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From the Department of Psychiatry (K.E.F., J.A.S., R.M.C.), Washington University School of Medicine, St. Louis, Missouri; Behavioral Medicine Unit and Department of Health Behavior (J.M.R.), University of Alabama at Birmingham, Birmingham, Alabama; Department of Psychiatry (C.B.T.), Stanford University School of Medicine, Palo Alto, California; Department of Preventive Medicine (C.F.MDL.), Rush-Presbyterian-St. Luke’s Medical Center, Chicago, Illinois; Department of Psychology (G.I.), University of Miami, Coral Gables, Florida; Department of Biostatistics (M.E.Y.), University of North Carolina, Chapel Hill, North Carolina; Department of Psychiatry (K.R.R.K.), Duke University Medical Center, Durham, North Carolina; and Department of Psychiatry and Behavioral Sciences (R.C.V.), University of Washington, Seattle, Washington.
Address reprint requests to: James D. Hosking, PhD, Collaborative Studies Coordinating Center, Department of Biostatistics CB 8030, University of North Carolina, 137 E. Franklin Street, Suite 203, Chapel Hill, NC 27514-4145.
OBJECTIVE: The Depression Interview and Structured Hamilton (DISH) is a semistructured interview developed for the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study, a multicenter clinical trial of treatment for depression and low perceived social support after acute myocardial infarction. The DISH is designed to diagnose depression in medically ill patients and to assess its severity on an embedded version of Williams’ Structured Interview Guide for the Hamilton Depression scale (SIGH-D). This article describes the development and characteristics of the DISH and presents a validity study and data on its use in ENRICHD.
METHODS: In the validity study, the DISH and the Structured Clinical Interview for DSM-IV (SCID) were administered in randomized order to 57 patients. Trained interviewers administered the DISH, and clinicians administered the SCID. In ENRICHD, trained research nurses administered the DISH and recorded a diagnosis. Clinicians reviewed 42% of the interviews and recorded their own diagnosis. The Beck Depression Inventory (BDI) was administered in both studies.
RESULTS: In the validity study, the SCID diagnosis agreed with the DISH on 88% of the interviews (weighted 
= 0.86). In ENRICHD, the clinicians agreed with 93% of the research nurses’ diagnoses. The BDI and the Hamilton depression scores derived from the DISH in the two studies correlated 0.76 (p < .0001) in the validity study and 0.64 (p < .0001) in ENRICHD.
CONCLUSIONS: These findings support the validity of the DISH as a semistructured interview to assess depression in medically ill patients. The DISH is efficient in yielding both a DSM-IV depression diagnosis and a 17-item Hamilton depression score.
Key Words: depressive disorder, • psychiatric status rating scales, • psychological tests, • coronary disease, • myocardial infarction.
Abbreviations: BDI = Beck Depression Inventory;; DISH = Diagnostic Interview and Structured Hamilton;; DSM-IV = Diagnostic and Statistic Manual of Mental Disorders, 4th edition;; ENRICHD = Enhancing Recovery in Coronary Heart Disease;; HRSD = Hamilton Rating Scale for Depression;; MI = myocardial infarction;; SIGH-D = Structured Interview Guide for the Hamilton Depression Scale.
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