviews and other materials. This article reviews the contributors to this trend, alternative approaches to these scoring systems, the published literature on the adequacy of diagnoses so generated, and new empirical findings from a study of diagnoses of children. The empirical evidence suggests that DSM-III-R diagnoses that incorporate population norm-referenced measures of diagnostic certainty are more valid than the currently standard method of scoring the DISC and DISC-P diagnostic interviews.

Critical examination of data generated by the clinical interview has been kindled by dissatisfaction with unsturctured interviews used for assigning diagnoses. Identification of sources of variance, the use of operational definitions, and the application of measures of reliability and validity to interview research have enhanced the capacity of the clinician to locate deficiencies in the diagnostic interview. Fairly good agreement for diagnosis of psychiatric disorders of adults has been achieved, but remaining variability invites further scrutiny of the effects of categorical versus dimensional approaches, the use of best estimate diagnoses in validity research, and other factors. Practical questions arising for clinicians concern what training in techniques for specific structured interviews is required, whether routine use of standardized instruments is practical, and how structured interviews are related to other clinical measures, such as behavior checklists.