Psychometric Properties of WHO’s Schedules for Clinical Assessment in Neuropsychiatry: A Systematic Review.

Psychometric Properties of WHO’s Schedules for Clinical Assessment in Neuropsychiatry: A Systematic Review. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Psychometric Properties of WHO’s Schedules for Clinical Assessment in Neuropsychiatry: A Systematic Review. Wubalem Fekadu, Awoke Mihretu, Atalay Alem, Traolach Brugha, Mark van Ommeren, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7730040/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background WHO’s Schedules for Clinical Assessment in Neuropsychiatry ( SCAN) is often used as the gold standard for psychiatric classification. We systematically reviewed studies on the psychometric properties of the SCAN to support its adaptation to the revised international classification systems. Methods We searched PubMed, PsycINFO, Embase, Global Health, and Global Index Medicus up to April 17, 2025, and contacted experts. The protocol was registered in PROSPERO (CRD42024522395). Results Titles and abstracts of 4,241 records were screened, with 296 full-text articles evaluated. Ninety-three articles were included in the final review: 46 assessing SCAN’s psychometric properties and 47 validating other measures using SCAN as a gold standard. The internal consistency of the SCAN and its predecessor, the Present State Examination (PSE), ranged from good to excellent. Both demonstrated acceptable intra-rater, inter-rater, and test-retest reliability, with reliability especially high for psychotic disorders. There was also evidence supporting concurrent, construct, semantic, and content validity, although there was an absence of evidence for predictive validity. We also found acceptable psychometric properties for the different syndrome-based sections of the SCAN. Conclusion Although recent, high-quality studies are scarce, the SCAN is a promising tool for diagnosing a variety of psychiatric issues, particularly psychotic disorders. It demonstrates established reliability and evidence of concurrent, construct, semantic, and content validity. However, there is a need to revise the current version of SCAN to align it with contemporary diagnostic systems. Additionally, further research is required, especially regarding the assessment of non-psychotic conditions. Psychiatry Psychology Schedules for Clinical Assessment in Neuropsychiatry Psychometric Properties Systematic review Figures Figure 1 Figure 2 1. Introduction Structured mental disorders’ classification instruments remain fundamental tools for mental health research and evidence-based practice. While simple self-reported symptom scales are commonly used to determine the occurrence of mental health symptoms and track the course of illness, classification tools are critical for accurately identifying illness conditions, delineating co-morbidity, and assisting in planning services and better care [ 1 ]. The Schedules for Clinical Assessment in Neuropsychiatry (SCAN) is a semi-structured World Health Organization (WHO) assessment interview tool that systematises the clinical examination, the elicitation of psychopathology to match a standard definition in a glossary, and the classification of neuropsychiatric conditions [ 2 – 4 ]. SCAN allows the identification of disorders according to standard international diagnostic systems, through accompanying algorithms that interpret the clinical descriptions or diagnostic criteria of these systems, and offers the possibility of dimensional categorization of psychopathology [ 2 ] . The development of SCAN began in the late 1950s, with the Present State Examination, and has since been revised several times. These revisions have remained true to the fundamental commitment of the SCAN to ensuring accurate assessment, systematisation, and transcultural applicability [ 3 – 6 ]. It has been translated into more than 35 languages [ 2 ] SCAN is a collection of instruments designed to assess, measure, and classify psychopathology. It consists of four main components: the Present State Examination, the Glossary of Differential Definitions, the Item Group Checklist, and the Clinical History Schedule. The Present State Examination is divided into two parts: Part One focuses on non-psychotic disorders, while Part Two addresses psychotic and cognitive disorders [ 2 ]. The SCAN offers flexibility in constructing a clinical database which is not confined to any specific nosology. This approach enables adaptability in the interview process, allowing for modifications in question order and wording based on the course of the interview. Interviewers have the freedom to explore certain lines of inquiry while bypassing others as needed. Importantly, the examiner determines the presence of symptoms rather than relying solely on the person's report. SCAN has been used in efforts to examine the manifestations and epidemiology of psychosis in the Global South [ 7 , 8 ] and for trials of interventions for people with psychosis in Africa [ 9 ]. It was also used in Indigenous Andean culture [ 10 ]. SCAN is used every seven years in England in the Adult Psychiatric Morbidity Survey (APMS) as a second-stage (confirmatory) examination in persons in the community when psychosis is suspected [ 11 ]. It is being utilized in a global study across 19 sites in 12 countries throughout Asia, Africa, the Americas, and Europe. The aim is to understand the molecular and systemic factors linking COVID-19 to both short-term and long-term neurological illnesses [ 12 ]. Although studies have evaluated the psychometric properties of SCAN [ 6 , 13 ] or some of its sections [ 14 ], there are also questions about its design, the requirement for specialized training, and the perceived unfriendliness of the format [ 1 ]. Moreover, with the availability of new diagnostic instruments since the development of the PSE (and the SCAN), for example, the Structured Clinical Interview for DSM (SCID), it is important to revisit its ongoing relevance in a way that informs the SCAN revision for ICD-11 and the broader advancement of psychiatric research enabled by technology. We conducted a systematic review to establish the psychometric properties of the various revisions of the SCAN, including its predecessor, the Present State Examination (PSE). We also profiled the studies that used the SCAN as a gold standard in validating other diagnostic and screening measures. 2. Methods We adhered to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to conduct and report this systematic review [ 15 ] and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria [ 16 ]. These guidelines cover reporting, data extraction, methodological quality criteria, and risk of bias assessment [ 17 ]. The protocol was registered on the PROSPERO International Register of Systematic Reviews (CRD42024522395). 2.1. Search strategy We searched five databases: PubMed, Embase, PsycINFO, Global Health, and Global Index Medicus. The databases were searched from the inception of each database with no language restriction up to April 17, 2024. Forward and backward searches were conducted to identify additional relevant studies. We also ‘snowballed based on recommendations of people who had published using SCAN. The search terms consisted of keywords, MeSH and Emtree terms, and vocabularies for SCAN and psychometric properties. The terms were combined with the Boolean term AND: Terms Terms for SCAN : SCAN OR SCAN 1∙0 OR SCAN 2 OR SCAN 2∙1 OR “Schedules for Clinical Assessment in Neuropsychiatry“ OR “Schedules for Clinical Assessment in Neuropsychiatry 1.0“ OR “Schedules for Clinical Assessment in Neuropsychiatry 2.0“ OR “Schedules for Clinical Assessment in Neuropsychiatry 2.1“ OR PSE OR “Present State Examination” OR “MINI SCAN” Terms for psychometric Properties : Psychometric* OR Validity OR Reliability OR "Reproducibility of Results" (Supplementary file_1). 2.2. Eligibility criteria We included studies that met the following criteria: Validation studies that reported the psychometric properties of any of the versions of the SCAN; Studies that used SCAN as a gold standard to validate other diagnostic and screening measures. 2.3. Data extraction WF and AM screened the titles and abstracts of identified records. Two reviewers (WF and AM) then independently conducted full reviews of the articles. Discrepancies were resolved with discussion. The excluded articles and reasons for exclusion were documented. The two reviewers divided the studies and extracted data, frequently discussing them when needed. The data extraction was started on May 6th 2024. The extraction sheet included: author, publication year, country, the SCAN sections assessed, participant characteristics and psychometric properties. 2.4. Risk of Bias Assessment The two reviewers assessed bias using the COSMIN checklist [ 18 ]. The tool has 10 domains of psychometric properties: tool development/adaptation procedure, content validity, structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, hypotheses testing for construct validity, and responsiveness. Items under each domain are rated as very good, adequate, doubtful, and inadequate. 2.5. Data synthesis We summarized the results of studies on SCAN's psychometric properties using descriptive statistics. We narrated the findings for domains where a statistical summary was not applicable. We narrated the profile of the studies that used SCAN as a gold standard, including the type of instrument, setting, and country. 3. Results 3.1. Study selection See Fig. 1 for the PRISMA diagram. A total of 4,241 records were included. After title and abstract screening, 3,977 articles were removed because they did not study any of the SCAN versions. Two hundred ninety-six articles were considered for full-text review, including 32 articles from experts' suggestions and hand-searched for similar articles. Out of these, 203 were not eligible for this review because the studies mainly used SCAN for diagnosing neuropsychiatric problems for prevalence or intervention studies, rather than evaluating the properties of SCAN. In total, 93 articles were included in the review: 46 assessed the psychometric properties of SCAN, while the remaining 47 articles used SCAN as a gold standard. 3.2. Study characteristics Among the 46 articles assessing the performance of SCAN, 31 articles were from high-income countries. Two were multi-county studies that included at least one low- and/or middle-income country [ 19 , 20 ]. Out of the remaining 13, nine studies were from Thailand, two were from Ethiopia, one from Turkey and one from Brazil. In these studies, SCAN and PSE were translated into more than 19 languages. The publication year ranged from 1977 to 2011 (Fig. 2). The study sample sizes ranged from eight video-recorded ratings to 1244 general population participants. These studies were conducted among participants admitted to hospitals, outpatient departments, and general population settings. Some of the studies recruited participants from more than one place. Twenty-eight studies reported on the full SCAN or PSE, while the remaining 18 studies reported on selected sections or items. Most of the studies used either trained psychiatrists, general practitioners or clinical psychologists, while some employed trainee psychiatrists, psychiatric nurses and lay interviewers (Table 1 ) Table 1 Characteristics of studies examining the psychometric properties of SCAN or PSE No Author (Year) Country (language SCAN sections Rater 1. Aboraya et al (1998) [ 53 ] USA SCAN 2·1 Psychiatrists 2. Adamowski, Kiejna, Hadryś (2006) [ 27 ] Poland (Polish) SCAN 2·1 Psychiatrists 3. Alem et al (2004) [ 39 ] Ethiopia (Amharic) SCAN 2·1 Psychiatrists 4. Andrews et al (1995) [ 54 ] Australia Anxiety & depressive disorders Clinical psychologists and psychiatrists 5. Arunpongpaisal et al (2006) [ 55 ] Thailand (Thai) Alcohol and Use of Tobacco Section Psychiatrists 6. Brugha et al (1999) [ 41 ] UK SCAN 1 Psychiatrists & lay interviewers 7. Brugha et al (1999) [ 56 ] UK Survey form Psychiatrists & lay interviewers 8. Brugha et al (2001) [ 49 ] UK SCAN Psychiatrists 9. Cheng et al (2001) [ 45 ] China/Taiwan (Mandarin) SCAN Psychiatrists 10. Compton et al (1996) [ 30 ] USA Substance use Clinicians and senior psychiatric trainees 11. Cooper et al (1977) [ 32 ] UK PSE-8 Psychiatrists vs trained non-psychiatrists (psychologist, sociologist, sociology student) 12. Easton et al (1997) [ 34 ] USA & Turkey (English & Turkish) Alcohol & drug sections Psychiatrists & psychologists 13. Fink et al (2005) [ 28 ] Denmark SCAN 2·1 Neurologists 14. Fink et al (2010) [ 29 ] Denmark SCAN 2·1 Physicians 15. Hansen et al (2002) [ 57 ] Denmark SCAN 2·1 Psychiatrists 16. Hanson 2001 [ 40 ] Denmark SCAN 2·1 Psychiatrists 17. Hesselbrock et al (1999) [ 58 ] UK Substance use Psychiatrists 18. Krisanaprakornkit et al (2006) [ 59 ] Thailand (Thai) Mood disorders section Psychiatrists 19. Krisanaprakornkit et al (2007) [ 14 ] Thailand (Thai) Anxiety disorder section Psychiatrists 20. Lesage et al (1991) [ 60 ] Cananda (French) PSE-9 Psychiatric nurses 21. Luria & Berry (1979) [ 26 ] USA PSE Psychiatrists & psychologists 22. Małyszczak et al (2002) [ 31 ] Poland SCAN 2·1 Psychiatrists 23. Maurer et al (1991) [ 5 ] Switzerland PSE-10 Not mentioned 24. Mignolli et al (1988) [ 35 ] Italy PSE-9 Psychiatrists 25. Nienhuis et al (2010) [ 33 ] Netherlands Mini-SCAN Psychiatrists and clinical psychologists 26. Paholpak et al (2006) [ 59 ] Thailand Somatoform and dissociative sections Psychiatrists 27. Paholpak et al (2008) [ 23 ] Thailand Psychotic disorder Psychiatrists 28. Paholpak et al (2010) [ 25 ] Thailand SCAN 2·1 Psychiatrists 29. Patjanasoontorn et al (2011) [ 22 ] Thailand Eating disorder Psychiatrists 30. Pitta & Blay (1997) [ 61 ] Brazil Psychosis and anxiety Psychiatrists 31. Piyavhatkul et al (2008) [ 44 ] Thailand Cognitive Psychiatrists 32. Piyavhatkul et al (2008) [ 43 ] Thailand Stress and adjustment Psychiatrists 33. Pull et al (1997) [ 42 ] Luxembourg, Greece and the US. SCAN alcohol module Psychiatrists 34. Rijnders et al (2000) [ 6 ] Netherlands PSE-10 Psychologists 35. Roca et al, (1999) [ 62 ] Spain PSE-10 Psychiatric trainees and psychologists 36. Rodgers, Mann (1986) [ 38 ] UK PSE-9 Lay interviewer 37. Schützwohl, Kallert, Jurjanz (2007) [ 13 ] Germany PSE-9:47 items from Part I of SCAN 2·1 Clinical psychologist, psychiatrist 38. Schützwohl, Kallert, Jurjanz (2007) [ 21 ] Dresden (Germany), Michalovce (Slovak Republic), Prague (Czech Republic), and Wrocław (Poland) SCAN 2·1 Clinical psychologist, psychiatrist 39. Shibre et al (2002) [ 37 ] Ethiopia (Amharic) SCAN 2·1 Psychiatrists 40. Silverstone (1993) [ 63 ] Canada SCAN Not mentioned 41. Toft et al (2005) [ 64 ] Denmark SCAN 2·1 Physicians 42. Toft et al (2010) [ 65 ] Denmark SCAN 2·1 General Practionaires 43. Ustün et al (1997) [ 20 ] Netherlands, Romania, Turkey, Greece, India, USA,, Nigeria, Luxembourg, Puerto Rico, Australia (2 cites) Substance use Not mentioned 44. Van Hout Griez (1984) [ 66 ] Netherland PSE-9 Psychiatrists 45. Vázquez-Barquero et al (1994) [ 19 ] 20 centers of different countries (Spanish) PSE-10 Not mentioned 46. Wing et al (1977) [ 3 ] UK PSE-9 Lay interviewer 3.3. Bias Assessment Out of the ten COSMIN risk of bias checklist boxes, we did not rate the first two boxes: development and content validity, as none of the studies we included evaluated these domains for PSE or SCAN. As most of the studies assessed only inter- and intra-rater reliability, we did not rate the studies for most of the boxes. We completed the checklist for studies that included information on Cronbach's alpha, test-retest reliability, concurrent validity, and structural validity. The most common issues we identified were low sample sizes, insufficient characterization of the sample, lack of reporting on the time interval between tests, and inadequate description of the comparator instrument used (Supplementary file 1). 