New women-specific diagnostic modules: the Composite International Diagnostic Interview for Women (CIDI-VENUS)

  • Julia Martini
  • Hans-Ulrich Wittchen
  • Claudio N. Soares
  • Amber Rieder
  • Meir SteinerEmail author
Original Contribution


The World Health Organization-Composite International Diagnostic Interview (WHO-CIDI) is a highly structured interview for the assessment of mental disorders, based on the definitions and criteria of the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Over the past decade it has become evident that the CIDI does not sufficiently address the assessment needs of women. Women are affected by most mental disorders, particularly mood and anxiety disorders, approximately twice as frequently as men. Women-specific disorders, such as Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), psychiatric disorders during pregnancy and postpartum as well as during the perimenopause, menopause and beyond are not addressed by the standard CIDI diagnostic modules. In addition, the CIDI in its current form does not address the potential effect that female reproductive milestones may have on diagnosis, treatment and prevention of mental disorders in women. Our aim was to develop a new women specific platform (CIDI-VENUS; CIDI-V) to be embedded in the existing CIDI that will address the above mentioned current deficiencies. Guided by a team of experts in the field of Women’s Mental Health from Canada and Germany the following modules were developed: 1) A complete menstrual history and comprehensive contraceptive history with a link to the Premenstrual Symptoms Screening Tool (PSST). 2) A complete perinatal history of pregnancies, miscarriages, terminations, still births, death of a child, with details of current pregnancy including gestation and expected date of confinement, labour history and breastfeeding, history of tobacco, alcohol, and other substance use including prescription drugs during pregnancy and postpartum, a section on specific phobias and on recurrent obsessive/compulsive thoughts/behaviours (OCD) related to the baby with a link to the Perinatal Obsessive-Compulsive Scale (POCS), as well as a link to the Edinburgh Postnatal Depression Scale (EPDS). 3). A detailed history of use of hormone therapy (e.g. pills, patches, implants, etc.) with a focus on (peri-) menopausal women, differentiating between physical and psychological symptoms with a link to the Menopause Visual Analogue Scales (M-VAS) and to the Greene Climacteric Scale. 4) An iterative module concluding each CIDI section to specify the course of mental disorders during the reproductive stages and menopausal transition. While retaining core diagnostic sections and diagnostic algorithms, the CIDI-V is enriched by women-specific diagnostic modules, providing a wealth of clinically relevant information about women’s mental health, not available anywhere else in our current psychiatric diagnostic instruments.


Composite international diagnostic interview CIDI-VENUS Menstrual cycle Pregnancy Postpartum Menopausal transition 



The authors would like to thank team members of the Women’s Health Concerns Clinic, St. Joseph’s Healthcare, Hamilton, Ontario, Canada who participated in the development and language editing of the CIDI-V, in particular Leslie Born, as well as Jens Siegert and Christian Soltau (Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany) for their expert input into the design of the CIDI and the structured programming of the CIDI-V CAPI Version.


