A diagnosis may be said to be reliable if the same observer reaches the same diagnosis in a repeat of the same clinical situation (test-retest reliability), or if two observers reach the same diagnosis in the same clinical situation (interrater reliability). Studies in clinical practice have often shown low reliability for psychiatric diagnosis because psychiatrists differ in the way they interview patients and interpret the information elicited. Diagnostic practices also vary between different parts of the world. Reliability is better for individual symptoms and signs. Reliability can be improved by using standardized interviews and questionnaires (Chapter 3), and by using the diagnostic criteria laid down in ICD-10 and DSM-IV (see below). This is necessary for research purposes, but it is too time-consuming to be a usual part of daily clinical practice.

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