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The Comprehensive Assessment of Symptoms and History (CASH): An Instrument for Assessing Diagnosis and Psychopathology

The Comprehensive Assessment of Symptoms and History (CASH): An Instrument for Assessing... Abstract • The Comprehensive Assessment of Symptoms and History was developed for research studies of schizophrenia spectrum conditions and affective spectrum conditions. It is designed to provide a comprehensive information base concerning current and past signs and symptoms, premorbid functioning, cognitive functioning, sociodemographic status, treatment, and course of illness. Because the information base is broad, it is not wedded to a specific diagnostic system but rather permits clinicians and investigators to make diagnoses using a wide range of systems, including Research Diagnostic Criteria, DSM-III, DSM-III-R, and the International Classification of Diseases. Given the fact that disorders in psychiatry are not defined at the etiological or pathophysiological level, diagnostic criteria are prone to ongoing revision as our knowledge base changes. Research strategies suggest that investigators should maintain a flexible database to permit them to adapt to changes in diagnostic systems, to do comparative nosological studies, and, ultimately, to develop new diagnostic systems based on knowledge concerning the underlying neurobiological nature of disorders. Because it provides a comprehensive information base, the Comprehensive Assessment of Symptoms and History facilitates research of this type. Extensive developmental work has been done with the Comprehensive Assessment of Symptoms and History, including interrater and test-retest reliability studies, validity studies, training programs, and data entry programs. References 1. Kreitman N, Sainsbury P, Morrissey J. The reliability of psychiatric assessment: an analysis . J Ment Sci . 1961;107:877-908. 2. Beck AT, Ward CH, Mendelson M. Reliability of psychiatric diagnosis, II: a study of consistency of clinical judgements and ratings . Am J Psychiatry . 1962;119:351-357. 3. Sandifer MG, Pettus G, Quade D. A study of psychiatric diagnosis . J Nerv Ment Dis . 1964;139:350-356.Crossref 4. Sandifer MG, Hordern A, Timbury GC. Psychiatric diagnosis: a comparative study in North Carolina, London and Glasgow . Br J Psychiatry . 1968;114:1-9.Crossref 5. Kendell RE, Cooper JE, Gourlay AG. Diagnostic criteria of American and British psychiatrists . Arch Gen Psychiatry . 1971;25:123-130.Crossref 6. Cooper JE, Kendell RE, Gurland BJ, Sharp L, Copeland JRM, Simon R. Psychiatric Diagnosis in New York and London . New York, NY: Oxford University Press Inc; 1972. Maudsley Monograph No. 20. 7. Spitzer RL, Fleiss JL. A reanalysis of the reliability of psychiatric diagnosis . Br J Psychiatry . 1974;125:341-347.Crossref 8. Feighner JP, Robins E, Guze SB, Woodruff RA Jr, Winokur G, Munoz R. Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry . 1972;26:57-63.Crossref 9. Spitzer RL, Endicott J, Robins E. Research Diagnostic Criteria . New York, NY: Biometrics Research Division, New York State Psychiatric Institute; 1975. 10. Spitzer RL, Endicott J, Robins E. Research diagnostic criteria: rationale and reliability . Arch Gen Psychiatry . 1978;35:773-782.Crossref 11. Spitzer RL, Endicott J. Schedule for Affective Disorders and Schizophrenia-Lifetime Version . New York, NY: Biometrics Research Division, New York State Psychiatric Institute; 1975. 12. Endicott J, Spitzer RL. A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia (SADS) . Arch Gen Psychiatry . 1978;35: 837-844.Crossref 13. Spitzer RL, Endicott J, Kuriansky J, Gurland B. Preliminary report of the reliability of research diagnostic criteria applied to psychiatric case records . In: Sudilovsky A, Gershon S, Beef B, eds. Predictability in Psychopharmacology: Preclinical and Clinical Correlations . New York, NY: Raven Press; 1975:1-47. 