  1. American Psychiatric Association (APA) (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. DSM-III. American Psychiatric Association, Washington DCGoogle Scholar
  2. American Psychiatric Association (APA) (1987) Diagnostic and statistical manual of mental disorders, 3rd rev. edn. DSM-III-R. American Psychiatric Association, Washington DCGoogle Scholar
  3. American Psychiatric Association (APA) (2000) Diagnostic and statistical manual of mental disorders, 4th edn. text revision. DSM-IV-TR. American Psychiatric Association, Washington DCCrossRefGoogle Scholar
  4. Andrade L, Caraveo-Anduaga JJ, Berglund PA, Bijl RV, de Graaf R, Vollebergh WAM, Dragomirecka E, Kohn R, Keller M, Kessler RC, Kawakami N, Kilic C, Offord D, Ustun TB, Wittchen H-U (2003) The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys. Int J Methods Psychiatr Res 12:3–21PubMedCrossRefGoogle Scholar
  5. Andrews G, Peters L (1998) The psychometric properties of the composite international diagnostic interview. Soc Psychiatry Psychiatr Epidemiol 33:80–88PubMedCrossRefGoogle Scholar
  6. Andrews G, Wittchen H-U (1995) Clinical practice, measurement and information technology. Psychol Med 25:443–446PubMedCrossRefGoogle Scholar
  7. Born L, Steiner M (2000) Irritability: the forgotten dimension of female-specific mood disorders. Arch Womens Ment Health 2:153–167CrossRefGoogle Scholar
  8. Born L, Koren G, Lin E, Steiner M (2008) A new, female-specific irritability rating scale. J Psychiatry Neurosci 33:344–354PubMedGoogle Scholar
  9. Cottler L, Robins LN, Grant B, Blaine J, Towle I, Wittchen H-U, Sortorius N (1991) The CIDI-core substance abuse and dependence questions: cross cultural and nosological issues. Br J Psychiatry 159:653–658PubMedCrossRefGoogle Scholar
  10. Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786PubMedCrossRefGoogle Scholar
  11. Endicott J, Spitzer RL (1978) A diagnostic interview: the schedule for affective disorders and Schizophrenia. Arch Gen Psychiatry 35:837–844PubMedGoogle Scholar
  12. Escobar JI, Rubiostipec M, Canino G, Karno M (1989) Somatic Symptom Index (SSI)—New and abridged somatization construct—Prevalence and epidemiological correlates in 2 large community samples. J Nerv Ment Dis 177:140–146PubMedCrossRefGoogle Scholar
  13. Essau CA, Wittchen H-U (1993) An overview of the Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 3:79–85Google Scholar
  14. Fairburn CG, Harrison PJ (2003) Eating disorders. Lancet 361:407–416PubMedCrossRefGoogle Scholar
  15. Fehm L, Pelissolo A, Furmark T, Wittchen H-U (2005) Size and burden of social phobia in Europe. Eur Neuropsychopharmacol 15:453–462PubMedCrossRefGoogle Scholar
  16. Greene JG (1998) Constructing a standard climacteric scale. Maturitas 29:25–31PubMedCrossRefGoogle Scholar
  17. Kessler RC (2003) Epidemiology of women and depression. J Affect Disord 74:5–13PubMedCrossRefGoogle Scholar
  18. Kessler RC, Üstün TB (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organziation (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 13:93–121PubMedCrossRefGoogle Scholar
  19. Kessler RC, Andrews G, Mroczek D, Üstün B, Wittchen H-U (1998a) The world health organization Composite International Diagnostic Interview Short-Form (CIDI-SF). Int J Methods Psychiatr Res 7:171–185CrossRefGoogle Scholar
  20. Kessler RC, Wittchen H-U, Abelson JM, McGonagle K, Schwarz N, Kendler KS, Knäuper B, Zhao S (1998b) Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US National Comorbidity Survey (NCS). Int J Methods Psychiatr Res 7:33–55CrossRefGoogle Scholar
  21. Kessler RC, Wittchen H-U, Abelson J, Zhao S (2000) Methodological issues in assessing psychiatric disorders with self-reports. In: Stone AA, Turrkan JS, Bachrach CA, Jobe JB, Kurtzman HS, Cain VS (eds) The science of self-report. Implications for research and practice. Lawrence Erlbaum Associates, New Jersey, pp 229–255Google Scholar
