Validity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis

Acta Psychiatr Scand. 1996 Nov;94(5):337-43. doi: 10.1111/j.1600-0447.1996.tb09869.x.


Psychological autopsies are an important research tool in establishing risk factors associated with suicide. We report the results of a validity study comparing psychological autopsy-generated DSM-III-R diagnoses in suicides and non-suicides with chart diagnoses generated by clinicians who had treated the subjects prior to death. The Structured Clinical Interview for DSM-III-R Disorders (SCID-P) and the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) were used to make independent post-mortem diagnoses. Comparison of research diagnoses with clinician ante-mortem diagnoses generated kappa coefficients of 0.85 for Axis I diagnoses and 0.65 for Axis II conditions. These kappa coefficients compare favourably with direct patient interview reliability studies. This provides evidence for the validity of the psychological autopsy as a method of determining psychiatric diagnosis.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Accidents / psychology
  • Adolescent
  • Adult
  • Aged
  • Death, Sudden
  • Female
  • Homicide / psychology
  • Humans
  • Male
  • Mental Disorders / classification
  • Mental Disorders / diagnosis*
  • Mental Disorders / psychology
  • Middle Aged
  • Observer Variation
  • Patient Care Team*
  • Personality Disorders / classification
  • Personality Disorders / diagnosis
  • Personality Disorders / psychology
  • Psychiatric Status Rating Scales / statistics & numerical data*
  • Psychometrics
  • Reproducibility of Results
  • Retrospective Studies
  • Suicide / psychology*