3.4. Reliability of SCAN or PSE Our review showed that different versions of the SCAN or PSE were assessed for their reliability, including internal consistency, inter-rater reliability, intra-rater reliability, and test-retest reliability. In the studies that reported on the internal consistency of SCAN, Cronbach’s alpha values ranged from 0·55 to 0·98 [ 13 , 21 ]. This indicated good to excellent internal consistency, reflecting the coherence of different domains within SCAN and PSE. There were also studies (n = 8) that examined the intra-rater reliability (instrument administered by the same rater at a prespecified interval, for example, two weeks) of SCAN. These studies reported acceptable agreement across various items or sections of SCAN. The mean intra-rater kappa value ranged from substantial to almost perfect, although it was slightly lower (but still good) for some sections of SCAN. For somatoform and dissociative symptoms it was at 0.89, anxiety at 0.84, mood at 0.86, eating disorders at 0.76, use of alcohol at 0.82, stress and adjustment disorders at 0.94, psychosis at 0.76, cognitive impairment at 0.78, and observed behaviour, affect, and speech at 0.51. For stress and adjustment disorders and cognitive impairment, the values were between 0.65 and 0.86 [ 22 – 25 ]. The intra-class correlation coefficient (ICC) of the SCAN sections ranged from 0·84 to 0·86 [ 26 ]. The other reliability indicator was inter-rater reliability. Overall, there was acceptable agreement in most studies, although not across all settings and mental health conditions. One study indicated a significant level of difference in the parameters across the different mental health conditions: kappa for inter-rater reliability was 0.14 for neurotic disorders and 0.65 for psychotic disorders [ 27 ]. Section-level inter-rater agreement (kappa value) was also reported: somatoform or dissociative symptoms from 0.77 to 0.88 [ 28 , 29 ], anxiety at 0.79, mood at 0.80, eating disorders at 0.73, use of alcohol at 0.66, stress and adjustment disorders at 0·90, psychosis at 0.68, cognitive impairment at 0.72, and observed behaviour, affect, and speech at 0.45 [ 22 ]. For the substance use disorders section of SCAN, the kappa level of agreement was 0.69 for alcohol, 0.49 for opioids, 0.61 for cocaine and 0.5 for cannabis [ 30 ]. A high level of inter-rater agreement was observed for the classification of schizophrenia and other psychotic disorders, while a lower level of agreement was found for other mental health conditions. For example, a Kappa value of 0.36 was found for depression, compared to 0.62 for schizophrenia [ 31 ]. One study reported an overall agreement of 0.81 from live interviews and 0.96 for tape-recorded interviews [ 3 ]. Six studies assessed the test-retest reliability of SCAN or PSE. One study indicated good consistency with a correlation coefficient of 0.67 [ 3 ]. The kappa values ranged from 0.7 to 0.9 [ 20 ], indicating substantial agreement. Another study reported a kappa level from 0.24 to 0.64 [ 6 ]. Test-retest also worked better for psychotic symptoms (kappa = 0.82) than non-psychotic symptoms (kappa = 0.16) [ 32 ]. There was also a 0.90 kappa for many sections of SCAN [ 33 ]. Regarding substance use disorders, there was acceptable consistency of the SCAN across time for alcohol (0.77–0.85), opiates (0.93–0.98), cannabis (0.63–0.78), and cocaine (0.69–0.74) [ 34 ]. One study indicated a Total Disagreement Index (TDI: total number of disagreements between raters/mean number of positive ratings), and the results were low, indicating the TDI mean is 0.09 ( 0-0.31) [ 35 ]. Validity of SCAN or PSE Twenty-nine studies reported the concurrent, structural, technical, semantic or language validity of SCAN and PSE. Concurrent validity of SCAN or PSE Correlation between SCAN and clinical diagnoses using ICD-10 and DSM-IV has been found to vary, ranging from low to strong correlations [ 6 , 20 , 35 – 37 ]. It had strong or perfect agreement with a clinical diagnosis made by a nurse [ 38 ] or a trainee psychiatrist, especially for schizophrenia, but low agreement for depression [ 31 , 39 ]. Another study showed that SCAN demonstrated 100% agreement for schizophrenia, 95.3% for bipolar disorder, and 93% for depression when compared to clinical diagnoses [ 39 ]. One study reported a sensitivity of 0.38 and specificity of 0.91 for physicians at admission and a sensitivity of 0.48 and specificity of 0.87 for nurses at admission. At discharge, the sensitivity was 0.40 and the specificity was 0.89 for physicians, while for nurses, the sensitivity was 0.56 and the specificity was 0.81 [ 40 ]. The sensitivity and specificity for the psychosis section of SCAN were notably higher at 0.69 and 0.94, respectively. However, specificity was lower for other modules, such as affective disorders (0.41) and neurotic disorders (0.5) [ 27 ]. The sensitivity against ICD-10 diagnoses from various studies ranged from 0.69 to 0.95, while specificity ranged from 0.41 to 0.94 [ 27 , 41 ] Construct validity of SCAN or PSE Convergent validity between SCAN and mini-SCAN demonstrated substantial agreement [ 33 , 42 ]. Structural validity, or the extent to which SCAN and PSE scores adequately reflect the dimensionality of the constructs they aim to measure, has also been examined using exploratory factor analysis. For the PSE, the findings indicated a unidimensional structure. Many of the PSE items had high loading on the dominant factor [ 21 ], but the shared variance was small [ 38 ]. The first extracted factor accounted for 20.3% of the total variance, but the values of the second, third, and fourth factors accounted for only 5.5%, 4.5%, and 3.7%, respectively [ 38 ]. The exploratory factor analysis further indicated that SCAN effectively captures major psychiatric dimensions. In section 10, the mood disorder section factor loading ranged from 0.88 to 0.97, the depression section with a factor loading ranged from 0.89 to 0.92, and the thinking section ranged from 0.24 to 0.88 [ 21 ]. There was also substantial agreement between the different sections of SCAN and its total scores [ 42 ]. Other properties The SCAN and PSE have also demonstrated flexibility in administration, including duration of administration and practicality. The studies indicated that the duration of administration fluctuates based on the complexity of the condition and the specific section [ 35 ] being administered. The mini-SCAN interview takes about 25 minutes less than the full SCAN [ 33 ]. The alcohol module alone took about 40 minutes to administer, the stress-related disorders module took about 26 minutes [ 43 ], and 60 minutes for people with cognitive impairment [ 44 ]. On average, it took 57 minutes for somatoform and dissociative disorders [ 24 ]. In all the studies and all sections of SCAN, administering SCAN to people with impairment took longer compared to the healthy population. This was particularly the case among people with severe mental health conditions. Administering SCAN to people with schizophrenia took 140 ± 36.0 minutes, while it only took 82 ± 25.9 minutes (range 48–124 minutes for the healthy population [ 23 ]. Two studies have indicated the acceptability of SCAN [ 33 , 41 ]. Nienhuis et al. (2010) reported that 77% and 79% of the participants rated the SCAN and mini-SCAN interviews, respectively, as pleasant or very pleasant [ 33 ]. There were minimal reported difficulties in administering SCAN, especially when experience builds. Studies that reported content, semantics, languages, and content validity indicated that SCAN could be effectively translated into different languages. There were no significant concerns reported (Table 2 ). Table 2 Summary of psychometric properties of SCAN or PSE Author and Year Internal consistency*, intra-rater and Inter-rater reliability Test-retest reliability Validity Feasibility/duration of administration and acceptability Aboraya et al (1998) kappa • 0·51 − 0·9 • Total item kappa for each interviewer (0·71 − 0·79) - - - Adamowski, Kiejna, Hadryś (2006) Cohen's kappa (0 · 14 − 0 · 65) • Psychosis section (0·65) • Affective disorder (0·31) • Neurotic disorder (0·14) Yule's Y • 0·57 − 0·71 Overall sensitivity (ICD 10 diagnosis) • 0·69 − 0·95 Specificity • 0·41 − 0·94 Psychosis section • Yule's Y (0·71) • Sensitivity (0·69) • Specificity (0·94) Affective disorder • kappa (0·31) • Sensitivity (0·95) • Specificity (0·41) Neurotic disorder • Sensitivity (0·95) • Specificity (0·5) Alem et al (2004) Kappa ( Comparison of computer-assisted SCAN diagnoses and clinical diagnoses) • 100% for schizophrenia • 95·3% for bipolar • 93·0% for depression • 0·8% against the clinical diagnosis • Semantic validity established Andrews et al (1995) Interrater • CIDI (1·00) • SCAN (0·67) - Arunpongpaisal et al (2006) Inter-rater • Tobacco use disorder ( 0·84) • Alcohol use disorder (0·66) Intra-rater • Alcohol use disorder (0·82) • Tobacco use disorder (0·87) - - - Brugha et al (1999) Inter-rater • Any ICD-10 non-psychotic diagnosis (0·25) • All neurosis (0.26) • Any acute or chronic case of depression (0·13) - Overall sensitivity of CIS-R • 0·5 Specificity • 0·8 − 0·9 - Brugha et al (1999) - - Concordance for any disorder • 0.·74 (0·57, 0·91) Any specific psychotic disorder • 0·63 (0·40, 0·86) For any specific neurotic disorder • 0·63 (0·43, 0·83). Sensitivity (ICD-10) • 0·6-0.82 Specificity • 0·83 − 0·93 • No evidence of rater bias • At first, lay interviewers found SCAN quite daunting • With experience in carrying out interviews, their confidence grew and with it enthusiasm for the procedure • The SCAN trainers were happy with the progress of the lay interviewers Brugha et al (2001) Concordance of SCAN and CIDI • 0·03 − 0·48 when the CIDI preceded the SCAN • 0·33 when it followed SCAN • Mean duration of the SCAN, 34 min (15 to 75). Cheng et al. (2001) Agreement between UK & US vs Taiwanese psychiatrists • 69% for section 8 • 100% for section 11 - - - Compton et al. (1996) Diagnosis agreement • Alcohol (0·69) • Opiate (0·49) • Cocaine (0·61) • Cannabis (0·5) - - - Cooper et al. (1977) Overall interrater agreement was 0.77 • Situational anxiety (0·34) • Depersonalization (0·96) • Item level agreement of the 150 items (0·74) Test re-test (0.49) • Worry (0·16) • Relationships and ideas of reference (0·82) - - Easton et al.(1997) - ICD 10 dependence • Alcohol (0·77 − 0·85) • Opiates (0·93 − 0·98) • Cannabis (0·63 − 0·78) • Cocaine (0·69 − 0·74) - - Fink et al (2005) • Interrater agreement of kappa = 0·88 - - - Fink et al (2010) • Inter-rater agreement on the presence of/lack of a somatoform diagnosis (kappa = 0·82) among six interviewers - • - Hansen et al (2001) • Interrater agreement kappa (psychiatrists) = 0·88 - Diagnosis by physicians and nurses at Internal medicine inpatients vs SCAN diagnosis • Physicians: sensitivity (0·38) and specificity 0·91 at admission • Nurses: sensitivity (0·48) and specificity (0·87) at admission • Physicians: sensitivity (0·40) and specificity (0·89) at discharge • Nurses: sensitivity (0·56) and specificity (0·81) at discharge - Hansen et al (2002) • Interrater agreement was kappa = 0·88 (agreement on 16 of 17) - - - Hesselbrock et al (1999) SSAGA comparison with the SCAN • Alcohol dependence (0·63) • Sedative dependence (0·48) • Cannabis dependence (0·53) • Stimulant dependence (0·85) • Opioid dependence (0·73) • Major depression (0·71) - - - Krisanaprakornkit et al (2006) Intra-rater • Sections 6 (0·80) • section 7 (0·67) • Section 8 (0·78) • Section 10 (0·84) - • Some adaptations were made to words or sequences of sentences describing symptoms to make them more understandable in the Thai cultural and linguistic context - Krisanaprakornkit et al (2007) Overall inter-rater reliability • (0·79) Section 3 • (0·75) Section 4 • (0·8) Section 5 • (0·76) Intra-rater reliability (two weeks) • (0·84) - • Some adaptations were made to words or sequences of sentences describing symptoms to make them more understandable in the Thai cultural and linguistic context - Lesage et al (1991) Inter-rater • 0·75 Positive agreement rate • 0·59 − 0·69 - - - Luria & Berry (1979) Inter-rater • ICC (0·84 − 0·86) - - - Małyszczak et al (2002) Cohen's kappa • Schizophrenia (0·62) Depression (0·36) - Kappa coefficient • Block F2 (0·78) • Schizophrenia (0·62) • Block F3 (0·42) • Depression (0·36) • Low agreement between clinical and SCAN diagnosis, particularly for mood disorder - Mignolli et al (1988) The total disagreement index (TDI) • 0 · 09 (0–0 · 31) Mean serious disagreement index (SDI) • 0·04 (0–0·21) • Between interviewer and reinterviewed were 0.37 (0-1.05) and 0·21 (range 0–0·86) respectively - - - Nienhuis et al (2010) - Prevalence SCAN vs Min-SCAN • No disorder (15 vs 15) • Affective disorder (30 vs 32) • Affective psychosis (12 vs 11) • Anxiety disorder (34 vs 33) • non-affective psychosis (15 vs 15) Mini-SCAN • Sensitvity (0·67 − 0·87) • Specificity (0·92 − 0·97) • PPV (0·73 − 0·97) • NPV (0·96 − 0·97) Concurrent validity of the mini-SCAN • 0·80• • Mini-SCAN interviews were 25 minutes shorter than the SCAN • SCAN, 77% rated the interview as pleasant or very pleasant • For the mini-SCAN this percentage was 79%. Paholpak et al (2006) Kappa (inter-rater) • 0·81 − 1·0, 0·61 − 0·80 and 0·00–0·20 in 49·6%, 30·0% and 8·9% of the items respectively • Kappas could not be calculated for 11·5% of the Items The intra-rater reliabilities were • 0·81 − 1·0, 0·61 − 0·80 and 0·00–0·20 in 54·9%, 26.5% and 2·7% of the items respectively • Kappas could not be calculated for 15·9% of the Items. - • Semantic validity established • Averaged = 57·1 ± 12·1 minutes while it was 42.1 ± 13·9 minutes for a normal subject Paholpak et al (2006) Kappa (inter and intra-rater ) agreement • Somatoform and dissociative symptoms module (0·77, 0·85) • Anxiety (0·79, 0·84) • Mood (0·80, 0·86) • Eating disorders (0·73, 0·76) • Use of alcohol (0·66, 0·82) • Stress and adjustment disorders (0·90, 0.94) • Psychosis (0·68, 0·76) • Cognitive impairment (0·72, 0·78) • Observed behavior, affect and speech module (0·45, 0·51) - • Semantic validity established - Patjanasoontorn et al (2011) • Kappa of the eating disorder section 0·73, (0·68,0·77). • Mean intra-rater reliabilities (0·76; 0·70-0.82) • 68·4% & 31·58% of the items had a substantial and almost perfect kappa respectively - • Semantic validity established - Pitta & Blay (1997) - - Kappa between ICD-9 'hysteria' and 'other reactive and non-specified psychoses' and the corresponding categories and the PSE/CATEGO program - 0·03 and 0·19 - Piyavhatkul et al (2008) • Kappa (0·90 (SD = 0·12) • Item level agreement 77·05%- 85·26% - • Semantic validity established • Averaged 17·92 minutes (25·59 for people with stress-related disorders and 6.41 for normal subjects). Piyavhatkul et al (2008) • Intra-rater: mean 0·94 (SD = 0·09) • Perfect level among many items; however, three items (3·66%) had poor and nine (6·67%) only slight inter-rater agreement • Inter and intra-rater reliability of the continuous data was 0·93 and 0·96. - • Semantic validity established • Cognitive impairment or Decline Section averaged 48.99 minutes (59·71 for participants with cognitive impairment and 33·77 for normal participants) Piyavhatkul et al (2008) Mean & SD of inter-rater reliability for sections 6, 17, 18 and 19 • 0·66 ± 0·17 • 0·71 ± 0·16 • 0· 70 ± 0·22 • 0.64 ± 0·23 Intra-rater reliability • 0·65 ± 0·11 • 0·74 ± 0·17 • 0·86 ± 0·17 • 0·80 ± 0·18 • Some sections had items with 100 percent agreement from the same rater when rated 2 weeks apart. - • Semantic validity established People with schizophrenia • 140·2 ± 36·0 minutes ( 75–193) Comparison • 81·9 ± 25·9 minutes ( 48–124) Pull et al (1997) - • The SCAN and AUDADIS-ADR also agreed more closely to one another than to the CIDI in terms of the neglect of interests and the much time spent and continued use despite physical and/or psychological harm criteria. • 40·3 min to administer Rijnders et al (2000) Kappa • 0·56 • 0·24 − 0·64 • Sensitivity as well as specificity proved to be substantial to almost perfect. • The agreement per interviewer about the reference diagnoses ranged from 87% (diagnostic group) to 94% (diagnostic caseness). • Agreement on the syndrome level (without duration and interference criteria of DSM-IV) was excellent. - Roca et al, (1999) - - • Of subjects with a positive GHQ, 47% were considered ``non-cases'' on the SCAN using the ICD-10 criteria - Rodgers, Mann (1986) - - The first factor extracted accounted • 20·3% of the total variance Second, third, and fourth factors • 5·5, 4·5 and 3·7% respectively • 71·5% showed perfect agreement and 24·9% had only 1 or 2 inconsistencies. • The remaining 3·6% contained 3 or more instances of disagreement between the nurse and the standard rating - Schützwohl, Kallert, Jurjanz (2007) Cronbach a • 0·55 to 0·98* - One factor solution Section 10-mood • highest loading-0·88 − 0·97 Depression section • 0·890 to 0·92 and Section 7 thinking • 0·24 to 0·88 Acceptable face validity - Schützwohl, Kallert, Jurjanz (2007) Cronbach α • 0·50 − 0·70 for most scale and > 0·7 for a few scales - High correlation between the scales generated by PCA and the section-specific scales. SCAN sub-sections - Shibre et al (2002) • Inter-rater reliability of the SCAN was not assessed formally, but a total agreement among the interviewers in terms of SCAN cases/non-case as well as in terms of diagnostic category. - Overlap between SCAN and CIDI • 26% Semantic validity established - Silverstone (1993) - - • Significant overall correlations for DSM-III—R diagnoses between SCAN and SADS • There were no significant differences in the incidence of diagnosis for any of the diagnostic groups - Toft et al (2005) • Interrater agreement ( kappa = 0·86) - - - Toft et al (2010) • Interrater agreement ( kappa 0.·82) - - - Ustün et al (1997) - Kappa • 0·7 − 0·9 Correlation with ICD-10 and DSM-IV • Ranges from 0·36 − 0·68. - Van Hout Griez (1984) - - Correlation between subsections of PSE and Wolpe and Lazarus’ Serf Rating Scale for Assertiveness, fear Survey Schedule, Zung’s Self Rating Scale for Depression and Maudsley Obsessive Compulsive Inventory • 0·24 − 0·67. • Average 30 mins Wing et al (1977) • For tape-recorded interviews, r (0·96) • Overall agreement for all cases is (0·81) • r (0·67) • Two sets of total PSE scores (0·73) - 3.5. SCAN or PSE as a gold standard Forty-seven articles used SCAN or PSE versions to evaluate the psychometric properties of other diagnostic or screening tools. The publication year ranged from 1989 to 2023. Most of the studies, except for five (Ethiopia (n = 3), Nigeria, and South Africa), were conducted in high-income countries. A total of 31 tools were validated using SCAN or PSE as a gold standard. Of the 31, 18 were used to assess depression, while the other measures were used to assess symptoms of psychosis, anxiety, somatoform, and substance use problems. Some of the scales or assessment instruments (n = 4), such as the CIDI, were used to identify more than one psychiatric problem. These 31 measures were validated in more than 15 different languages (Supplementary file 2). 