how reliably can mental health professionals make judgments about the cause of symptoms?
OBJECTIVE: To evaluate the reliability of the DSM-IV approach and five other schemes for counting symptoms toward the diagnosis of depression in hospitalized medically ill older patients and to examine whether mental health professionals can reliably make judgments about the etiology (medical or psychological) of depressive symptoms. METHOD: A sample of 38 patients aged 60 years or older admitted to the general medicine, cardiology, or neurology services at Duke University Medical Center were evaluated for depression using a structured psychiatric interview and the Hamilton Depression Scale. Interrater reliability for the diagnostic schemes, for unstructured clinical diagnoses, and for determinations of the causes of individual depressive symptoms was assessed by three pairs of mental health professionals. RESULTS: Agreement between raters for structured diagnoses was high regardless of diagnostic strategy, with the DSM-IV approach being only slightly less reliable than the strict incl