14. Andreasen NC, Grove WM, Shapiro RW, Keller MB, Hirschfeld RMA, McDonald-Scott P. Reliability of lifetime diagnosis: a multicenter collaborative perspective . Arch Gen Psychiatry . 1981;38:400-405.Crossref 15. Leckman JF, Sholomskas MA, Thompson WD, Belanger A, Weissman MM. Best estimate of lifetime psychiatric diagnosis . Arch Gen Psychiatry . 1982;39:879-883.Crossref 16. Endicott J, Nee J, Fleiss J, Cohen J, Williams JBW, Simon R. Diagnostic criteria for schizophrenia: reliabilities and agreement between systems . Arch Gen Psychiatry . 1982;39:884-889.Crossref 17. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 18. Robins LN, Helzer JE, Croughan J, Ratclaff KS. National Institutes of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity . Arch Gen Psychiatry . 1981;38:381-389.Crossref 19. Spitzer RL, Williams JBW. Structured Clinical Interview for DSM-III (SCID) . New York, NY: New York State Psychiatric Institute; 1984. 20. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 21. Spitzer RL, Williams JBW, Gibbon M, First MB. Structured Clinical Interview for DSM-III-R (SCID) . Washington, DC: American Psychiatric Association; 1990. 22. Andreasen NC. Comprehensive Assessment of Symptoms and History (CASH) . Iowa City, Iowa: The University of Iowa; 1985. 23. Bleuler E, Translated by J. Zinkin. Dementia Praecox of the Group of Schizophrenias (1911) . New York, NY: International Universities Press; 1950. 24. Schneider K; Hamilton MW, trans. Clinical Psychopathology . New York, NY: Grune & Stratton; 1959. 25. Mellor CS. First-rank symptoms of schizophrenia . Br J Psychiatry . 1970;117:15-23. 26. Wing JK. A standard form of psychiatric Present State Examinations (PSE) and a method for standardizing the classification of symptoms . In: Hare EH, Wing JK, eds. Psychiatric Epidemiology: An International Symposium . New York, NY: Oxford University Press Inc; 1970:93-108. 27. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders . Washington, DC: American Psychiatric Association; 1952. 28. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders, Second Edition . Washington, DC: American Psychiatric Association; 1968. 29. World Health Organization. 1989 draft of chapter 5: mental, behavioral and developmental disorders . In: ICD-10 . Geneva, Switzerland: World Health Organization; 1989. 30. Andreasen NC, Flaum M. Schizophrenia: the characteristic symptoms . Schizophr Bull . 1990;17:27-49.Crossref 31. Flaum M, Andreasen NC. Diagnostic criteria for schizophrenia and related disorders: options for DSM-IV . Schizophr Bull . 1991;17:133-142.Crossref 32. Wittman P. A scale for measuring prognosis in schizophrenic patients . In: Read CF, Leibert E, eds. Elgin Papers . Elgin, Ill: Elgin State Hospital; 1941; 4:20-33. 33. Gittelman-Klein R, Klein DF. Premorbid asocial adjustment and prognosis in schizophrenia . J Psychiatr Res . 1969;7:35-53.Crossref 34. Andreasen NC. The Scale for the Assessment of Negative Symptoms (SANS) . Iowa City, Iowa: The University of Iowa; 1983. 35. Andreasen NC. The Scale for the Assessment of Positive Symptoms (SAPS) . Iowa City, Iowa: The University of Iowa; 1984. 36. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 37. Overall J, Gorham D. Brief psychiatric rating scale . Psychol Rep . 1962;10:799-812.Crossref 38. Folstein MF, Folstein SE, McHugh P. 'Mini Mental State': a practical method for grading the cognitive state of patients for the clinician . J Psychiatr Res . 1975;12:189-198.Crossref 39. Endicott J, Spitzer RL, Fleiss JL, Cohen J. The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance . Arch Gen Psychiatry . 1976;33:766-771.Crossref 40. Andreasen NC. Psychiatric Symptoms You Currently Have: Baseline (PSYCH-BASE) . Iowa City, Iowa: The University of Iowa; 1987. 41. Andreasen NC. Psychiatric Symptoms You Currently Have: Follow-up (PSYCH-UP) . Iowa City, Iowa: The University of Iowa; 1987. 42. Andreasen NC. Comprehensive Assessment of Symptoms of History: Follow-up (CASH-UP) . Iowa City, Iowa: The University of Iowa; 1987. 43. Shapiro RW, Keller MB. Longitudinal Interval Follow-up Evaluation (LIFE) . Boston, Mass: Massachusetts General Hospital; 1979. 