SCID I and SCID II
SCID I –Structured Clinical Interview for DSM-IV Axis I Disorders
This scale is the result of a research project that since 1980 has aimed at creating a tool that contains all the relevant and useful questions to conduct a semi structured interview to make a diagnosis on the main disorders (either current or past) of Axis I of the Diagnostic and Statistical Manual of Mental Disorders (DSM), developed in 1980 by the American Psychiatric Association, whose fourth edition was published in 2001 and which is now in its fifth edition, published in 2013, of which we await the translation into Italian language in 2014. Axis I covers all clinical disorders defined in the classification of mental disorders except Personality Disorders and mental Retardation. Undoubtedly, it is useful as an aid to formulate accurate diagnosis, however, its limitations is the absence of indicators of answers reliability and of information needed to highlight any exaggerations or concealments of pathology, or at least answers that are not faithful. Therefore, it is specifically useful as a tool for a guided anamnesis, but should be compared with other tested data and with the clinical assessment performed by a specialist psychiatrist.
The interview begins with an examination of the occurrence of characteristic symptoms of the depressive episode, and according to the subject’s responses, it continues with the investigation of differential traits for Depressive or Bipolar Disorders, psychotic symptoms of the alcohol or substances abuse Disorder, Anxiety Disorders and other minor ailments.
If the interview is conducted in a sufficiently attentive and flexible way, the subject may express his characteristic style and enrich the anamnesis with significant episodes.
SCID II - Structured Clinical Interview for DSM-IV Axis II
This structured interview was made to define Personality Disorders or stable traits, already existing before any current Axis I pathology and it follows the diagnostic guidelines of DSM IV.
This is its main interesting aspect, because with information on the stable and permanent structure of the personality, it completes the self-reported information provided by the subject concerning psychopathological events arisen throughout his life, that were expressed in both SCID I and MMPI-2, which refers to the current reality of the subject at the time of assessment.
Even if this scale originates from the same need of SCID Axis I, but it refers to the 10 personality disorders described in the DSM IV - TR on Axis II (Avoidant, Dependent, Obsessive-Compulsive Disorder, Paranoid, Schizotypal, Schizoid, Histrionic, Narcissistic, Borderline, Antisocial) and to Passive Aggressive and Depressive Personality Disorders, it is nonetheless valid in terms of diagnosis usefulness. Even for this scale, the same to limitations expressed on SCID I apply, concerning the answers reliability. The analysis of the traits that are defined as relevant to the diagnosis of each Personality Disorder through relevant questions (in some cases very explicit ones) allows to explore aspects that sometimes do not emerge in the clinical interview and to redirect attention to the further hypothesis or to push the subject to tell episodes that can be illuminating for a better understanding of the whole person and experience.