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Biomedical subjects

J E Helzer

Publications and source records attributed to J E Helzer.

65 records · Page 4Linked to original sources
PubMed1978

Concurrent diagnostic validity of a structured psychiatric interview.

In order to estimate the concurrent validity of a structured psychiatric interview, we compared interview diagnoses obtained for 101 psychiatric inpatients to those recorded in the same patients' hospital charts. For most diagnoses considered, concordance was found to be high. For those in which concordance was low, we examined the reasons for the diagnostic discrepancy. Diagnostic errors that were judged to have occurred on the basis of the structural interview often seemed to have resulted from a lack of longitudinal clinical observation. However, more errors were judged to have occurred in the hospital charts, apparently because of physician oversight. We conclude that the concurrent validity of this structured interview is high and that such examinations might be useful not only for research but also for the routine initial evaluation of psychiatric patients.

Alcoholism↗
PubMed1977

Reliability of psychiatric diagnosis. I. A methodological review.

This article reviews some methodological aspects of studies of diagnostic reliability in psychiatry. We define and discuss the concept of interrater reliability and review some of the ways in which the design of the reliability study can influence the results. Three basic methodological issues are raised, including: importance of structured interviews and objective diagnostic criteria, the importance of a test/retest vs an interviewer/observer design, and the calculation of reliability in a way that takes chance agreement into account.

Attitude of Health Personnel↗
PubMed1977

Reliability of psychiatric diagnosis. II. The test/retest reliability of diagnostic classification.

In a study of interrater diagnostic reliability, 101 psychiatric inpatients were independently interviewed by physicians using a structured interview. Newly admitted patients were randomly selected and examined by one of three psychiatrists. A second psychiatrist reexamined the same patient about 24 hours later. Interviews from the two examinations were evaluated independently and diagnoses were made on the basis of objective criteria. The degree of diagnostic agreement for the two examinations were calculated using the kappa statistic. Agreement was found to be high as compared to other studies in the psychiatric literature, despite the fact that in most previous investigations diagnoses were not made independently. The results were also compared to studies of reliability of medical judgments. Possible reasons for the high interrater reliability are discussed and include the use of a structured interview and objective diagnostic criteria.

Attitude of Health Personnel↗
PubMed1976

Antecedents of narcotic use and addiction. A study of 898 Vietnam veterans.

Previous studies of predictors of narcotic abuse have been retrospective and based on samples of long-term addicts obtained from legal or medical channels. There are several methodological problems in this approach. The present study is an attempt to test certain alleged predictors of narcotic use in a cohort of 898 Vietnam veterans. The design overcomes several of the methodological weaknesses of previous studies. Eight variables which have been reported as predictors of drug use or addiction in the drug literature were inquired about during a personal interview which included the premilitary life of each subject. The antecedent variables were socioeconomic background, inner city residence, psychiatric illness, broken home, race, employment history, education and antisocial history. Using information obtained from interviews and military records, we then tested the predictive value of each of these antecedents by comparing narcotic used and addiction in Vietman and use after Vietnam in men differing with respect to each antecedent. Results indicate that some of the variables were very poor, and others very good predictors of the various levels of narcotic involvement. The predictive value and overall importance of each of the variables we tested are discussed.

Adult↗
PubMed1976

Depressive disorders in Vietnam returnees.

A random sample of 470 Army enlisted men who served tours of duty in Vietnam and returned to the United States in September, 1971 was selected from military records. Between May and September, 1972, these servicemen were located and personally interviewed. Additional information was obtained from their military records and from Veterans Administration files. Interviews were obtained for 95% and military records for 99%. Veterans Administration records were available for 22% of the sample. Depressive disorders appeared to be a significant problem in these enlistees after their return. Twenty-six per cent of the total sample reported at least some symptoms of depression, and 7 per cent reported a full affective syndrome. A third of those with depressive syndromes have had psychiatric care since their return. The association of depression with combat, use of illicit drugs, and other pre- and post-Vietnam variables is discussed.

Adult↗
PubMed1975

Narcotic use in southeast Asia and afterward. An interview study of 898 Vietnam returnees.

From all US Army enlistees leaving Vietnam in September 1971, a random sample of 943 men was selected. Of these, 470 represented a "general" sample of all enlistees returning at that time, and 495 represented a "drug positive" sample whose urine samples had been positive for opiates at the time of departure. We attempted to locate and personally interview all of the men in the samples. Results indicate that before arrival, hard drug use was largely casual, and less than 1% had ever been addicted to narcotics. In Vietnam, almost half of the general sample tried narcotics and 20% reported opiate addiction. After return, usage and addiction essentially decreased to pre-Vietnam levels. We discuss the use of nonnarcotic drugs, predictors and correlates of drug use in the samples, and the relationship of drugs to post-Vietnam social adjustment.

Age Factors↗
PubMed1975

Bipolar affective disorder in black and white men. A comparison of symptoms and familial illness.

Eleven black and 19 white men with conditions diagnosed as manic-depressive disease, manic type were given a systematic psychiatric interview. In addition, as many of their first-degree relatives as could be contacted were also interviewed. Demographic, clinical, and family history variables were compared for the two races. With the exception of a greater preponderance of alcoholism in the paternal relatives of the black men, few differences were found between the two groups in terms of the variables studied. It was concluded that the clinical and familial expression of bipolar affective disorder is similar in the two races.

Adult↗
PubMedDate not supplied

The use of the DSM-III-R Checklist for initial diagnostic assessments.

The DSM-III-R Checklist is an efficient method for screening psychiatric patients for major psychiatric disorders while amassing a data base that can be used for later clinical and research activities. It yields valid diagnoses and key adjunctive symptoms. Patients enjoyed the interview, demonstrating an interest in the computer as well as a feeling of confidence in the complete review of symptoms. The psychiatry resident users in this project found the Checklist to be a valuable teaching instrument, a way to develop their thinking about symptoms and diagnostic rules, an efficient means of collecting an automated clinical data base, and a stimulus to pursue further research activities. Finally, the Checklist is an ideal diagnostic tool to amass a research data base and is currently being used in numerous studies by clinicians and nonclinicians.

Adolescent↗