4. Discussion We aimed to systematically review the psychometric properties of the various revisions of the SCAN. We found 46 original psychometric papers on SCAN and PSE and another 47 articles that used SCAN as a gold standard to evaluate the psychometric properties of other mental health measures. Most of the studies used multiple sections of SCAN, while some used one or two sections out of the 27 sections. The internal consistency of the items in SCAN and PSE ranged from good to excellent. Additionally, both modules demonstrated acceptable intra-rater, inter-rater, and test-retest reliability. However, some studies reported percentages and mean [ 30 , 44 , 45 ] to calculate various types of reliabilities. This might introduce methodological biases and require cautious interpretation. There was also evidence supporting the concurrent, semantic, and content validity of both SCAN and PSE, though there was no evidence for predictive validity. The good to excellent internal consistency of SCAN and PSE suggests that the items effectively measure the underlying construct of psychopathology. But, internal consistency should have been calculated for each section of the SCAN or PSE, not the total score [ 46 ]. Another issue to consider is that the high internal consistency of the SCAN and PSE might be attributed to the large number of items in these scales, rather than their actual reliability [ 47 ]. High internal consistency is not an ideal indicator for tools with many items [ 46 ]. We also found acceptable agreement across various items or sections of SCAN and PSE. However, methodological concerns arise from the use of percentage agreement and Cohen’s Kappa when the studies calculated test-retest, intra-rater, and inter-rater reliability. Unlike Kappa, percentage agreement does not account for the possibility that agreement may occur by chance. Additionally, high agreement among raters on specific sections, particularly those related to schizophrenia or psychotic disorders, could positively influence the overall percentage of agreement when considering the entire SCAN and PSE. Only a few studies calculated the ICC, which is a rigorous methodology that considers total variance, including between participants, between raters, and residual error. However, these studies did not report measurement errors [ 46 ]. Although the evidence is not robust, both SCAN and PSE appear more reliable for psychotic disorders, which present with more severe, clear, and observable symptoms compared to neurotic or common mental disorders. Of interest, the strengths and weaknesses of the SCAN and instruments such as CIDI are inverse, as CIDI does not perform well for psychotic disorders [ 48 ]. This suggests that improving the sections on common mental disorders in the SCAN could be a focus for future research. As the PSE and SCAN have been translated into many languages, considerable experience has been gained. Translating concepts, not just words, and the flexibility of SCAN, allowing administrators to explain and probe, suggests its strong semantic validity [ 4 ]. Studies also showed that they were able to establish that the back-translation of SCAN and PSE into the original English is appropriate. Because SCAN is typically considered a gold standard, criterion validity has been difficult to study. Few studies have reported acceptable sensitivity and specificity of SCAN in comparison to diagnosis by clinicians, particularly for psychotic disorders as opposed to affective disorders [ 27 ]. The positive and negative predictive power of SCAN remains uncertain, as it has not been extensively studied. Correlations between SCAN and diagnosis using ICD-10 and DSM-IV were found to vary, ranging from low to strong correlation [ 6 , 20 , 36 , 37 ]. The semi-structured nature of SCAN allows flexibility for the test administrator to rephrase and probe, and the common practice of its use by highly trained mental health professionals could potentially contribute to better validity compared to other structured diagnostic tools, such as the CIDI [ 49 ]. There is a need for strong studies that report the construct validity of SCAN using factor analysis. There is only such a study which reported one dominant factor and high factor loading of the items [ 21 ]. This finding is like studies on CIDI and other diagnostic tools, which tend to be unidimensional per section [ 50 ]. Further research on the cultural invariance of SCAN is warranted, as this would facilitate cross-cultural comparisons of psychiatric disorders. SCAN is accepted and used globally [ 8 , 9 , 51 , 52 ]. Previous studies have also noted that SCAN can be effectively utilized by trained and experienced lay interviewers [ 41 ]. The computer algorithm for interpretation and its dimensional measurement capabilities are additional strengths of SCAN [ 2 ]. Conclusion Considering the methodological weakness of the studies that reported the psychometric properties of SCAN when evaluated against recently recommended standards, there is a clear need for further studies. Additionally, we couldn’t find recent studies that evaluate the psychometric properties of SCAN. Despite these limitations, SCAN continues to be a promising tool in terms of some of its psychometric properties and practical feasibility for diagnosing psychiatric disorders. The established semantics, content, along with some accepted reliability indicators, underscore its potential as a valuable diagnostic instrument. The next version of SCAN must consider its potential limitations, particularly in the non-psychotic sections. Additionally, it is important to revise the current version considering the ICD-11 and DSM-5 diagnostic systems, as the current version is based on the previous versions. Contributions MO, AF, AA, and WF conceived the study. WF, AM, AF, and AA contributed to the design of the review and the protocol development. WF and AM search the literature, data collection, and quality appraisal. All authors participated in contacting researchers who used SCAN and in retrieving some of the old publications. WF and AM drafted the manuscript. All authors revised the manuscript and approved the final manuscript. Declarations Contributions MO, AF, AA, and WF conceived the study. WF, AM, AF, and AA contributed to the design of the review and the protocol development. WF and AM search the literature, data collection, and quality appraisal. All authors participated in contacting researchers who used SCAN and in retrieving some of the old publications. WF and AM drafted the manuscript. All authors revised the manuscript and approved the final manuscript. Availability of Data and Materials The authors confirm that the data supporting the findings of this study are available in the article and its supplementary materials. Declarations of interest MVO is currently an employee of WHO, while SC is a former employee of the organization. Financial declarations WF and AM received support from WHO. WF and CH receive support from the Wellcome Trust through grants 222154/Z20/Z. CH receives support from NIHR through the NIHR Global Health Research Group on Homelessness and Mental Health in Africa (NIHR134325), using UK aid from the UK Government. CH also receives support from WT grant 223615/Z/21/Z. AM receives support from DELTAS Africa Initiative through the African Mental Health Research Initiative (AMARI) II project. The DELTAS Africa Initiative is a programme of the Science for Africa Foundation being implemented with support from Wellcome and the UK Foreign Commonwealth and Development Office (FCDO). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or WHO. For the purpose of open access, the authors have applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Author Manuscript version arising from this submission. References Sheehan DV et al (1998) The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59(20):22–33 WHO (1994) Schedules for clinical assessment in neuropsychiatry: version 2. American Psychiatric Wing J et al (1977) Reliability of the PSE used in a population study. Psychol Med 7(3):505–516 Wing JK et al (1990) SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 47(6):589–593 Maurer K et al (1985) [Experiences with Schedules for Clinical Assessment in Neuropsychiatry (SCAN) within the scope of a multicenter field study]. Schweiz Arch Neurol Psychiatr 1991. 142(3): pp. 235 – 45 Rijnders CA et al (2000) Psychometric properties of the schedules for clinical assessment in neuropsychiatry (SCAN-2.1). Soc Psychiatry Psychiatr Epidemiol 35(8):348–352 Morgan C et al (2023) Epidemiology of untreated psychoses in 3 diverse settings in the global south: The international research program on psychotic disorders in diverse settings (INTREPID II). JAMA psychiatry 80(1):40–48 Hanlon C et al (2024) Studying the context of psychoses to improve outcomes in Ethiopia (SCOPE): Protocol paper. PLoS ONE 19(5):e0293232 Hanlon C et al (2016) Task sharing for the care of severe mental disorders in a low-income country (TaSCS): study protocol for a randomised, controlled, non-inferiority trial. Trials 17:1–14 Uscamayta Ayvar M et al (2022) Non-affective psychosis in traditional Andean culture. Transcult Psychiatry, : p. 13634615221099795 Qassem T et al (2015) Prevalence of psychosis in black ethnic minorities in Britain: analysis based on three national surveys. Soc Psychiatry Psychiatr Epidemiol 50(7):1057–1064 de Erausquin GA et al (2022) Chronic neuropsychiatric sequelae of SARS-CoV-2: Protocol and methods from the Alzheimer's Association Global Consortium. Alzheimers Dement (N Y), 8(1): p. e12348 Schützwohl M, Kallert T, Jurjanz L (2007) Psychometric properties of dimensional measures derived from the latest German version of the Schedules for Clinical Assessment in Neuropsychiatry 2.1]. Nervenarzt 78(3):304–308 Krisanaprakornkit T et al (2007) The validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): anxiety disorders section. J Med Assoc Thai 90(2):341–347 Page MJ et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71 Prinsen CAC et al (2018) COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res 27(5):1147–1157 Gagnier JJ et al (2021) COSMIN reporting guideline for studies on measurement properties of patient-reported outcome measures. Qual Life Res 30(8):2197–2218 Mokkink LB et al (2018) COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures. Qual Life Res 27(5):1171–1179 Vázquez-Barquero JL et al (1994) [Development and verification of the Spanish version of the scanning system psychiatric interview (Questionnaires for clinical evaluation in neuropsychiatry]. Actas Luso Esp Neurol Psiquiatr Cienc Afines 22(3):109–120 Ustün B et al (1997) WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results. Drug Alcohol Depend 47(3):161–169 Schützwohl M, Kallert T, Jurjanz L (2007) Using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN 2.1) as a diagnostic interview providing dimensional measures: cross-national findings on the psychometric properties of psychopathology scales. Eur Psychiatry 22(4):229–238 Patjanasoontorn N, Paholpak S, Krisanaprakornkit T (2011) Validity and reliability study of the Thai version of WHO Schedules for Clinical Assessment in Neuropsychiatry: Eating Disorders Section. J Med Assoc Thai 94(4):490–497 Paholpak S et al (2008) Validity and reliability study of the Thai version of WHO schedules for clinical assessment in neuropsychiatry: sections on psychotic disorders. J Med Assoc Thai 91(3):408–416 Paholpak S et al (2006) Validity and reliability study of the Thai version of WHO SCAN: somatoform and dissociative symptoms section. J Med Assoc Thai 89(4):473–483 Paholpak S et al (2010) Validity and reliability study of the Thai version of WHO Schedules for Clinical Assessment in Neuropsychiatry version 2.1. J Med Assoc Thai 93(4):497–501 Luria RE, Berry R (1979) Reliability and descriptive validity of PSE syndromes. Arch Gen Psychiatry 36(11):1187–1195 Adamowski T, Kiejna A, Hadryś T (2006) Study of compatibility of psychiatric diagnoses with ICD-10 diagnostic criteria using the SCAN questionnaire]. Psychiatr Pol 40(4):761–773 Fink P, Hansen MS, Søndergaard L (2005) Somatoform disorders among first-time referrals to a neurology service. Psychosomatics 46(6):540–548 Fink P, Ørnbøl E, Christensen KS (2010) The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health. PLoS ONE 5(3):e9873 Compton WM et al (1996) Comparing assessments of DSM-IV substance dependence disorders using CIDI-SAM and SCAN. Drug Alcohol Depend 41(3):179–187 Małyszczak K et al (2002) [Comparison between a SCAN diagnosis and a clinical diagnosis]. Psychiatr Pol 36(6 Suppl):377–380 Cooper JE et al (1977) Further studies on interviewer training and inter-rater reliability of the Present State Examination (PSE). Psychol Med 7(3):517–523 Nienhuis FJ et al (2010) Validity of a short clinical interview for psychiatric diagnosis: the mini-SCAN. Br J Psychiatry 196(1):64–68 Easton C et al (1997) Test-retest reliability of the alcohol and drug use disorder sections of the schedules for clinical assessment in neuropsychiatry (SCAN). Drug Alcohol Depend 47(3):187–194 Mignolli G et al (1988) Inter-rater reliability of PSE-9 (full version): an Italian study. Soc Psychiatry Psychiatr Epidemiol 23:30–35 Fink P et al (1995) Psychiatric morbidity in primary public health care: a Nordic multicentre investigation. Part I: method and prevalence of psychiatric morbidity. Acta Psychiatr Scand 92(6):409–418 Shibre T et al (2002) An evaluation of two screening methods to identify cases with schizophrenia and affective disorders in a community survey in rural Ethiopia. Int J Soc Psychiatry 48(3):200–208 Rodgers B, Mann SA (1986) The reliability and validity of PSE assessments by lay interviewers: a national population survey. Psychol Med 16(3):689–700 Alem A et al (2004) Comparison of computer assisted scan diagnoses and clinical diagnoses of major mental disorders in Butajira, rural Ethiopia. Ethiop Med J 42(2):137–143 Hansen MS et al (2001) Mental disorders among internal medical inpatients: prevalence, detection, and treatment status. J Psychosom Res 50(4):199–204 Brugha TS et al (1999) Cross validation of a general population survey diagnostic interview: a comparison of CIS-R with SCAN ICD-10 diagnostic categories. Psychol Med 29(5):1029–1042 Pull CB et al (1997) Concordance between ICD-10 alcohol and drug use disorder criteria and diagnoses as measured by the AUDADIS-ADR, CIDI and SCAN: results of a cross-national study. Drug Alcohol Depend 47(3):207–216 Piyavhatkul N, Krisanaprakornkit T, Paholpak S (2008) Stress and Adjustment Disorder Section of WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN)--Thai version: validity and reliability study. J Med Assoc Thai 91(8):1263–1268 Piyavhatkul N et al (2008) Validity and reliability of WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN)-Thai version: Cognitive Impairment or Decline Section. J Med Assoc Thai 91(7):1129–1136 Cheng AT et al (2001) Cross-cultural implementation of a Chinese version of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) in Taiwan. Br J Psychiatry 178:567–572 Mokkink LB et al (2012) COSMIN checklist manual. University Medical Center, Amsterdam Meyer GJ et al (2001) Psychological testing and psychological assessment. A review of evidence and issues. Am Psychol 56(2):128–165 Cooper L, Peters L, Andrews G (1998) Validity of the Composite International Diagnostic Interview (CIDI) psychosis module in a psychiatric setting. J Psychiatr Res 32(6):361–368 Brugha TS et al (2001) A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Psychol Med 31(6):1001–1013 Gelaye B et al (2013) Diagnostic validity of the composite international diagnostic interview (CIDI) depression module in an East African population. Int J Psychiatry Med 46(4):387–405 Gureje O et al (2020) Effect of collaborative care between traditional and faith healers and primary health-care workers on psychosis outcomes in Nigeria and Ghana (COSIMPO): a cluster randomised controlled trial. Lancet 396(10251):612–622 Roberts T et al (2020) INTREPID II: protocol for a multistudy programme of research on untreated psychosis in India, Nigeria and Trinidad. BMJ open 10(6):e039004 Aboraya A et al (1998) Schedules for Clinical Assessment in Neuropsychiatry (SCAN): introduction to WV's mental health community. W V Med J 94(6):326–328 Andrews G et al (1995) A comparison of two structured diagnostic interviews: CIDI and SCAN. N Z J Psychiatry 29(1):124–132Aust Arunpongpaisal S et al (2006) Inter- and intra-rater reliability of the Thai version of SCAN: Use of Alcohol and Use of Tobacco Section. J Med Assoc Thai 89(12):2129–2137 Brugha TS et al (1999) The survey form of SCAN: the feasibility of using experienced lay survey interviewers to administer a semi-structured systematic clinical assessment of psychotic and non-psychotic disorders. Psychol Med 29(3):703–711 Hansen MS et al (2002) Use of health services, mental illness, and self-rated disability and health in medical inpatients. Psychosom Med 64(4):668–675 Hesselbrock M et al (1999) A validity study of the SSAGA-a comparison with the SCAN. Addiction 94(9):1361–1370 Krisanaprakornkit T, Paholpak S, Piyavhatkul N (2006) The validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): Mood Disorders Section. J Med Assoc Thai 89(2):205–211 Lesage AD, Cyr M, Toupin J (1991) Reliable use of the Present State Examination by psychiatric nurses for clinical studies of psychotic and nonpsychotic patients. Acta psychiatrica Scandinavica 83(2):121–124 Pitta JC, Blay SL (1997) Psychogenic (reactive) and hysterical psychoses: a cross-system reliability study , in Acta psychiatrica Scandinavica . United States, pp 112–118 Roca M et al (1999) Mental disorders on the island of Formentera: prevalence in general population using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Soc Psychiatry Psychiatr Epidemiol 34(8):410–415 Silverstone PH (1993) SCAN accurately gives diagnoses according to DSM-III—R criteria: Validation in psychiatric patients using SADS. International Journal of Methods in Psychiatric Research Toft T et al (2005) Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study. Psychol Med 35(8):1175–1184 Toft T et al (2010) Training general practitioners in the treatment of functional somatic symptoms: effects on patient health in a cluster-randomised controlled trial (the Functional Illness in Primary Care study). Psychother Psychosom 79(4):227–237 van den Hout MA, Griez E (1984) Validity and utility of the present state examination in assessing neurosis: empirical findings and critical considerations. J Psychiatr Res 18(2):161–172 Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryfileSearchstrategy.docx Search strategy Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7730040","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":521579145,"identity":"ff22e3f5-ae31-4e40-8e72-2e09bb7b8e1a","order_by":0,"name":"Wubalem Fekadu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABD0lEQVRIiWNgGAWjYFACHgaGB0CKvYENxLaBC+LXkgCiDoC1pCG04NaGquUwYS0GN3IPfkio2MbAw96W+OFt23l5/hkJjA/etjHI2ePUkpcskXDmNgMPz7HDknPbbhvOuJHAbDi3jcEYly1mN3IMJBLbbjPYS6Q3SPO23WZsuJHABmQwJPbg1mL8I/Ef0Bb5582/edvO2c+/kcAOZDDU49FiJpHYANQiwXYMaPiBxA1AW5iBWhJwOcz+zLs0i4Rjt3l4eNLSLOecS07eeOZhs+SccxKGPQewa5Fszz1840PNbTke9mPGN96U2dnOO5588MObMht59gYc1kABsisYQWol8KsfBaNgFIyCUYAXAAAOJlsxy98Z2wAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0001-7418-4955","institution":"Addis Ababa University","correspondingAuthor":true,"prefix":"","firstName":"Wubalem","middleName":"","lastName":"Fekadu","suffix":""},{"id":521581367,"identity":"f2067f03-feeb-4488-8cc7-b0a6fcada330","order_by":1,"name":"Awoke Mihretu","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Awoke","middleName":"","lastName":"Mihretu","suffix":""},{"id":521581368,"identity":"88505354-d544-4491-84ae-a6d27ba9fd27","order_by":2,"name":"Atalay Alem","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Atalay","middleName":"","lastName":"Alem","suffix":""},{"id":521581369,"identity":"3ed92783-9aca-4845-b234-1cdf453d22f9","order_by":3,"name":"Traolach Brugha","email":"","orcid":"","institution":"University of Leicester, Leicester, UK","correspondingAuthor":false,"prefix":"","firstName":"Traolach","middleName":"","lastName":"Brugha","suffix":""},{"id":521581370,"identity":"ce8df3fc-cc95-4fed-bb8b-fc75b4b52401","order_by":4,"name":"Mark van Ommeren","email":"","orcid":"","institution":"World Health Organization","correspondingAuthor":false,"prefix":"","firstName":"Mark","middleName":"van","lastName":"Ommeren","suffix":""},{"id":521581371,"identity":"3ed219ac-e344-496a-8bac-0a367df488b7","order_by":5,"name":"Somnath Chatterji","email":"","orcid":"","institution":"World Health Organization","correspondingAuthor":false,"prefix":"","firstName":"Somnath","middleName":"","lastName":"Chatterji","suffix":""},{"id":521581372,"identity":"b2384cd4-64c2-4453-a1ab-365a06afab89","order_by":6,"name":"Charlotte Hanlon","email":"","orcid":"","institution":"University of Edinburgh","correspondingAuthor":false,"prefix":"","firstName":"Charlotte","middleName":"","lastName":"Hanlon","suffix":""},{"id":521581373,"identity":"aa8225ab-8438-49d8-92fd-b1945993f74d","order_by":7,"name":"Abebaw Fekadu","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Abebaw","middleName":"","lastName":"Fekadu","suffix":""}],"badges":[],"createdAt":"2025-09-27 18:17:32","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7730040/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7730040/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":92491905,"identity":"406cf886-cdb9-4cce-84b9-b9ac6cbce6db","added_by":"auto","created_at":"2025-09-30 09:43:17","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":203861,"visible":true,"origin":"","legend":"","description":"","filename":"SCANreviewmainmanuscriptSPPE.docx","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/e68758c0e26d68706ec1a0a4.docx"},{"id":92492618,"identity":"4c554fdc-32e8-447e-a06d-6b6af1c306fe","added_by":"auto","created_at":"2025-09-30 09:51:17","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":342,"visible":true,"origin":"","legend":"","description":"","filename":"rs7730040.json","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/c7da858fda5d0d92740d8b4e.json"},{"id":92491910,"identity":"274752e5-efd8-4823-a60a-3e2bec73cbec","added_by":"auto","created_at":"2025-09-30 09:43:17","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":177014,"visible":true,"origin":"","legend":"","description":"","filename":"rs77300400enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/d0d6dcce5eaa2c83967e5d47.xml"},{"id":92491912,"identity":"d9c179ce-44cc-4344-8cec-caec56252bb5","added_by":"auto","created_at":"2025-09-30 09:43:17","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":174645,"visible":true,"origin":"","legend":"","description":"","filename":"rs77300400structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/f7a960e63465a4f0c1334c1a.xml"},{"id":92492619,"identity":"83ef4e77-9a39-4b1e-822d-9e671e4e91d4","added_by":"auto","created_at":"2025-09-30 09:51:17","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":187828,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/3ee1e47c1ad0aeb04ae6a961.html"},{"id":92491907,"identity":"b4f7faf5-50dc-45e9-b65f-bffa72533c26","added_by":"auto","created_at":"2025-09-30 09:43:17","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":520049,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e","description":"","filename":"Figure1PRISMAflowdiagramofthestudyselectionprocess.