Psychiatric research interview for substance and mental disorders: phenomenologically based diagnosis in patients who abuse alcohol or drugs

Abstract

The Psychiatric Research Interview for Substance and Mental Disorders (PRISM) is a psychiatric diagnostic interview designed to diagnose DSM-IV substance and mental disorders in patients who abuse alcohol or drugs. Primary disorders tested in the DSM-III-R version of the interview showed improved reliability over existing instruments, and substantially improved reliability for major depressive disorder (MDD). Developments for DSM-IV include a systematic set of procedures for differentiating primary disorders, substance-induced disorders, and the expected effects of intoxication and withdrawal based on the phenomenology of symptoms in conjunction with alcohol and drug use. A longitudinal version of the PRISM provides data on remission and relapse that can be analyzed with survival methods. Pilot and preliminary testing of the DSM-IV and longitudinal versions of the instruments is presented. By making use of psychometric principles, particularly the need to reduce criterion variance, these instruments can clarify some of the longstanding issues in the diagnosis of patients who abuse alcohol and drugs.