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The World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration International Pilot Study of Personality Disorders

Armand W. Loranger, PhD; Norman Sartorius, MD, PhD; Antonio Andreoli, MD; Peter Berger, MD; Peter Buchheim, MD; S. M. Channabasavanna, MD; Bina Coid, PhD; Alv Dahl, MD; Rene F. W. Diekstra, PhD; Brian Ferguson, MD; Lawrence B. Jacobsberg, MD, PhD; W. Mombour, MD; Charles Pull, MD; Yutaka Ono, MD; Darrel A. Regier, MD

Arch Gen Psychiatry. 1994;51(3):215-224.

Abstract
Background
One of the aims of the World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration joint program on psychiatric diagnosis and classification is the development and standardization of diagnostic assessment instruments for use in clinical research worldwide. The International Personality Disorder Examination (IPDE) is a semistructured clinical interview compatible with the International Classification of Diseases, Tenth Revision, and the DMS-III-R classification systems. This is the first report of the results of a field trial to investigate the feasibility of using the IPDE to assess personality disorders worldwide.

Methods
The IPDE was administered by 58 psychiatrists and clinical psychologists to 716 patients enrolled in clinical facilities at 14 participating centers in 11 countries in North America, Europe, Africa, and Asia. To determine interrater reliability, 141 of the IPDEs (20%) were independently rated by a silent observer. To determine temporal stability, 243 patients (34%) were reexamined after an average interval of 6 months.

Results
The IPDE proved acceptable to clinicians and demonstrated an interrater reliability and temporal stability roughly similar to instruments used to diagnose the psychoses, mood, anxiety, and substance use disorders.

Conclusion
It is possible to assess personality disorders with reasonably good reliability in different nations, languages, and cultures using a semistructured clinical interview that experienced clinicians find relevant, meaningful, and user-friendly.

Author Affiliations
From the Department of Psychiatry, Cornell University Medical College, New York, NY (Drs Loranger and Jacobsberg); World Health Organization (Dr Sartorius), and Institutions Universitaires de Psychiatrie-Genéve (Dr Andreoli), Geneva, Switzerland; Psychiatrische Universitätsklinik, Vienna, Austria (Dr Berger); Nervenklinik der Universität Munchen, Munich, Germany (Dr Buchheim); National Institute of Mental Health and Neurosciences, Bangalore, India (Dr Channabasavanna); Institute of Psychiatry, London, England (Dr Coid); Universitetet I Oslo Psychiatrisk Institutt, Oslo, Norway (Dr Dahl); Rijksuniversiteit Te Leiden, Leiden, the Netherlands (Dr Diekstra); Stonebridge Research Centre, Nottingham, England (Dr Ferguson); Max-Planck-Institut für Psychiatrie, Munich (Dr Mombour); Centre Hospitalier de Luxembourg, Luxembourg (Dr Pull); Keio University School of Medicine, Tokyo, Japan (Dr Ono); and National Institute of Mental Health, Rockville, Md (Dr Regier).

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