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/ec24ca903ec54b3ee74103c1.jpg"},{"id":92491909,"identity":"99805a89-e986-4d51-8e05-c7a8fc09d4ac","added_by":"auto","created_at":"2025-09-30 09:43:17","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":184690,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"Figure2CountrieswhereSCANhasbeenused.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/c2c26d0082b118f69f1cfd63.jpg"},{"id":92493613,"identity":"81777c29-7a70-48a9-b62e-a3e00009eaa1","added_by":"auto","created_at":"2025-09-30 09:59:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3270622,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/025c8254-9b0e-4511-b050-1fa61cfa5c9b.pdf"},{"id":92491906,"identity":"a418de15-c9fb-453a-b0c8-82cf78520515","added_by":"auto","created_at":"2025-09-30 09:43:17","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":61038,"visible":true,"origin":"","legend":"\u003cp\u003eSearch strategy\u003c/p\u003e","description":"","filename":"SupplementaryfileSearchstrategy.docx","url":"https://assets-eu.researchsquare.com/files/rs-7730040/v1/18c8fd163fea28ff155aa455.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003ePsychometric Properties of WHO’s Schedules for Clinical Assessment in Neuropsychiatry: A Systematic Review.\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eStructured mental disorders\u0026rsquo; classification instruments remain fundamental tools for mental health research and evidence-based practice. While simple self-reported symptom scales are commonly used to determine the occurrence of mental health symptoms and track the course of illness, classification tools are critical for accurately identifying illness conditions, delineating co-morbidity, and assisting in planning services and better care [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe Schedules for Clinical Assessment in Neuropsychiatry (SCAN) is a semi-structured World Health Organization (WHO) assessment interview tool that systematises the clinical examination, the elicitation of psychopathology to match a standard definition in a glossary, and the classification of neuropsychiatric conditions [\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. SCAN allows the identification of disorders according to standard international diagnostic systems, through accompanying algorithms that interpret the clinical descriptions or diagnostic criteria of these systems, and offers the possibility of dimensional categorization of psychopathology [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] .\u003c/p\u003e\u003cp\u003eThe development of SCAN began in the late 1950s, with the Present State Examination, and has since been revised several times. These revisions have remained true to the fundamental commitment of the SCAN to ensuring accurate assessment, systematisation, and transcultural applicability [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. It has been translated into more than 35 languages [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eSCAN is a collection of instruments designed to assess, measure, and classify psychopathology. It consists of four main components: the Present State Examination, the Glossary of Differential Definitions, the Item Group Checklist, and the Clinical History Schedule. The Present State Examination is divided into two parts: Part One focuses on non-psychotic disorders, while Part Two addresses psychotic and cognitive disorders [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe SCAN offers flexibility in constructing a clinical database which is not confined to any specific nosology. This approach enables adaptability in the interview process, allowing for modifications in question order and wording based on the course of the interview. Interviewers have the freedom to explore certain lines of inquiry while bypassing others as needed. Importantly, the examiner determines the presence of symptoms rather than relying solely on the person's report.\u003c/p\u003e\u003cp\u003eSCAN has been used in efforts to examine the manifestations and epidemiology of psychosis in the Global South [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] and for trials of interventions for people with psychosis in Africa [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. It was also used in Indigenous Andean culture [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. SCAN is used every seven years in England in the Adult Psychiatric Morbidity Survey (APMS) as a second-stage (confirmatory) examination in persons in the community when psychosis is suspected [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIt is being utilized in a global study across 19 sites in 12 countries throughout Asia, Africa, the Americas, and Europe. The aim is to understand the molecular and systemic factors linking COVID-19 to both short-term and long-term neurological illnesses [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Although studies have evaluated the psychometric properties of SCAN [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] or some of its sections [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], there are also questions about its design, the requirement for specialized training, and the perceived unfriendliness of the format [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Moreover, with the availability of new diagnostic instruments since the development of the PSE (and the SCAN), for example, the Structured Clinical Interview for DSM (SCID), it is important to revisit its ongoing relevance in a way that informs the SCAN revision for ICD-11 and the broader advancement of psychiatric research enabled by technology.\u003c/p\u003e\u003cp\u003e We conducted a systematic review to establish the psychometric properties of the various revisions of the SCAN, including its predecessor, the Present State Examination (PSE). We also profiled the studies that used the SCAN as a gold standard in validating other diagnostic and screening measures.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003eWe adhered to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to conduct and report this systematic review [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These guidelines cover reporting, data extraction, methodological quality criteria, and risk of bias assessment [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The protocol was registered on the PROSPERO International Register of Systematic Reviews (CRD42024522395).\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Search strategy\u003c/h2\u003e\u003cp\u003eWe searched five databases: PubMed, Embase, PsycINFO, Global Health, and Global Index Medicus. The databases were searched from the inception of each database with no language restriction up to April 17, 2024. Forward and backward searches were conducted to identify additional relevant studies. We also \u0026lsquo;snowballed based on recommendations of people who had published using SCAN. The search terms consisted of keywords, MeSH and Emtree terms, and vocabularies for SCAN and psychometric properties. The terms were combined with the Boolean term AND:\u003c/p\u003e\u003cp\u003e\u003cb\u003eTerms\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eTerms for SCAN\u003c/b\u003e: SCAN OR SCAN 1∙0 OR SCAN 2 OR SCAN 2∙1 OR \u0026ldquo;Schedules for Clinical Assessment in Neuropsychiatry\u0026ldquo; OR \u0026ldquo;Schedules for Clinical Assessment in Neuropsychiatry 1.0\u0026ldquo; OR \u0026ldquo;Schedules for Clinical Assessment in Neuropsychiatry 2.0\u0026ldquo; OR \u0026ldquo;Schedules for Clinical Assessment in Neuropsychiatry 2.1\u0026ldquo; OR PSE OR \u0026ldquo;Present State Examination\u0026rdquo; OR \u0026ldquo;MINI SCAN\u0026rdquo;\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eTerms for psychometric Properties\u003c/b\u003e: Psychometric* OR Validity OR Reliability OR \"Reproducibility of Results\" (Supplementary file_1).\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2. Eligibility criteria\u003c/h2\u003e\u003cp\u003eWe included studies that met the following criteria:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eValidation studies that reported the psychometric properties of any of the versions of the SCAN;\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eStudies that used SCAN as a gold standard to validate other diagnostic and screening measures.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3. Data extraction\u003c/h2\u003e\u003cp\u003eWF and AM screened the titles and abstracts of identified records. Two reviewers (WF and AM) then independently conducted full reviews of the articles. Discrepancies were resolved with discussion. The excluded articles and reasons for exclusion were documented. The two reviewers divided the studies and extracted data, frequently discussing them when needed. The data extraction was started on May 6th 2024. The extraction sheet included: author, publication year, country, the SCAN sections assessed, participant characteristics and psychometric properties.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4. Risk of Bias Assessment\u003c/h2\u003e\u003cp\u003eThe two reviewers assessed bias using the COSMIN checklist [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The tool has 10 domains of psychometric properties: tool development/adaptation procedure, content validity, structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, hypotheses testing for construct validity, and responsiveness. Items under each domain are rated as very good, adequate, doubtful, and inadequate.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5. Data synthesis\u003c/h2\u003e\u003cp\u003eWe summarized the results of studies on SCAN's psychometric properties using descriptive statistics. We narrated the findings for domains where a statistical summary was not applicable. We narrated the profile of the studies that used SCAN as a gold standard, including the type of instrument, setting, and country.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.1. Study selection\u003c/h2\u003e\u003cp\u003eSee Fig.\u0026nbsp;1 for the PRISMA diagram. A total of 4,241 records were included. After title and abstract screening, 3,977 articles were removed because they did not study any of the SCAN versions. Two hundred ninety-six articles were considered for full-text review, including 32 articles from experts' suggestions and hand-searched for similar articles. Out of these, 203 were not eligible for this review because the studies mainly used SCAN for diagnosing neuropsychiatric problems for prevalence or intervention studies, rather than evaluating the properties of SCAN. In total, 93 articles were included in the review: 46 assessed the psychometric properties of SCAN, while the remaining 47 articles used SCAN as a gold standard.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.2. Study characteristics\u003c/h2\u003e\u003cp\u003eAmong the 46 articles assessing the performance of SCAN, 31 articles were from high-income countries. Two were multi-county studies that included at least one low- and/or middle-income country [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Out of the remaining 13, nine studies were from Thailand, two were from Ethiopia, one from Turkey and one from Brazil. In these studies, SCAN and PSE were translated into more than 19 languages. The publication year ranged from 1977 to 2011 (Fig.\u0026nbsp;2).\u003c/p\u003e\u003cp\u003eThe study sample sizes ranged from eight video-recorded ratings to 1244 general population participants. These studies were conducted among participants admitted to hospitals, outpatient departments, and general population settings. Some of the studies recruited participants from more than one place.\u003c/p\u003e\u003cp\u003eTwenty-eight studies reported on the full SCAN or PSE, while the remaining 18 studies reported on selected sections or items. Most of the studies used either trained psychiatrists, general practitioners or clinical psychologists, while some employed trainee psychiatrists, psychiatric nurses and lay interviewers (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of studies examining the psychometric properties of SCAN or PSE\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAuthor (Year)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCountry (language\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN sections\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRater\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAboraya et al (1998) [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAdamowski, Kiejna, Hadryś (2006) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePoland (Polish)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAlem et al (2004) [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEthiopia (Amharic)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAndrews et al (1995) [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAustralia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAnxiety \u0026amp; depressive disorders\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eClinical psychologists and psychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eArunpongpaisal et al (2006) [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand (Thai)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAlcohol and Use of Tobacco Section\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBrugha et al (1999) [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists \u0026amp; lay interviewers\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBrugha et al (1999) [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSurvey form\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists \u0026amp; lay interviewers\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBrugha et al (2001) [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCheng et al (2001) [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eChina/Taiwan (Mandarin)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCompton et al (1996) [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSubstance use\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eClinicians and senior psychiatric trainees\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCooper et al (1977) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists vs trained non-psychiatrists (psychologist, sociologist, sociology student)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEaston et al (1997) [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUSA \u0026amp; Turkey (English \u0026amp; Turkish)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAlcohol \u0026amp; drug sections\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists \u0026amp; psychologists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFink et al (2005) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDenmark\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNeurologists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFink et al (2010) [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDenmark\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePhysicians\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHansen et al (2002) [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDenmark\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHanson 2001 [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDenmark\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHesselbrock et al (1999) [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSubstance use\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKrisanaprakornkit et al (2006) [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand (Thai)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMood disorders section\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e19.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKrisanaprakornkit et al (2007) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand (Thai)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAnxiety disorder section\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLesage et al (1991) [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCananda (French)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatric nurses\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e21.