  22. Knappe S, Runge J, Beesdo K, Jacobi F, Wittchen H-U (2008) Diagnosing Mental disorders: gold or Tin Standard. Psychother Psych Med 58:72–75CrossRefGoogle Scholar
  23. Lachner G, Wittchen H-U (1996) Das Composite International Diagnostic Interview Substance Abuse Module (CIDI-SAM). Ein neues Instrument zur klinischen Forschung und Diagnostik. In: Mann K, Buchkremer G (eds) Sucht. Grundlagen, Diagnostik, Therapie. Gustav Fischer Verlag, Stuttgart, pp 147–156Google Scholar
  24. Lachner G, Wittchen H-U, Perkonigg A, Holly A, Schuster P, Wunderlich U, Türk D, Garczynski E, Pfister H (1988) Structure, content and reliability of the Munich-Composite International Diagnostic Interview (M-CIDI) substance use sections. Eur Addict Res 4:28–41CrossRefGoogle Scholar
  25. Lépine J-P, Wittchen H-U, Essau CA (1993) Lifetime and current comorbidity of anxiety and depressive disorders: results from the international WHO/ADAMHA CIDI field trials. Int J Methods Psychiatr Res 3:67–77Google Scholar
  26. Lewinsohn PM, Rohde P, Seeley JR (1998) Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications. Clin Psychol Rev 18:765–794PubMedCrossRefGoogle Scholar
  27. Lieb R, Isensee B, von Sydow K, Wittchen H-U (2000) The Early Developmental Stages of Psychopathology Study (EDSP): a methodological update. Eur Addict Res 6:170–182PubMedCrossRefGoogle Scholar
  28. Lord C, Rieder A, Hall G, Soares C, Steiner M (2008) Perinatal Obsessive-Compulsive Scale (POCS): preliminary data. Eur Neuropsychopharm 18(suppl.4):S500CrossRefGoogle Scholar
  29. Martini J, Steiner M, Siegert J, Soltau C, Wittchen H-U (2007a) German Version of the Composite International Diagnostic Interview for women (CIDI-V). Institute of Clinical Psychology and Psychotherapy, TU Dresden, DresdenGoogle Scholar
  30. Martini J, Steiner M, Siegert J, Soltau C, Wittchen H-U (2007b) German Version of the Composite International Diagnostic Interview for women (CIDI-V): respondent booklet. Institute of Clinical Psychology and Psychotherapy, TU Dresden, DresdenGoogle Scholar
  31. Reed V, Gander F, Pfister H, Steiger A, Sonntag H, Trenkwalder C, Sonntag A, Hundt W, Wittchen H-U (1998) To what degree the Composite International Diagnostic Interview (CIDI) correctly identify DSM-IV disorders? Testing validity issues in a clinical sample. Int J Methods Psychiatr Res 7:142–155CrossRefGoogle Scholar
  32. Regier DA (2007) Dimensional approaches to psychiatric classification: refining the research agenda for DSM-V: an introduction. Int J Methods in Psychiatr Res 16:S1–S5CrossRefGoogle Scholar
  33. Rieder AD, Soares CN, Lord C, Wittchen H-U, Martini J, Steiner M (2009) Validation of the Composite International Diagnostic Interview—for women (CIDI-VENUS) in a perinatal psychiatric population. Biol Psychiatry 65(suppl)128SGoogle Scholar
  34. Rief W, Hessel A, Brähler E (2001) Somatization symptoms and hypochondriacal features in the general population. Psychosom Med 63:595–602PubMedGoogle Scholar
  35. Robins LN, Helzer JE, Croughan JL, Ratcliff KS (1981) National institute of mental health diagnostic interview schedule: its history, characteristics and validity. Arch Gen Psychiatry 38:381–389PubMedGoogle Scholar
  36. Robins JN, Wing J, Wittchen H-U, Helzer JE, Babor TF, Burke J, Farmer A, Jablenski A, Pickens R, Regier DA, Sartorius N, Towle LH (1988) The composite international diagnostic interview. An epidemiologic instrument suitable for the use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 45:1069–1077PubMedGoogle Scholar
  37. Rubio-Stipec M, Canino GJ, Robins LN, Wittchen H-U, Sartorius N, Torres de Miranda C (1993) The somatization schedule of the composite international diagnostic interview: the use of the probe chart in 17 different countries. Int J Methods Psychiatr Res 3:129–136Google Scholar