44. Keller MB, Lavori PW, McDonald-Scott P, Andreasen NC. The LIFE: a videotape study on the reliability of obtaining prospective longitudinal follow-up data . Arch Gen Psychiatry . 1987;44:540-548.Crossref 45. Degreef G, Bilder M, Bogerts B. Symptom correlates of ventricle size in schizophrenia. Presented to the American Psychiatric Association; May 1990; New York, NY. Abstract. 46. Barta PE, Pearlson GD, Powers RE, Richard SS, Tune LE. Auditory hallucinations and smaller superior temporal gyral volume in schizophrenia . Am J Psychiatry . 1990;147:1457-1462. 47. Volkow ND, Wolf AP, Van Gelder P, Brodie JD, Overall JE, Cancro R, Gomez-Mont F. Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia . Am J Psychiatry . 1987;144:151-158. 48. Andreasen NC, Smith MR, Jacoby CG, Dennert JW, Olsen SA. Ventricular enlargement in schizophrenia: definition and prevalence . Am J Psychiatry . 1982;139:292-296. 49. Andreasen NC. Negative symptoms in schizophrenia: definition and reliability . Arch Gen Psychiatry . 1982;39:784-788.Crossref 50. Andreasen NC. Negative versus positive schizophrenia: definition and validation . Arch Gen Psychiatry . 1982;39:789-794.Crossref 51. Andreasen NC, Nasrallah HA, Dunn VD, Olson SC, Grove WM, Ehrhardt JC, Coffman JA, Grossett JHW. Structural abnormalities in the frontal system in schizophrenia: a magnetic resonance imaging study . Arch Gen Psychiatry . 1986;43:136-144.Crossref 52. Andreasen NC, Ehrhardt JC, Swayze VW, Alliger R, Yuh WTC, Cohen G, Ziebell S. Magnetic resonance imaging of the brain in schizophrenia: the pathophysiological significance of structural abnormalities . Arch Gen Psychiatry . 1990;47:35-44.Crossref 53. McGorry PD, Copolov DL, Singh BS. Royal Park Multidiagnostic Instrument for Psychosis, I: rationale and review . Schizophr Bull . 1990;16: 501-515.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

The Comprehensive Assessment of Symptoms and History (CASH): An Instrument for Assessing Diagnosis and Psychopathology

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References (55)

Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1992.01820080023004
Publisher site
See Article on Publisher Site

Abstract

Abstract • The Comprehensive Assessment of Symptoms and History was developed for research studies of schizophrenia spectrum conditions and affective spectrum conditions. It is designed to provide a comprehensive information base concerning current and past signs and symptoms, premorbid functioning, cognitive functioning, sociodemographic status, treatment, and course of illness. Because the information base is broad, it is not wedded to a specific diagnostic system but rather permits clinicians and investigators to make diagnoses using a wide range of systems, including Research Diagnostic Criteria, DSM-III, DSM-III-R, and the International Classification of Diseases. Given the fact that disorders in psychiatry are not defined at the etiological or pathophysiological level, diagnostic criteria are prone to ongoing revision as our knowledge base changes. Research strategies suggest that investigators should maintain a flexible database to permit them to adapt to changes in diagnostic systems, to do comparative nosological studies, and, ultimately, to develop new diagnostic systems based on knowledge concerning the underlying neurobiological nature of disorders. Because it provides a comprehensive information base, the Comprehensive Assessment of Symptoms and History facilitates research of this type. Extensive developmental work has been done with the Comprehensive Assessment of Symptoms and History, including interrater and test-retest reliability studies, validity studies, training programs, and data entry programs. References 1. Kreitman N, Sainsbury P, Morrissey J. The reliability of psychiatric assessment: an analysis . J Ment Sci . 1961;107:877-908. 2. Beck AT, Ward CH, Mendelson M. Reliability of psychiatric diagnosis, II: a study of consistency of clinical judgements and ratings . Am J Psychiatry . 