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLuria \u0026amp; Berry (1979) [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists \u0026amp; psychologists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e22.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMałyszczak et al (2002) [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePoland\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e23.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaurer et al (1991) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSwitzerland\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNot mentioned\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e24.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMignolli et al (1988) [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eItaly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e25.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNienhuis et al (2010) [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNetherlands\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMini-SCAN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists and clinical psychologists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePaholpak et al (2006) [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSomatoform and dissociative sections\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e27.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePaholpak et al (2008) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePsychotic disorder\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e28.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePaholpak et al (2010) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e29.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePatjanasoontorn et al (2011) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEating disorder\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePitta \u0026amp; Blay (1997) [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBrazil\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePsychosis and anxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e31.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePiyavhatkul et al (2008) [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCognitive\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e32.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePiyavhatkul et al (2008) [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStress and adjustment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e33.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePull et al (1997) [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLuxembourg, Greece and the US.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN alcohol module\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e34.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRijnders et al (2000) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNetherlands\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychologists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e35.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRoca et al, (1999) [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSpain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatric trainees and psychologists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e36.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRodgers, Mann (1986) [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLay interviewer\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e37.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSch\u0026uuml;tzwohl, Kallert, Jurjanz (2007) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGermany\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-9:47 items from Part I of SCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eClinical psychologist, psychiatrist\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e38.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSch\u0026uuml;tzwohl, Kallert, Jurjanz (2007) [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDresden (Germany), Michalovce (Slovak Republic), Prague (Czech Republic), and Wrocław (Poland)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eClinical psychologist, psychiatrist\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e39.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eShibre et al (2002) [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEthiopia (Amharic)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e40.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSilverstone (1993) [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCanada\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNot mentioned\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e41.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eToft et al (2005) [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDenmark\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePhysicians\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e42.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eToft et al (2010) [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDenmark\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSCAN 2\u0026middot;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGeneral Practionaires\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e43.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUst\u0026uuml;n et al (1997) [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNetherlands, Romania, Turkey, Greece, India, USA,, Nigeria, Luxembourg, Puerto Rico, Australia (2 cites)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSubstance use\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNot mentioned\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e44.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVan Hout Griez (1984) [\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNetherland\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychiatrists\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eV\u0026aacute;zquez-Barquero et al (1994) [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20 centers of different countries (Spanish)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNot mentioned\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e46.\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWing et al (1977) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePSE-9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLay interviewer\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.3. Bias Assessment\u003c/h2\u003e\u003cp\u003eOut of the ten COSMIN risk of bias checklist boxes, we did not rate the first two boxes: development and content validity, as none of the studies we included evaluated these domains for PSE or SCAN.\u003c/p\u003e\u003cp\u003eAs most of the studies assessed only inter- and intra-rater reliability, we did not rate the studies for most of the boxes. We completed the checklist for studies that included information on Cronbach's alpha, test-retest reliability, concurrent validity, and structural validity. The most common issues we identified were low sample sizes, insufficient characterization of the sample, lack of reporting on the time interval between tests, and inadequate description of the comparator instrument used (Supplementary file 1).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.4. Reliability of SCAN or PSE\u003c/h2\u003e\u003cp\u003e Our review showed that different versions of the SCAN or PSE were assessed for their reliability, including internal consistency, inter-rater reliability, intra-rater reliability, and test-retest reliability.\u003c/p\u003e\u003cp\u003eIn the studies that reported on the internal consistency of SCAN, Cronbach\u0026rsquo;s alpha values ranged from 0\u0026middot;55 to 0\u0026middot;98 [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. This indicated good to excellent internal consistency, reflecting the coherence of different domains within SCAN and PSE.\u003c/p\u003e\u003cp\u003eThere were also studies (n\u0026thinsp;=\u0026thinsp;8) that examined the intra-rater reliability (instrument administered by the same rater at a prespecified interval, for example, two weeks) of SCAN. These studies reported acceptable agreement across various items or sections of SCAN.\u003c/p\u003e\u003cp\u003eThe mean intra-rater kappa value ranged from substantial to almost perfect, although it was slightly lower (but still good) for some sections of SCAN. For somatoform and dissociative symptoms it was at 0.89, anxiety at 0.84, mood at 0.86, eating disorders at 0.76, use of alcohol at 0.82, stress and adjustment disorders at 0.94, psychosis at 0.76, cognitive impairment at 0.78, and observed behaviour, affect, and speech at 0.51. For stress and adjustment disorders and cognitive impairment, the values were between 0.65 and 0.86 [\u003cspan additionalcitationids=\"CR23 CR24\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The intra-class correlation coefficient (ICC) of the SCAN sections ranged from 0\u0026middot;84 to 0\u0026middot;86 [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe other reliability indicator was inter-rater reliability. Overall, there was acceptable agreement in most studies, although not across all settings and mental health conditions. One study indicated a significant level of difference in the parameters across the different mental health conditions: kappa for inter-rater reliability was 0.14 for neurotic disorders and 0.65 for psychotic disorders [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSection-level inter-rater agreement (kappa value) was also reported: somatoform or dissociative symptoms from 0.77 to 0.88 [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], anxiety at 0.79, mood at 0.80, eating disorders at 0.73, use of alcohol at 0.66, stress and adjustment disorders at 0\u0026middot;90, psychosis at 0.68, cognitive impairment at 0.72, and observed behaviour, affect, and speech at 0.45 [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. For the substance use disorders section of SCAN, the kappa level of agreement was 0.69 for alcohol, 0.49 for opioids, 0.61 for cocaine and 0.5 for cannabis [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eA high level of inter-rater agreement was observed for the classification of schizophrenia and other psychotic disorders, while a lower level of agreement was found for other mental health conditions. For example, a Kappa value of 0.36 was found for depression, compared to 0.62 for schizophrenia [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. One study reported an overall agreement of 0.81 from live interviews and 0.96 for tape-recorded interviews [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSix studies assessed the test-retest reliability of SCAN or PSE. One study indicated good consistency with a correlation coefficient of 0.67 [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The kappa values ranged from 0.7 to 0.9 [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], indicating substantial agreement. Another study reported a kappa level from 0.24 to 0.64 [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Test-retest also worked better for psychotic symptoms (kappa\u0026thinsp;=\u0026thinsp;0.82) than non-psychotic symptoms (kappa\u0026thinsp;=\u0026thinsp;0.16) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. There was also a 0.90 kappa for many sections of SCAN [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eRegarding substance use disorders, there was acceptable consistency of the SCAN across time for alcohol (0.77\u0026ndash;0.85), opiates (0.93\u0026ndash;0.98), cannabis (0.63\u0026ndash;0.78), and cocaine (0.69\u0026ndash;0.74) [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. One study indicated a Total Disagreement Index (TDI: total number of disagreements between raters/mean number of positive ratings), and the results were low, indicating the TDI mean is 0.09 ( 0-0.31) [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eValidity of SCAN or PSE\u003c/p\u003e\u003cp\u003eTwenty-nine studies reported the concurrent, structural, technical, semantic or language validity of SCAN and PSE.\u003c/p\u003e\u003cp\u003eConcurrent validity of SCAN or PSE\u003c/p\u003e\u003cp\u003eCorrelation between SCAN and clinical diagnoses using ICD-10 and DSM-IV has been found to vary, ranging from low to strong correlations [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. It had strong or perfect agreement with a clinical diagnosis made by a nurse [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e] or a trainee psychiatrist, especially for schizophrenia, but low agreement for depression [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Another study showed that SCAN demonstrated 100% agreement for schizophrenia, 95.3% for bipolar disorder, and 93% for depression when compared to clinical diagnoses [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOne study reported a sensitivity of 0.38 and specificity of 0.91 for physicians at admission and a sensitivity of 0.48 and specificity of 0.87 for nurses at admission. At discharge, the sensitivity was 0.40 and the specificity was 0.89 for physicians, while for nurses, the sensitivity was 0.56 and the specificity was 0.81 [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe sensitivity and specificity for the psychosis section of SCAN were notably higher at 0.69 and 0.94, respectively. However, specificity was lower for other modules, such as affective disorders (0.41) and neurotic disorders (0.5) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The sensitivity against ICD-10 diagnoses from various studies ranged from 0.69 to 0.95, while specificity ranged from 0.41 to 0.94 [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eConstruct validity of SCAN or PSE\u003c/p\u003e\u003cp\u003eConvergent validity between SCAN and mini-SCAN demonstrated substantial agreement [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Structural validity, or the extent to which SCAN and PSE scores adequately reflect the dimensionality of the constructs they aim to measure, has also been examined using exploratory factor analysis.\u003c/p\u003e\u003cp\u003eFor the PSE, the findings indicated a unidimensional structure. Many of the PSE items had high loading on the dominant factor [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], but the shared variance was small [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The first extracted factor accounted for 20.3% of the total variance, but the values of the second, third, and fourth factors accounted for only 5.5%, 4.5%, and 3.7%, respectively [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The exploratory factor analysis further indicated that SCAN effectively captures major psychiatric dimensions. In section 10, the mood disorder section factor loading ranged from 0.88 to 0.97, the depression section with a factor loading ranged from 0.89 to 0.92, and the thinking section ranged from 0.24 to 0.88 [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. There was also substantial agreement between the different sections of SCAN and its total scores [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOther properties\u003c/p\u003e\u003cp\u003eThe SCAN and PSE have also demonstrated flexibility in administration, including duration of administration and practicality. The studies indicated that the duration of administration fluctuates based on the complexity of the condition and the specific section [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] being administered. The mini-SCAN interview takes about 25 minutes less than the full SCAN [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe alcohol module alone took about 40 minutes to administer, the stress-related disorders module took about 26 minutes [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e], and 60 minutes for people with cognitive impairment [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. On average, it took 57 minutes for somatoform and dissociative disorders [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn all the studies and all sections of SCAN, administering SCAN to people with impairment took longer compared to the healthy population. This was particularly the case among people with severe mental health conditions. Administering SCAN to people with schizophrenia took 140\u0026thinsp;\u0026plusmn;\u0026thinsp;36.0 minutes, while it only took 82\u0026thinsp;\u0026plusmn;\u0026thinsp;25.9 minutes (range 48\u0026ndash;124 minutes for the healthy population [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eTwo studies have indicated the acceptability of SCAN [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Nienhuis et al. (2010) reported that 77% and 79% of the participants rated the SCAN and mini-SCAN interviews, respectively, as pleasant or very pleasant [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. There were minimal reported difficulties in administering SCAN, especially when experience builds.