The reliability of psychiatric and psychological diagnosis

Experience suggests that many psychologists and psychiatrists, as well as most attorneys, judges, and other individuals whose work requires a knowledge of the extent of the reliability of psychologic and psychiatric diagnosis are not aware that recent research has dramatically influenced the conclusions one may draw in regard to the fallability of such human judgments. The purpose here is to provide a brief introduction of the history of such diagnostic judgments from the time of the early Greek philosophers through the decade of the 1960's. This will be followed by a review of a series of important studies from several research centers which were published during the past decade and which presented the first robust evidence that such clinician-to-clinician diagnoses have now attained remarkably high levels of reliability. In the last section, studies will be reviewed which show that the concurrent development of standardized interview schedules now allow layperson interviewers to achieve levels of reliability for psychiatric and psychologic interviews which are comparable to the high levels now attainable by mental health professionals.