Existing standardized diagnostic interviews (SDIs) were designed for researchers and produce mainly categorical diagnoses. There is an urgent need for a clinician-administered tool that produces dimensional measures, in addition to categorical diagnoses. The Standard for Clinicians' Interview in Psychiatry (SCIP) is a method of assessment of psychopathology for adults. It is designed to be administered by clinicians and includes the SCIP manual and the SCIP interview. Clinicians use the SCIP questions and rate the responses according to the SCIP manual rules. Clinicians use the patient's responses to questions, observe the patient's behaviors and make the final rating of the various signs and symptoms assessed. The SCIP method of psychiatric assessment has three components: 1) the SCIP interview (dimensional) component, 2) the etiological component, and 3) the disorder classification component. The SCIP produces three main categories of clinical data: 1) a diagnostic classification of psychiatric disorders, 2) dimensional scores, and 3) numeric data. The SCIP provides diagnoses consistent with criteria from editions of the Diagnostic and Statistical Manual (DSM) and International Classification of Disease (ICD). The SCIP produces 18 dimensional measures for key psychiatric signs or symptoms: anxiety, posttraumatic stress, obsessions, compulsions, depression, mania, suicidality, suicidal behavior, delusions, hallucinations, agitation, disorganized behavior, negativity, catatonia, alcohol addiction, drug addiction, attention, and hyperactivity. The SCIP produces numeric severity data for use in either clinical care or research. The SCIP was shown to be a valid and reliable assessment tool, and the validity and reliability results were published in 2014 and 2015. The SCIP is compatible with personalized psychiatry research and is in line with the Research Domain Criteria framework.

CASE Worsening psychosis Ms. R, age 21, is admitted to our psychiatric facility while experiencing paranoid delusions and auditory hallucinations. Upon admission, she is agitated and her mood is labile. Ms. R has 4 previous brief psychiatric admissions and was diagnosed with schizoaffective disorder, bipolar type and moderate mental retardation. Her family history is positive for psychiatric illness, as her mother was diagnosed with schizophrenia. Prior to admission, Ms. R was taking ziprasidone, 160 mg/d, and lithium, 450 mg/d, for 11 months. Both were discontinued during the first week of admission because Ms. R was not responding. During this admission, the treating psychiatrist assesses Ms. R using the Schedules for Clinicians' Interview in Psychiatry (SCIP), an instrument developed by the lead author (AA) for psychiatrists to use in conjunction with their routine clinical interviews in inpatient and outpatient settings (see Related Resources, page 68). The SCIP includes a 25-question screening section and a diagnostic section that consists of 7 modules that represent major psychiatric diagnoses defined by DSM and International Classification of Diseases criteria. (1) Related Resources * Schedules for Clinicians' Interview in Psychiatry (SCIP). Available from Ahmed Aboraya, ahmedaboraya@wvdhhr.org. * Valevski A, Loebl T, Keren T, et al. Response of catatonia to risperidone: two case reports. Clin Neuropharmacol. 2001;24(4):228-231. * Van Den Eede F, Van Hecke J, Van Dalfsen A, et al. The use of atypical antipsychotics in the treatment of catatonia. Eur Psychiatry. 2005;20(5-6):422-429. Drug Brand Names Haloperidol * Haldol Lithium * Eskalith, Lithobid Lorazepam * Ativan Olanzapine * Zyprexa Risperidone * Risperdal Risperidone long-acting injection * Risperdal Consta Ziprasidone * Geodon Disclosure The authors have no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products. During the first week of admission, we monitor Ms. R and administer haloperidol as needed, 10 mg total. Eight days after admission, she develops severe catatonia. On the catatonia scale of the SCIP, Ms. R scores the maximum on measures of immobility, catalepsy/waxy flexibility, and mutism (Table). Table Patient's catatonia symptoms: Response to pharmacotherapy Lorazepam Lorazepam + Risperidone Risperidone only risperidone oral only long-acting injection only Dosage(s) 7 mg total Lorazepam: 4 8 mg/d 37.5 mg over 7 mg/d every 2 days Risperidone: weeks 4 mg/d Scores on SCIP catatonia scale: * Immobility 2 1 0 0 Catalepsy/waxy 2 1 0 0 flexibility [dagger] Mutism 2 0 0 0 Total score 6 2 0 0 * Scale of 0 to 2, with 0 = none, 1 = less than half the time, and 2 = more than half the time. Symptoms are evaluated over a 1-day period [dagger] For this category, 0 = none, 1 = brief (usually 1 minute SCIP: Schedules for Clinicians' Interview in Psychiatry How would you treat Ms. R's catatonia? a) restart ziprasidone and lithium b) refer her for medical evaluation to rule out organic causes of catatonia c) prescribe a benzodiazepine d) try a different antipsychotic The authors' observations DSM-IV-TR recognizes catatonia as a schizophrenia subtype, as a descriptor for mania and major depression, and as being caused by various medical conditions, such as neuroleptic malignant syndrome, encephalopathy, or renal failure. …