\u003c/p\u003e\u003cp\u003eStudies that reported content, semantics, languages, and content validity indicated that SCAN could be effectively translated into different languages. There were no significant concerns reported (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSummary of psychometric properties of SCAN or PSE\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAuthor and Year\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInternal consistency*, intra-rater and Inter-rater reliability\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTest-retest reliability\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eValidity\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFeasibility/duration of administration and acceptability\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAboraya et al (1998)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003ekappa\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;51\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;9\u003c/p\u003e\u003cp\u003e\u0026bull; Total item kappa for each interviewer (0\u0026middot;71\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdamowski, Kiejna, Hadryś (2006)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCohen's kappa (0\u003c/b\u003e\u0026middot;\u003cb\u003e14\u0026thinsp;\u0026minus;\u0026thinsp;0\u003c/b\u003e\u0026middot;\u003cb\u003e65)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Psychosis section (0\u0026middot;65)\u003c/p\u003e\u003cp\u003e\u0026bull; Affective disorder (0\u0026middot;31)\u003c/p\u003e\u003cp\u003e\u0026bull; Neurotic disorder (0\u0026middot;14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eYule's Y\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;57\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;71\u003c/p\u003e\u003cp\u003e\u003cb\u003eOverall sensitivity (ICD 10 diagnosis)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;69\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;95\u003c/p\u003e\u003cp\u003e\u003cb\u003eSpecificity\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;41\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;94\u003c/p\u003e\u003cp\u003e\u003cb\u003ePsychosis section\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Yule's Y (0\u0026middot;71)\u003c/p\u003e\u003cp\u003e\u0026bull; Sensitivity (0\u0026middot;69)\u003c/p\u003e\u003cp\u003e\u0026bull; Specificity (0\u0026middot;94)\u003c/p\u003e\u003cp\u003e\u003cb\u003eAffective disorder\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; kappa (0\u0026middot;31)\u003c/p\u003e\u003cp\u003e\u0026bull; Sensitivity (0\u0026middot;95)\u003c/p\u003e\u003cp\u003e\u0026bull; Specificity (0\u0026middot;41)\u003c/p\u003e\u003cp\u003e\u003cb\u003eNeurotic disorder\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Sensitivity (0\u0026middot;95)\u003c/p\u003e\u003cp\u003e\u0026bull; Specificity (0\u0026middot;5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlem et al (2004)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eKappa (\u003c/b\u003eComparison of computer-assisted SCAN diagnoses and clinical diagnoses)\u003c/p\u003e\u003cp\u003e\u0026bull; 100% for schizophrenia\u003c/p\u003e\u003cp\u003e\u0026bull; 95\u0026middot;3% for bipolar\u003c/p\u003e\u003cp\u003e\u0026bull; 93\u0026middot;0% for depression\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;8% against the clinical diagnosis\u003c/p\u003e\u003cp\u003e\u0026bull; Semantic validity established\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAndrews et al (1995)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eInterrater\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; CIDI (1\u0026middot;00)\u003c/p\u003e\u003cp\u003e\u0026bull; SCAN (0\u0026middot;67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eArunpongpaisal et al (2006)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eInter-rater\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Tobacco use disorder ( 0\u0026middot;84)\u003c/p\u003e\u003cp\u003e\u0026bull; Alcohol use disorder (0\u0026middot;66)\u003c/p\u003e\u003cp\u003e\u003cb\u003eIntra-rater\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Alcohol use disorder (0\u0026middot;82)\u003c/p\u003e\u003cp\u003e\u0026bull; Tobacco use disorder (0\u0026middot;87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBrugha et al (1999)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eInter-rater\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Any ICD-10 non-psychotic diagnosis (0\u0026middot;25)\u003c/p\u003e\u003cp\u003e\u0026bull; All neurosis (0.26)\u003c/p\u003e\u003cp\u003e\u0026bull; Any acute or chronic case of depression\u003c/p\u003e\u003cp\u003e(0\u0026middot;13)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eOverall\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003esensitivity of CIS-R\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;5\u003c/p\u003e\u003cp\u003e\u003cb\u003eSpecificity\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;8\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBrugha et al (1999)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eConcordance for any disorder\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0.\u0026middot;74 (0\u0026middot;57, 0\u0026middot;91)\u003c/p\u003e\u003cp\u003e\u003cb\u003eAny specific psychotic disorder\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;63 (0\u0026middot;40, 0\u0026middot;86)\u003c/p\u003e\u003cp\u003e\u003cb\u003eFor any specific neurotic disorder\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;63 (0\u0026middot;43, 0\u0026middot;83).\u003c/p\u003e\u003cp\u003e\u003cb\u003eSensitivity (ICD-10)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;6-0.82\u003c/p\u003e\u003cp\u003e\u003cb\u003eSpecificity\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;83\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;93\u003c/p\u003e\u003cp\u003e\u0026bull; No evidence of rater bias\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026bull; At first, lay interviewers found SCAN quite daunting\u003c/p\u003e\u003cp\u003e\u0026bull; With experience in carrying out interviews, their confidence grew and with it enthusiasm for the procedure\u003c/p\u003e\u003cp\u003e\u0026bull; The SCAN trainers were happy with the progress of the lay interviewers\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBrugha et al (2001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eConcordance of SCAN and CIDI\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;03\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;48 when the CIDI preceded the SCAN\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;33 when it followed SCAN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026bull; Mean duration of the SCAN, 34 min (15 to 75).\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCheng et al. (2001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAgreement between UK \u0026amp; US vs Taiwanese psychiatrists\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 69% for section 8\u003c/p\u003e\u003cp\u003e\u0026bull; 100% for section 11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCompton et al. (1996)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eDiagnosis agreement\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Alcohol (0\u0026middot;69)\u003c/p\u003e\u003cp\u003e\u0026bull; Opiate (0\u0026middot;49)\u003c/p\u003e\u003cp\u003e\u0026bull; Cocaine (0\u0026middot;61)\u003c/p\u003e\u003cp\u003e\u0026bull; Cannabis (0\u0026middot;5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCooper et al. (1977)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOverall interrater agreement was 0.77\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Situational anxiety (0\u0026middot;34)\u003c/p\u003e\u003cp\u003e\u0026bull; Depersonalization (0\u0026middot;96)\u003c/p\u003e\u003cp\u003e\u0026bull; Item level agreement of the 150 items (0\u0026middot;74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eTest re-test (0.49)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Worry (0\u0026middot;16)\u003c/p\u003e\u003cp\u003e\u0026bull; Relationships and ideas of reference (0\u0026middot;82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEaston et al.(1997)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eICD 10 dependence\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Alcohol (0\u0026middot;77\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;85)\u003c/p\u003e\u003cp\u003e\u0026bull; Opiates (0\u0026middot;93\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;98)\u003c/p\u003e\u003cp\u003e\u0026bull; Cannabis (0\u0026middot;63\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;78)\u003c/p\u003e\u003cp\u003e\u0026bull; Cocaine (0\u0026middot;69\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFink et al (2005)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Interrater agreement of kappa\u0026thinsp;=\u0026thinsp;0\u0026middot;88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFink et al (2010)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Inter-rater agreement on the presence of/lack of a somatoform diagnosis (kappa\u0026thinsp;=\u0026thinsp;0\u0026middot;82) among six interviewers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull;\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHansen et al (2001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Interrater agreement kappa (psychiatrists)\u0026thinsp;=\u0026thinsp;0\u0026middot;88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eDiagnosis by physicians and nurses at Internal medicine inpatients vs SCAN diagnosis\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Physicians: sensitivity (0\u0026middot;38) and specificity 0\u0026middot;91 at admission\u003c/p\u003e\u003cp\u003e\u0026bull; Nurses: sensitivity (0\u0026middot;48) and specificity (0\u0026middot;87) at admission\u003c/p\u003e\u003cp\u003e\u0026bull; Physicians: sensitivity (0\u0026middot;40) and specificity (0\u0026middot;89) at discharge\u003c/p\u003e\u003cp\u003e\u0026bull; Nurses: sensitivity (0\u0026middot;56) and specificity (0\u0026middot;81) at discharge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHansen\u0026nbsp;et al (2002)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Interrater agreement was kappa\u0026thinsp;=\u0026thinsp;0\u0026middot;88 (agreement on 16 of 17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHesselbrock et al (1999)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eSSAGA comparison with the SCAN\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Alcohol dependence (0\u0026middot;63)\u003c/p\u003e\u003cp\u003e\u0026bull; Sedative dependence (0\u0026middot;48)\u003c/p\u003e\u003cp\u003e\u0026bull; Cannabis dependence (0\u0026middot;53)\u003c/p\u003e\u003cp\u003e\u0026bull; Stimulant dependence (0\u0026middot;85)\u003c/p\u003e\u003cp\u003e\u0026bull; Opioid dependence (0\u0026middot;73)\u003c/p\u003e\u003cp\u003e\u0026bull; Major depression (0\u0026middot;71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKrisanaprakornkit et al (2006)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eIntra-rater\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Sections 6 (0\u0026middot;80)\u003c/p\u003e\u003cp\u003e\u0026bull; section 7 (0\u0026middot;67)\u003c/p\u003e\u003cp\u003e\u0026bull; Section 8 (0\u0026middot;78)\u003c/p\u003e\u003cp\u003e\u0026bull; Section 10 (0\u0026middot;84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Some adaptations were made to words or sequences of sentences describing symptoms to make them more understandable in the Thai cultural and linguistic context\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKrisanaprakornkit et al (2007)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOverall inter-rater reliability\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; (0\u0026middot;79)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSection 3\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; (0\u0026middot;75)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSection 4\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; (0\u0026middot;8)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSection 5\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; (0\u0026middot;76)\u003c/p\u003e\u003cp\u003e\u003cb\u003eIntra-rater reliability (two weeks)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; (0\u0026middot;84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Some adaptations were made to words or sequences of sentences describing symptoms to make them more understandable in the Thai cultural and linguistic context\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLesage et al (1991)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eInter-rater\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;75\u003c/p\u003e\u003cp\u003e\u003cb\u003ePositive agreement rate\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;59\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLuria \u0026amp; Berry (1979)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eInter-rater\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; ICC (0\u0026middot;84\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;86)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMałyszczak et al (2002)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCohen's kappa\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Schizophrenia (0\u0026middot;62)\u003c/p\u003e\u003cp\u003eDepression (0\u0026middot;36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eKappa coefficient\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Block F2 (0\u0026middot;78)\u003c/p\u003e\u003cp\u003e\u0026bull; Schizophrenia (0\u0026middot;62)\u003c/p\u003e\u003cp\u003e\u0026bull; Block F3 (0\u0026middot;42)\u003c/p\u003e\u003cp\u003e\u0026bull; Depression (0\u0026middot;36)\u003c/p\u003e\u003cp\u003e\u0026bull; Low agreement between clinical and SCAN diagnosis, particularly for mood disorder\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMignolli et al (1988)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eThe total disagreement index (TDI)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; \u003cb\u003e0\u003c/b\u003e\u0026middot;\u003cb\u003e09 (0\u0026ndash;0\u003c/b\u003e\u0026middot;\u003cb\u003e31)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eMean serious disagreement index (SDI)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;04 (0\u0026ndash;0\u0026middot;21)\u003c/p\u003e\u003cp\u003e\u0026bull; Between interviewer and reinterviewed were 0.37 (0-1.05) and 0\u0026middot;21 (range 0\u0026ndash;0\u0026middot;86) respectively\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNienhuis et al (2010)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePrevalence SCAN vs Min-SCAN\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; No disorder (15 vs 15)\u003c/p\u003e\u003cp\u003e\u0026bull; Affective disorder (30 vs 32)\u003c/p\u003e\u003cp\u003e\u0026bull; Affective psychosis (12 vs 11)\u003c/p\u003e\u003cp\u003e\u0026bull; Anxiety disorder (34 vs 33)\u003c/p\u003e\u003cp\u003e\u0026bull; non-affective psychosis (15 vs 15)\u003c/p\u003e\u003cp\u003e\u003cb\u003eMini-SCAN\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Sensitvity (0\u0026middot;67\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;87)\u003c/p\u003e\u003cp\u003e\u0026bull; Specificity (0\u0026middot;92\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;97)\u003c/p\u003e\u003cp\u003e\u0026bull; PPV (0\u0026middot;73\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;97)\u003c/p\u003e\u003cp\u003e\u0026bull; NPV (0\u0026middot;96\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eConcurrent validity of the mini-SCAN\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;80\u0026bull;\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026bull; Mini-SCAN interviews were 25 minutes shorter than the SCAN\u003c/p\u003e\u003cp\u003e\u0026bull; SCAN, 77% rated the interview as pleasant or very pleasant\u003c/p\u003e\u003cp\u003e\u0026bull; For the mini-SCAN this percentage was 79%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePaholpak et al (2006)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKappa (inter-rater)\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;81\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;0, 0\u0026middot;61\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;80 and 0\u0026middot;00\u0026ndash;0\u0026middot;20 in 49\u0026middot;6%, 30\u0026middot;0% and 8\u0026middot;9% of the items respectively\u003c/p\u003e\u003cp\u003e\u0026bull; Kappas could not be calculated for 11\u0026middot;5% of the Items\u003c/p\u003e\u003cp\u003eThe intra-rater reliabilities were\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;81\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;0, 0\u0026middot;61\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;80 and 0\u0026middot;00\u0026ndash;0\u0026middot;20 in 54\u0026middot;9%, 26.5% and 2\u0026middot;7% of the items respectively\u003c/p\u003e\u003cp\u003e\u0026bull; Kappas could not be calculated for 15\u0026middot;9% of the Items.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Semantic validity established\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026bull; Averaged\u0026thinsp;=\u0026thinsp;57\u0026middot;1\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;12\u0026middot;1 minutes while it was 42.1\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;13\u0026middot;9 minutes for a normal subject\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePaholpak et al (2006)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eKappa (inter and intra-rater ) agreement\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; Somatoform and dissociative symptoms module (0\u0026middot;77, 0\u0026middot;85)\u003c/p\u003e\u003cp\u003e\u0026bull; Anxiety (0\u0026middot;79, 0\u0026middot;84)\u003c/p\u003e\u003cp\u003e\u0026bull; Mood (0\u0026middot;80, 0\u0026middot;86)\u003c/p\u003e\u003cp\u003e\u0026bull; Eating disorders (0\u0026middot;73, 0\u0026middot;76)\u003c/p\u003e\u003cp\u003e\u0026bull; Use of alcohol (0\u0026middot;66, 0\u0026middot;82)\u003c/p\u003e\u003cp\u003e\u0026bull; Stress and adjustment disorders (0\u0026middot;90, 0.94)\u003c/p\u003e\u003cp\u003e\u0026bull; Psychosis (0\u0026middot;68, 0\u0026middot;76)\u003c/p\u003e\u003cp\u003e\u0026bull; Cognitive impairment (0\u0026middot;72, 0\u0026middot;78)\u003c/p\u003e\u003cp\u003e\u0026bull; Observed behavior, affect and speech module (0\u0026middot;45, 0\u0026middot;51)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Semantic validity established\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatjanasoontorn et al (2011)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; \u003cb\u003eKappa of the eating disorder section\u003c/b\u003e 0\u0026middot;73, (0\u0026middot;68,0\u0026middot;77).\u003c/p\u003e\u003cp\u003e\u0026bull; Mean intra-rater reliabilities (0\u0026middot;76; 0\u0026middot;70-0.82)\u003c/p\u003e\u003cp\u003e\u0026bull; 68\u0026middot;4% \u0026amp; 31\u0026middot;58% of the items had a substantial and almost perfect kappa respectively\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Semantic validity established\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePitta \u0026amp; Blay (1997)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eKappa between ICD-9 'hysteria' and 'other reactive and non-specified psychoses' and the corresponding categories and the PSE/CATEGO program\u003c/p\u003e\u003cp\u003e- 0\u0026middot;03 and 0\u0026middot;19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePiyavhatkul et al (2008)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Kappa (0\u0026middot;90 (SD\u0026thinsp;=\u0026thinsp;0\u0026middot;12)\u003c/p\u003e\u003cp\u003e\u0026bull; Item level agreement 77\u0026middot;05%- 85\u0026middot;26%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Semantic validity established\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026bull; Averaged 17\u0026middot;92 minutes (25\u0026middot;59 for people with stress-related disorders and 6.41 for normal subjects).