Clinical reappraisal of the Composite International Diagnostic Interview Version 3.0 in the Saudi National Mental Health Survey

OBJECTIVES: The DSM‐IV diagnoses generated by the fully structured lay‐administered Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) in the Saudi National Mental Health Survey (SNMHS) were compared to diagnoses based on blinded clinical reappraisal interviews. METHODS: Telephone follow‐up interviews were administered using the clinician‐administered non‐patient edition of the Structured Clinical Interview for DSM‐IV (SCID) in separate sub‐samples of SNMHS respondents who screened positive for four disorders that are of special importance in Arab countries: obsessive–compulsive disorder, separation anxiety disorder, social phobia, and major depressive episode. RESULTS: Initial diagnoses based on the CIDI were found to have higher prevalence than those based on the SCID for all four disorders. For reasons having to do with respondent denial of symptoms in the SCID reported in the CIDI, we interpreted these differences as due more to under‐diagnoses in the SCID than over‐diagnoses in the CIDI. Nonetheless, CIDI diagnostic thresholds for three of the four disorders were increased to make sure prevalence estimates based on the CIDI were conservative. The procedures used to implement these recalibrations are described in this paper. CONCLUSIONS: The CIDI interviews used in the SNMHS generated valid but conservative diagnoses of common mental disorders in the Saudi population.