1962;119:351-357. 3. Sandifer MG, Pettus G, Quade D. A study of psychiatric diagnosis . J Nerv Ment Dis . 1964;139:350-356.Crossref 4. Sandifer MG, Hordern A, Timbury GC. Psychiatric diagnosis: a comparative study in North Carolina, London and Glasgow . Br J Psychiatry . 1968;114:1-9.Crossref 5. Kendell RE, Cooper JE, Gourlay AG. Diagnostic criteria of American and British psychiatrists . Arch Gen Psychiatry . 1971;25:123-130.Crossref 6. Cooper JE, Kendell RE, Gurland BJ, Sharp L, Copeland JRM, Simon R. Psychiatric Diagnosis in New York and London . New York, NY: Oxford University Press Inc; 1972. Maudsley Monograph No. 20. 7. Spitzer RL, Fleiss JL. A reanalysis of the reliability of psychiatric diagnosis . Br J Psychiatry . 1974;125:341-347.Crossref 8. Feighner JP, Robins E, Guze SB, Woodruff RA Jr, Winokur G, Munoz R. Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry . 1972;26:57-63.Crossref 9. Spitzer RL, Endicott J, Robins E. Research Diagnostic Criteria . New York, NY: Biometrics Research Division, New York State Psychiatric Institute; 1975. 10. Spitzer RL, Endicott J, Robins E. Research diagnostic criteria: rationale and reliability . Arch Gen Psychiatry . 1978;35:773-782.Crossref 11. Spitzer RL, Endicott J. Schedule for Affective Disorders and Schizophrenia-Lifetime Version . New York, NY: Biometrics Research Division, New York State Psychiatric Institute; 1975. 12. Endicott J, Spitzer RL. A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia (SADS) . Arch Gen Psychiatry . 1978;35: 837-844.Crossref 13. Spitzer RL, Endicott J, Kuriansky J, Gurland B. Preliminary report of the reliability of research diagnostic criteria applied to psychiatric case records . In: Sudilovsky A, Gershon S, Beef B, eds. Predictability in Psychopharmacology: Preclinical and Clinical Correlations . New York, NY: Raven Press; 1975:1-47. 14. Andreasen NC, Grove WM, Shapiro RW, Keller MB, Hirschfeld RMA, McDonald-Scott P. Reliability of lifetime diagnosis: a multicenter collaborative perspective . Arch Gen Psychiatry . 1981;38:400-405.Crossref 15. Leckman JF, Sholomskas MA, Thompson WD, Belanger A, Weissman MM. Best estimate of lifetime psychiatric diagnosis . Arch Gen Psychiatry . 1982;39:879-883.Crossref 16. Endicott J, Nee J, Fleiss J, Cohen J, Williams JBW, Simon R. Diagnostic criteria for schizophrenia: reliabilities and agreement between systems . Arch Gen Psychiatry . 1982;39:884-889.Crossref 17. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 18. Robins LN, Helzer JE, Croughan J, Ratclaff KS. National Institutes of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity . Arch Gen Psychiatry . 1981;38:381-389.Crossref 19. Spitzer RL, Williams JBW. Structured Clinical Interview for DSM-III (SCID) . New York, NY: New York State Psychiatric Institute; 1984. 20. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 21. Spitzer RL, Williams JBW, Gibbon M, First MB. Structured Clinical Interview for DSM-III-R (SCID) . Washington, DC: American Psychiatric Association; 1990. 22. Andreasen NC. Comprehensive Assessment of Symptoms and History (CASH) . Iowa City, Iowa: The University of Iowa; 1985. 23. Bleuler E, Translated by J. Zinkin. Dementia Praecox of the Group of Schizophrenias (1911) . New York, NY: International Universities Press; 1950. 24. Schneider K; Hamilton MW, trans. Clinical Psychopathology . New York, NY: Grune & Stratton; 1959. 25. Mellor CS. First-rank symptoms of schizophrenia . Br J Psychiatry . 1970;117:15-23. 26. Wing JK. A standard form of psychiatric Present State Examinations (PSE) and a method for standardizing the classification of symptoms . In: Hare EH, Wing JK, eds. Psychiatric Epidemiology: An International Symposium . New York, NY: Oxford University Press Inc; 1970:93-108. 27. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders . Washington, DC: American Psychiatric Association; 1952. 28. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders, Second Edition . Washington, DC: American Psychiatric Association; 1968. 