\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePiyavhatkul et al (2008)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Intra-rater: mean 0\u0026middot;94 (SD\u0026thinsp;=\u0026thinsp;0\u0026middot;09)\u003c/p\u003e\u003cp\u003e\u0026bull; Perfect level among many items; however, three items (3\u0026middot;66%) had poor and nine (6\u0026middot;67%) only slight inter-rater agreement\u003c/p\u003e\u003cp\u003e\u0026bull; Inter and intra-rater reliability of the continuous data was 0\u0026middot;93 and 0\u0026middot;96.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Semantic validity established\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026bull; Cognitive impairment or Decline Section averaged 48.99 minutes (59\u0026middot;71 for participants with cognitive impairment and 33\u0026middot;77 for normal participants)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePiyavhatkul et al (2008)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMean \u0026amp; SD of inter-rater reliability for sections 6, 17, 18 and 19\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;66\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0\u0026middot;17\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;71\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0\u0026middot;16\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot; 70\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0\u0026middot;22\u003c/p\u003e\u003cp\u003e\u0026bull; 0.64\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0\u0026middot;23\u003c/p\u003e\u003cp\u003e\u003cb\u003eIntra-rater reliability\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;65\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0\u0026middot;11\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;74\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0\u0026middot;17\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;86\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0\u0026middot;17\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;80\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0\u0026middot;18\u003c/p\u003e\u003cp\u003e\u0026bull; Some sections had items with 100 percent agreement from the same rater when rated 2 weeks apart.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Semantic validity established\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003ePeople with schizophrenia\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 140\u0026middot;2\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;36\u0026middot;0 minutes ( 75\u0026ndash;193)\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 81\u0026middot;9\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;25\u0026middot;9 minutes ( 48\u0026ndash;124)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePull et al (1997)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; The SCAN and AUDADIS-ADR also agreed more closely to one another than to the CIDI in terms of the neglect of interests and the much time spent and continued use despite physical and/or psychological harm criteria.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026bull; 40\u0026middot;3 min to administer\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRijnders et al (2000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKappa\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; 0\u0026middot;24\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Sensitivity as well as specificity proved to be substantial to almost perfect.\u003c/p\u003e\u003cp\u003e\u0026bull; The agreement per interviewer about the reference diagnoses ranged from 87% (diagnostic group) to 94% (diagnostic caseness).\u003c/p\u003e\u003cp\u003e\u0026bull; Agreement on the syndrome level (without duration and interference criteria of DSM-IV) was excellent.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRoca et al, (1999)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Of subjects with a positive GHQ, 47% were considered ``non-cases'' on the SCAN using the ICD-10 criteria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRodgers, Mann (1986)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eThe first factor extracted accounted\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 20\u0026middot;3% of the total variance\u003c/p\u003e\u003cp\u003e\u003cb\u003eSecond, third, and fourth factors\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 5\u0026middot;5, 4\u0026middot;5 and 3\u0026middot;7% respectively\u003c/p\u003e\u003cp\u003e\u0026bull; 71\u0026middot;5% showed perfect agreement and 24\u0026middot;9% had only 1 or 2 inconsistencies.\u003c/p\u003e\u003cp\u003e\u0026bull; The remaining 3\u0026middot;6% contained 3 or more instances of disagreement between the nurse and the standard rating\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSch\u0026uuml;tzwohl, Kallert, Jurjanz (2007)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCronbach a\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;55 to 0\u0026middot;98*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eOne factor solution\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eSection 10-mood\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; highest loading-0\u0026middot;88\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;97\u003c/p\u003e\u003cp\u003e\u003cb\u003eDepression section\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;890 to 0\u0026middot;92 and\u003c/p\u003e\u003cp\u003e\u003cb\u003eSection 7 thinking\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;24 to 0\u0026middot;88\u003c/p\u003e\u003cp\u003eAcceptable face validity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSch\u0026uuml;tzwohl, Kallert, Jurjanz (2007)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCronbach α\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;50\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;70 for most scale and \u0026gt;\u0026thinsp;0\u0026middot;7 for a few scales\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHigh correlation between the scales generated by PCA and the section-specific scales.\u003c/p\u003e\u003cp\u003eSCAN sub-sections\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eShibre et al (2002)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Inter-rater reliability of the SCAN was not assessed formally, but a total agreement among the interviewers in terms of SCAN cases/non-case as well as in terms of diagnostic category.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOverlap between SCAN and CIDI\u003c/p\u003e\u003cp\u003e\u0026bull; 26%\u003c/p\u003e\u003cp\u003eSemantic validity established\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSilverstone (1993)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Significant overall correlations for DSM-III\u0026mdash;R diagnoses between SCAN and SADS\u003c/p\u003e\u003cp\u003e\u0026bull; There were no significant differences in the incidence of diagnosis for any of the diagnostic groups\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eToft et al (2005)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Interrater agreement ( kappa\u0026thinsp;=\u0026thinsp;0\u0026middot;86)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eToft et al (2010)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Interrater agreement ( kappa 0.\u0026middot;82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUst\u0026uuml;n et al (1997)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eKappa\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;7\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCorrelation with\u003c/p\u003e\u003cp\u003eICD-10 and DSM-IV\u003c/p\u003e\u003cp\u003e\u0026bull; Ranges from 0\u0026middot;36\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;68.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVan Hout Griez (1984)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCorrelation between subsections of PSE and Wolpe and Lazarus\u0026rsquo; Serf Rating Scale for Assertiveness, fear Survey Schedule, Zung\u0026rsquo;s Self Rating Scale for Depression and Maudsley Obsessive Compulsive Inventory\u003c/p\u003e\u003cp\u003e\u0026bull; 0\u0026middot;24\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;67.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026bull; Average 30 mins\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWing et al (1977)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; For tape-recorded interviews, r (0\u0026middot;96)\u003c/p\u003e\u003cp\u003e\u0026bull; Overall agreement for all cases is (0\u0026middot;81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; r (0\u0026middot;67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Two sets of total PSE scores (0\u0026middot;73)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.5. SCAN or PSE as a gold standard\u003c/h2\u003e\u003cp\u003eForty-seven articles used SCAN or PSE versions to evaluate the psychometric properties of other diagnostic or screening tools. The publication year ranged from 1989 to 2023. Most of the studies, except for five (Ethiopia (n\u0026thinsp;=\u0026thinsp;3), Nigeria, and South Africa), were conducted in high-income countries.\u003c/p\u003e\u003cp\u003eA total of 31 tools were validated using SCAN or PSE as a gold standard. Of the 31, 18 were used to assess depression, while the other measures were used to assess symptoms of psychosis, anxiety, somatoform, and substance use problems. Some of the scales or assessment instruments (n\u0026thinsp;=\u0026thinsp;4), such as the CIDI, were used to identify more than one psychiatric problem. These 31 measures were validated in more than 15 different languages (Supplementary file 2).\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003e We aimed to systematically review the psychometric properties of the various revisions of the SCAN. We found 46 original psychometric papers on SCAN and PSE and another 47 articles that used SCAN as a gold standard to evaluate the psychometric properties of other mental health measures. Most of the studies used multiple sections of SCAN, while some used one or two sections out of the 27 sections.\u003c/p\u003e\u003cp\u003eThe internal consistency of the items in SCAN and PSE ranged from good to excellent. Additionally, both modules demonstrated acceptable intra-rater, inter-rater, and test-retest reliability. However, some studies reported percentages and mean [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e] to calculate various types of reliabilities. This might introduce methodological biases and require cautious interpretation.\u003c/p\u003e\u003cp\u003eThere was also evidence supporting the concurrent, semantic, and content validity of both SCAN and PSE, though there was no evidence for predictive validity. The good to excellent internal consistency of SCAN and PSE suggests that the items effectively measure the underlying construct of psychopathology. But, internal consistency should have been calculated for each section of the SCAN or PSE, not the total score [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. Another issue to consider is that the high internal consistency of the SCAN and PSE might be attributed to the large number of items in these scales, rather than their actual reliability [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. High internal consistency is not an ideal indicator for tools with many items [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWe also found acceptable agreement across various items or sections of SCAN and PSE. However, methodological concerns arise from the use of percentage agreement and Cohen\u0026rsquo;s Kappa when the studies calculated test-retest, intra-rater, and inter-rater reliability. Unlike Kappa, percentage agreement does not account for the possibility that agreement may occur by chance.\u003c/p\u003e\u003cp\u003eAdditionally, high agreement among raters on specific sections, particularly those related to schizophrenia or psychotic disorders, could positively influence the overall percentage of agreement when considering the entire SCAN and PSE. Only a few studies calculated the ICC, which is a rigorous methodology that considers total variance, including between participants, between raters, and residual error. However, these studies did not report measurement errors [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAlthough the evidence is not robust, both SCAN and PSE appear more reliable for psychotic disorders, which present with more severe, clear, and observable symptoms compared to neurotic or common mental disorders. Of interest, the strengths and weaknesses of the SCAN and instruments such as CIDI are inverse, as CIDI does not perform well for psychotic disorders [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. This suggests that improving the sections on common mental disorders in the SCAN could be a focus for future research.\u003c/p\u003e\u003cp\u003eAs the PSE and SCAN have been translated into many languages, considerable experience has been gained. Translating concepts, not just words, and the flexibility of SCAN, allowing administrators to explain and probe, suggests its strong semantic validity [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Studies also showed that they were able to establish that the back-translation of SCAN and PSE into the original English is appropriate.\u003c/p\u003e\u003cp\u003eBecause SCAN is typically considered a gold standard, criterion validity has been difficult to study. Few studies have reported acceptable sensitivity and specificity of SCAN in comparison to diagnosis by clinicians, particularly for psychotic disorders as opposed to affective disorders [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe positive and negative predictive power of SCAN remains uncertain, as it has not been extensively studied. Correlations between SCAN and diagnosis using ICD-10 and DSM-IV were found to vary, ranging from low to strong correlation [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe semi-structured nature of SCAN allows flexibility for the test administrator to rephrase and probe, and the common practice of its use by highly trained mental health professionals could potentially contribute to better validity compared to other structured diagnostic tools, such as the CIDI [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThere is a need for strong studies that report the construct validity of SCAN using factor analysis. There is only such a study which reported one dominant factor and high factor loading of the items [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. This finding is like studies on CIDI and other diagnostic tools, which tend to be unidimensional per section [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. Further research on the cultural invariance of SCAN is warranted, as this would facilitate cross-cultural comparisons of psychiatric disorders.\u003c/p\u003e\u003cp\u003eSCAN is accepted and used globally [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Previous studies have also noted that SCAN can be effectively utilized by trained and experienced lay interviewers [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. The computer algorithm for interpretation and its dimensional measurement capabilities are additional strengths of SCAN [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eConsidering the methodological weakness of the studies that reported the psychometric properties of SCAN when evaluated against recently recommended standards, there is a clear need for further studies. Additionally, we couldn\u0026rsquo;t find recent studies that evaluate the psychometric properties of SCAN.\u003c/p\u003e\u003cp\u003eDespite these limitations, SCAN continues to be a promising tool in terms of some of its psychometric properties and practical feasibility for diagnosing psychiatric disorders. The established semantics, content, along with some accepted reliability indicators, underscore its potential as a valuable diagnostic instrument.\u003c/p\u003e\u003cp\u003eThe next version of SCAN must consider its potential limitations, particularly in the non-psychotic sections. Additionally, it is important to revise the current version considering the ICD-11 and DSM-5 diagnostic systems, as the current version is based on the previous versions.\u003c/p\u003e\u003cp\u003eContributions\u003c/p\u003e\u003cp\u003eMO, AF, AA, and WF conceived the study. WF, AM, AF, and AA contributed to the design of the review and the protocol development. WF and AM search the literature, data collection, and quality appraisal. All authors participated in contacting researchers who used SCAN and in retrieving some of the old publications. WF and AM drafted the manuscript. All authors revised the manuscript and approved the final manuscript.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eContributions\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eMO, AF, AA, and WF conceived the study. WF, AM, AF, and AA contributed to the design of the review and the protocol development. WF and AM search the literature, data collection, and quality appraisal. All authors participated in contacting researchers who used SCAN and in retrieving some of the old publications. \u0026nbsp;WF and AM \u0026nbsp; drafted the manuscript. \u0026nbsp;All authors revised the manuscript and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eAvailability of Data and Materials\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe authors confirm that the data supporting the findings of this study are available in the article and its supplementary materials.\u003c/p\u003e\n\u003ch2\u003eDeclarations of interest\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eMVO is currently an employee of WHO, while SC is a former employee of the organization.\u003c/p\u003e\n\u003ch2\u003eFinancial declarations\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eWF and AM received support from WHO. WF and CH receive support from the Wellcome Trust through grants 222154/Z20/Z. CH receives support from NIHR through the NIHR Global Health Research Group on Homelessness and Mental Health in Africa (NIHR134325), using UK aid from the UK Government. \u0026nbsp;CH also receives support from WT grant 223615/Z/21/Z. AM receives support from DELTAS Africa Initiative through the African Mental Health Research Initiative (AMARI) II project. The DELTAS Africa Initiative is a programme of the Science for Africa Foundation being implemented with support from Wellcome and the UK Foreign Commonwealth and Development Office (FCDO). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or WHO.\u003c/p\u003e\n\u003cp\u003eFor the purpose of open access, the authors have applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Author Manuscript version arising\u0026nbsp;from this submission. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSheehan DV et al (1998) The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59(20):22\u0026ndash;33\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWHO (1994) Schedules for clinical assessment in neuropsychiatry: version 2. American Psychiatric\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWing J et al (1977) Reliability of the PSE used in a population study. Psychol Med 7(3):505\u0026ndash;516\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWing JK et al (1990) SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 47(6):589\u0026ndash;593\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMaurer K et al (1985) \u003cem\u003e[Experiences with Schedules for Clinical Assessment in Neuropsychiatry (SCAN) within the scope of a multicenter field study].\u003c/em\u003e Schweiz Arch Neurol Psychiatr 1991. 142(3): pp. 235\u0026thinsp;\u0026ndash;\u0026thinsp;45\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRijnders CA et al (2000) Psychometric properties of the schedules for clinical assessment in neuropsychiatry (SCAN-2.1). Soc Psychiatry Psychiatr Epidemiol 35(8):348\u0026ndash;352\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMorgan C et al (2023) Epidemiology of untreated psychoses in 3 diverse settings in the global south: The international research program on psychotic disorders in diverse settings (INTREPID II). JAMA psychiatry 80(1):40\u0026ndash;48\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHanlon C et al (2024) Studying the context of psychoses to improve outcomes in Ethiopia (SCOPE): Protocol paper. PLoS ONE 19(5):e0293232\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHanlon C et al (2016) Task sharing for the care of severe mental disorders in a low-income country (TaSCS): study protocol for a randomised, controlled, non-inferiority trial. Trials 17:1\u0026ndash;14\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUscamayta Ayvar M et al (2022) \u003cem\u003eNon-affective psychosis in traditional Andean culture.\u003c/em\u003e Transcult Psychiatry, : p. 13634615221099795\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eQassem T et al (2015) Prevalence of psychosis in black ethnic minorities in Britain: analysis based on three national surveys. Soc Psychiatry Psychiatr Epidemiol 50(7):1057\u0026ndash;1064\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ede Erausquin GA et al (2022) \u003cem\u003eChronic neuropsychiatric sequelae of SARS-CoV-2: Protocol and methods from the Alzheimer's Association Global Consortium.\u003c/em\u003e Alzheimers Dement (N Y), 8(1): p. e12348\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSch\u0026uuml;tzwohl M, Kallert T, Jurjanz L (2007) Psychometric properties of dimensional measures derived from the latest German version of the Schedules for Clinical Assessment in Neuropsychiatry 2.1]. Nervenarzt 78(3):304\u0026ndash;308\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKrisanaprakornkit T et al (2007) The validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): anxiety disorders section. J Med Assoc Thai 90(2):341\u0026ndash;347\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePage MJ et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePrinsen CAC et al (2018) COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res 27(5):1147\u0026ndash;1157\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGagnier JJ et al (2021) COSMIN reporting guideline for studies on measurement properties of patient-reported outcome measures. Qual Life Res 30(8):2197\u0026ndash;2218\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMokkink LB et al (2018) COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures. Qual Life Res 27(5):1171\u0026ndash;1179\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eV\u0026aacute;zquez-Barquero JL et al (1994) [Development and verification of the Spanish version of the scanning system psychiatric interview (Questionnaires for clinical evaluation in neuropsychiatry]. Actas Luso Esp Neurol Psiquiatr Cienc Afines 22(3):109\u0026ndash;120\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUst\u0026uuml;n B et al (1997) WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results. Drug Alcohol Depend 47(3):161\u0026ndash;169\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSch\u0026uuml;tzwohl M, Kallert T, Jurjanz L (2007) Using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN 2.1) as a diagnostic interview providing dimensional measures: cross-national findings on the psychometric properties of psychopathology scales. Eur Psychiatry 22(4):229\u0026ndash;238\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePatjanasoontorn N, Paholpak S, Krisanaprakornkit T (2011) Validity and reliability study of the Thai version of WHO Schedules for Clinical Assessment in Neuropsychiatry: Eating Disorders Section. J Med Assoc Thai 94(4):490\u0026ndash;497\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePaholpak S et al (2008) Validity and reliability study of the Thai version of WHO schedules for clinical assessment in neuropsychiatry: sections on psychotic disorders. J Med Assoc Thai 91(3):408\u0026ndash;416\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePaholpak S et al (2006) Validity and reliability study of the Thai version of WHO SCAN: somatoform and dissociative symptoms section. J Med Assoc Thai 89(4):473\u0026ndash;483\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePaholpak S et al (2010) Validity and reliability study of the Thai version of WHO Schedules for Clinical Assessment in Neuropsychiatry version 2.1. J Med Assoc Thai 93(4):497\u0026ndash;501\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLuria RE, Berry R (1979) Reliability and descriptive validity of PSE syndromes. Arch Gen Psychiatry 36(11):1187\u0026ndash;1195\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAdamowski T, Kiejna A, Hadryś T (2006) Study of compatibility of psychiatric diagnoses with ICD-10 diagnostic criteria using the SCAN questionnaire]. Psychiatr Pol 40(4):761\u0026ndash;773\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFink P, Hansen MS, S\u0026oslash;ndergaard L (2005) Somatoform disorders among first-time referrals to a neurology service. Psychosomatics 46(6):540\u0026ndash;548\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFink P, \u0026Oslash;rnb\u0026oslash;l E, Christensen KS (2010) The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health. PLoS ONE 5(3):e9873\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCompton WM et al (1996) Comparing assessments of DSM-IV substance dependence disorders using CIDI-SAM and SCAN. Drug Alcohol Depend 41(3):179\u0026ndash;187\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMałyszczak K et al (2002) [Comparison between a SCAN diagnosis and a clinical diagnosis]. Psychiatr Pol 36(6 Suppl):377\u0026ndash;380\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCooper JE et al (1977) Further studies on interviewer training and inter-rater reliability of the Present State Examination (PSE). Psychol Med 7(3):517\u0026ndash;523\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNienhuis FJ et al (2010) Validity of a short clinical interview for psychiatric diagnosis: the mini-SCAN. Br J Psychiatry 196(1):64\u0026ndash;68\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEaston C et al (1997) Test-retest reliability of the alcohol and drug use disorder sections of the schedules for clinical assessment in neuropsychiatry (SCAN). Drug Alcohol Depend 47(3):187\u0026ndash;194\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMignolli G et al (1988) Inter-rater reliability of PSE-9 (full version): an Italian study. Soc Psychiatry Psychiatr Epidemiol 23:30\u0026ndash;35\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFink P et al (1995) Psychiatric morbidity in primary public health care: a Nordic multicentre investigation. Part I: method and prevalence of psychiatric morbidity. Acta Psychiatr Scand 92(6):409\u0026ndash;418\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShibre T et al (2002) An evaluation of two screening methods to identify cases with schizophrenia and affective disorders in a community survey in rural Ethiopia. Int J Soc Psychiatry 48(3):200\u0026ndash;208\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRodgers B, Mann SA (1986) The reliability and validity of PSE assessments by lay interviewers: a national population survey. Psychol Med 16(3):689\u0026ndash;700\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlem A et al (2004) Comparison of computer assisted scan diagnoses and clinical diagnoses of major mental disorders in Butajira, rural Ethiopia. Ethiop Med J 42(2):137\u0026ndash;143\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHansen MS et al (2001) Mental disorders among internal medical inpatients: prevalence, detection, and treatment status. J Psychosom Res 50(4):199\u0026ndash;204\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrugha TS et al (1999) Cross validation of a general population survey diagnostic interview: a comparison of CIS-R with SCAN ICD-10 diagnostic categories. Psychol Med 29(5):1029\u0026ndash;1042\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePull CB et al (1997) Concordance between ICD-10 alcohol and drug use disorder criteria and diagnoses as measured by the AUDADIS-ADR, CIDI and SCAN: results of a cross-national study. Drug Alcohol Depend 47(3):207\u0026ndash;216\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePiyavhatkul N, Krisanaprakornkit T, Paholpak S (2008) Stress and Adjustment Disorder Section of WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN)--Thai version: validity and reliability study. J Med Assoc Thai 91(8):1263\u0026ndash;1268\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePiyavhatkul N et al (2008) Validity and reliability of WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN)-Thai version: Cognitive Impairment or Decline Section. J Med Assoc Thai 91(7):1129\u0026ndash;1136\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCheng AT et al (2001) Cross-cultural implementation of a Chinese version of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) in Taiwan. Br J Psychiatry 178:567\u0026ndash;572\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMokkink LB et al (2012) COSMIN checklist manual. University Medical Center, Amsterdam\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMeyer GJ et al (2001) Psychological testing and psychological assessment. A review of evidence and issues. Am Psychol 56(2):128\u0026ndash;165\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCooper L, Peters L, Andrews G (1998) Validity of the Composite International Diagnostic Interview (CIDI) psychosis module in a psychiatric setting. J Psychiatr Res 32(6):361\u0026ndash;368\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrugha TS et al (2001) A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Psychol Med 31(6):1001\u0026ndash;1013\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGelaye B et al (2013) Diagnostic validity of the composite international diagnostic interview (CIDI) depression module in an East African population. Int J Psychiatry Med 46(4):387\u0026ndash;405\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGureje O et al (2020) Effect of collaborative care between traditional and faith healers and primary health-care workers on psychosis outcomes in Nigeria and Ghana (COSIMPO): a cluster randomised controlled trial. Lancet 396(10251):612\u0026ndash;622\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRoberts T et al (2020) INTREPID II: protocol for a multistudy programme of research on untreated psychosis in India, Nigeria and Trinidad. BMJ open 10(6):e039004\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAboraya A et al (1998) Schedules for Clinical Assessment in Neuropsychiatry (SCAN): introduction to WV's mental health community. W V Med J 94(6):326\u0026ndash;328\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAndrews G et al (1995) A comparison of two structured diagnostic interviews: CIDI and SCAN. N Z J Psychiatry 29(1):124\u0026ndash;132Aust\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eArunpongpaisal S et al (2006) Inter- and intra-rater reliability of the Thai version of SCAN: Use of Alcohol and Use of Tobacco Section. J Med Assoc Thai 89(12):2129\u0026ndash;2137\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrugha TS et al (1999) The survey form of SCAN: the feasibility of using experienced lay survey interviewers to administer a semi-structured systematic clinical assessment of psychotic and non-psychotic disorders. Psychol Med 29(3):703\u0026ndash;711\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHansen MS et al (2002) Use of health services, mental illness, and self-rated disability and health in medical inpatients. Psychosom Med 64(4):668\u0026ndash;675\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHesselbrock M et al (1999) A validity study of the SSAGA-a comparison with the SCAN. Addiction 94(9):1361\u0026ndash;1370\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKrisanaprakornkit T, Paholpak S, Piyavhatkul N (2006) The validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): Mood Disorders Section. J Med Assoc Thai 89(2):205\u0026ndash;211\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLesage AD, Cyr M, Toupin J (1991) Reliable use of the Present State Examination by psychiatric nurses for clinical studies of psychotic and nonpsychotic patients. Acta psychiatrica Scandinavica 83(2):121\u0026ndash;124\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePitta JC, Blay SL (1997) \u003cem\u003ePsychogenic (reactive) and hysterical psychoses: a cross-system reliability study\u003c/em\u003e, in \u003cem\u003eActa psychiatrica Scandinavica\u003c/em\u003e. United States, pp 112\u0026ndash;118\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRoca M et al (1999) Mental disorders on the island of Formentera: prevalence in general population using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Soc Psychiatry Psychiatr Epidemiol 34(8):410\u0026ndash;415\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSilverstone PH (1993) SCAN accurately gives diagnoses according to DSM-III\u0026mdash;R criteria: Validation in psychiatric patients using SADS. International Journal of Methods in Psychiatric Research\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eToft T et al (2005) Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study. Psychol Med 35(8):1175\u0026ndash;1184\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eToft T et al (2010) Training general practitioners in the treatment of functional somatic symptoms: effects on patient health in a cluster-randomised controlled trial (the Functional Illness in Primary Care study). Psychother Psychosom 79(4):227\u0026ndash;237\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003evan den Hout MA, Griez E (1984) Validity and utility of the present state examination in assessing neurosis: empirical findings and critical considerations. J Psychiatr Res 18(2):161\u0026ndash;172\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"World Health Organization","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Schedules for Clinical Assessment in Neuropsychiatry, Psychometric Properties, Systematic review","lastPublishedDoi":"10.21203/rs.3.rs-7730040/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7730040/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eWHO\u0026rsquo;s Schedules for Clinical Assessment in Neuropsychiatry \u003cb\u003e(\u003c/b\u003eSCAN) is often used as the gold standard for psychiatric classification. We systematically reviewed studies on the psychometric properties of the SCAN to support its adaptation to the revised international classification systems.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe searched PubMed, PsycINFO, Embase, Global Health, and Global Index Medicus up to April 17, 2025, and contacted experts. The protocol was registered in PROSPERO (CRD42024522395).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eTitles and abstracts of 4,241 records were screened, with 296 full-text articles evaluated. Ninety-three articles were included in the final review: 46 assessing SCAN\u0026rsquo;s psychometric properties and 47 validating other measures using SCAN as a gold standard. The internal consistency of the SCAN and its predecessor, the Present State Examination (PSE), ranged from good to excellent. Both demonstrated acceptable intra-rater, inter-rater, and test-retest reliability, with reliability especially high for psychotic disorders. There was also evidence supporting concurrent, construct, semantic, and content validity, although there was an absence of evidence for predictive validity. We also found acceptable psychometric properties for the different syndrome-based sections of the SCAN.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eAlthough recent, high-quality studies are scarce, the SCAN is a promising tool for diagnosing a variety of psychiatric issues, particularly psychotic disorders. It demonstrates established reliability and evidence of concurrent, construct, semantic, and content validity. However, there is a need to revise the current version of SCAN to align it with contemporary diagnostic systems. Additionally, further research is required, especially regarding the assessment of non-psychotic conditions.\u003c/p\u003e","manuscriptTitle":"Psychometric Properties of WHO’s Schedules for Clinical Assessment in Neuropsychiatry: A Systematic Review.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-30 09:43:12","doi":"10.21203/rs.3.rs-7730040/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8395e251-285c-45fb-afa9-a2d5b450b9ad","owner":[],"postedDate":"September 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":55440656,"name":"Psychiatry"},{"id":55440657,"name":"Psychology"}],"tags":[],"updatedAt":"2025-10-12T21:38:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-30 09:43:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7730040","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7730040","identity":"rs-7730040","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}