OBJECTIVE: The study evaluated the utility to clinicians and the
acceptability to patients of the self-administered computerized version of
the Composite International Diagnostic Interview (CIDI-Auto) in an acute
psychiatric setting. METHODS: Patients admitted to an acute psychiatric
unit completed the CIDI-Auto. Reports of CIDI-Auto diagnoses and symptoms
were given to treating psychiatrists, who completed a questionnaire
evaluating the accuracy and usefulness of the reports. Patients answered a
questionnaire about their attitudes toward computers before completing the
CIDI-Auto, and after completing it, they answered a questionnaire about
their reactions to the interview. RESULTS: Psychiatrists agreed with only
50 percent of CIDI-Auto current diagnoses and indicated that only 22
percent of CIDI-Auto reports provided useful new diagnoses, although 63
percent helped to clarify diagnoses and 58 percent could save clinicians
some time. They endorsed the CIDI-Auto as a possible aid to indirect or
remote diagnosis where histories would be taken by nonexpert staff.
Ninety-four percent of patients liked the computerized interview, and 83
percent understood the questions without difficulty. Sixty percent felt
more comfortable with the computerized interview than with a doctor.
Education and previous computer experience promoted positive attitudes and
satisfaction with the computerized interview. CONCLUSIONS: Psychiatrists
considered the current CIDI-Auto completed by patients to be of limited
value in diagnosis and history taking. Despite patients' acceptance and
positive reactions to the computer interview, satisfactory computerized
diagnosis is yet to be attained.