29. World Health Organization. 1989 draft of chapter 5: mental, behavioral and developmental disorders . In: ICD-10 . Geneva, Switzerland: World Health Organization; 1989. 30. Andreasen NC, Flaum M. Schizophrenia: the characteristic symptoms . Schizophr Bull . 1990;17:27-49.Crossref 31. Flaum M, Andreasen NC. Diagnostic criteria for schizophrenia and related disorders: options for DSM-IV . Schizophr Bull . 1991;17:133-142.Crossref 32. Wittman P. A scale for measuring prognosis in schizophrenic patients . In: Read CF, Leibert E, eds. Elgin Papers . Elgin, Ill: Elgin State Hospital; 1941; 4:20-33. 33. Gittelman-Klein R, Klein DF. Premorbid asocial adjustment and prognosis in schizophrenia . J Psychiatr Res . 1969;7:35-53.Crossref 34. Andreasen NC. The Scale for the Assessment of Negative Symptoms (SANS) . Iowa City, Iowa: The University of Iowa; 1983. 35. Andreasen NC. The Scale for the Assessment of Positive Symptoms (SAPS) . Iowa City, Iowa: The University of Iowa; 1984. 36. Hamilton M. A rating scale for depression . J Neurol Neurosurg Psychiatry . 1960;23:56-62.Crossref 37. Overall J, Gorham D. Brief psychiatric rating scale . Psychol Rep . 1962;10:799-812.Crossref 38. Folstein MF, Folstein SE, McHugh P. 'Mini Mental State': a practical method for grading the cognitive state of patients for the clinician . J Psychiatr Res . 1975;12:189-198.Crossref 39. Endicott J, Spitzer RL, Fleiss JL, Cohen J. The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance . Arch Gen Psychiatry . 1976;33:766-771.Crossref 40. Andreasen NC. Psychiatric Symptoms You Currently Have: Baseline (PSYCH-BASE) . Iowa City, Iowa: The University of Iowa; 1987. 41. Andreasen NC. Psychiatric Symptoms You Currently Have: Follow-up (PSYCH-UP) . Iowa City, Iowa: The University of Iowa; 1987. 42. Andreasen NC. Comprehensive Assessment of Symptoms of History: Follow-up (CASH-UP) . Iowa City, Iowa: The University of Iowa; 1987. 43. Shapiro RW, Keller MB. Longitudinal Interval Follow-up Evaluation (LIFE) . Boston, Mass: Massachusetts General Hospital; 1979. 44. Keller MB, Lavori PW, McDonald-Scott P, Andreasen NC. The LIFE: a videotape study on the reliability of obtaining prospective longitudinal follow-up data . Arch Gen Psychiatry . 1987;44:540-548.Crossref 45. Degreef G, Bilder M, Bogerts B. Symptom correlates of ventricle size in schizophrenia. Presented to the American Psychiatric Association; May 1990; New York, NY. Abstract. 46. Barta PE, Pearlson GD, Powers RE, Richard SS, Tune LE. Auditory hallucinations and smaller superior temporal gyral volume in schizophrenia . Am J Psychiatry . 1990;147:1457-1462. 47. Volkow ND, Wolf AP, Van Gelder P, Brodie JD, Overall JE, Cancro R, Gomez-Mont F. Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia . Am J Psychiatry . 1987;144:151-158. 48. Andreasen NC, Smith MR, Jacoby CG, Dennert JW, Olsen SA. Ventricular enlargement in schizophrenia: definition and prevalence . Am J Psychiatry . 1982;139:292-296. 49. Andreasen NC. Negative symptoms in schizophrenia: definition and reliability . Arch Gen Psychiatry . 1982;39:784-788.Crossref 50. Andreasen NC. Negative versus positive schizophrenia: definition and validation . Arch Gen Psychiatry . 1982;39:789-794.Crossref 51. Andreasen NC, Nasrallah HA, Dunn VD, Olson SC, Grove WM, Ehrhardt JC, Coffman JA, Grossett JHW. Structural abnormalities in the frontal system in schizophrenia: a magnetic resonance imaging study . Arch Gen Psychiatry . 1986;43:136-144.Crossref 52. Andreasen NC, Ehrhardt JC, Swayze VW, Alliger R, Yuh WTC, Cohen G, Ziebell S. Magnetic resonance imaging of the brain in schizophrenia: the pathophysiological significance of structural abnormalities . Arch Gen Psychiatry . 1990;47:35-44.Crossref 53. McGorry PD, Copolov DL, Singh BS. Royal Park Multidiagnostic Instrument for Psychosis, I: rationale and review . Schizophr Bull . 1990;16: 501-515.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Aug 1, 1992

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