  38. Semler G, Wittchen H-U, Joschke K, Zaudig M, von Geiso T, Kaiser S, von Cranach M, Pfister H (1987) Test-retest reliability of a Standardized Psychiatric Interview (DIS/CIDI). Eur Arch Psychiatr Neurol Sci 236:214–222CrossRefGoogle Scholar
  39. Sheehan DV, Lecrubier Y, Harnett-Sheehan K, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar G (1998) The MINI International Neuropsychiatric Interview (M.I.N.I.). The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59:S22–S33Google Scholar
  40. Shear MK, Bjelland I, Beesdo K, Gloster AT, Wittchen H-U (2007) Supplementary dimensional assessment in anxiety disorders. Int J Methods in Psychiatr Res 16:S52–S64CrossRefGoogle Scholar
  41. Soares CN, Zitek B (2008) Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability? J Psychiatry Neurosci 33:331–343PubMedGoogle Scholar
  42. Spengler P, Wittchen H-U (1988) Procedural validity of standardized symptom questions for the assessment of psychotic symptoms—a comparison of the DIS with two clinical methods. Compr Psychiatry 29:309–322PubMedCrossRefGoogle Scholar
  43. Spitzer RL, Williams JBW, Gibbon M, First MB (1992) The Structured Clinical Interview for DSM-III-R (SCID) 1: history, rationale, and description. Arch Gen Psychiatry 49:624–629PubMedGoogle Scholar
  44. Steiner M, Dunn E, Born L (2003a) Hormones and mood: from menarche to menopause and beyond. J Affect Disord 74:67–83PubMedCrossRefGoogle Scholar
  45. Steiner M, Macdougall M, Brown E (2003b) The Premenstrual Symptoms Screening Tool (PSST) for clinicians. Arch Womens Ment Health 6:203–209PubMedCrossRefGoogle Scholar
  46. Steiner M, Martini J, Soltau C, Siegert J, Rieder A, Soares C, Wittchen H-U (2007a) Composite International Diagnostic Interview for women (CIDI-V). Institute of Clinical Psychology and Psychotherapy, TU Dresden, DresdenGoogle Scholar
  47. Steiner M, Martini J, Soltau C, Siegert J, Rieder A, Soares C, Wittchen H-U (2007b) Composite International Diagnostic Interview for women (CIDI-V): respondent booklet. Institute of Clinical Psychology and Psychotherapy, TU Dresden, DresdenGoogle Scholar
  48. Steiner M, Rieder A, Soares CN, Martini J, Wittchen H-U (2008) The Composite International Diagnostic Interview—for women (CIDI-VENUS): a pilot study. Int J Neuropsychopharmacol 11:S311Google Scholar
  49. van Engeland H, Buitelaar JK (2008) Autism spectrum disorders. In: Ruter M, Bishop D, Pine D, Scott S, Stevenson J, Taylor E, Thapar A (eds) Rutter’s child and adolescent psychiatry, 5th edn. Blackwell, Massachusetts, pp 759–781Google Scholar
  50. van Gülick-Bailer M, Maurer K, Häfner H (1995) Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Huber, BernGoogle Scholar
  51. Williams JB, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, Howes J, Kane J, Pope HG, Rounsaville B, Wittchen H-U (1992) The structured clinical interview for DSM-III-R (SCID).II.Multi-site test-retest-reliability. Arch Gen Psychiatry 49:630–636PubMedGoogle Scholar
  52. Wing JK, Cooper JE, Sartorius N (1974) Measurement and classification of psychiatric symptoms. Cambridge University Press, CambridgeGoogle Scholar
  53. Wittchen HU (1993) Computer scoring of CIDI diagnoses. Int J Methods Psychiatr Res 3:101–107Google Scholar
  54. Wittchen H-U (1994) Reliability and validity studies of the WHO—Composite International Diagnostic Interview (CIDI): a critical review. J Psychiat Res 28:57–84PubMedCrossRefGoogle Scholar
  55. Wittchen H-U, Jacobi F (2005) Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies. Eur Neuropsychopharmacalogy 15:357–376CrossRefGoogle Scholar
  56. Wittchen H-U, Nelson CB (1996) The Composite International Diagnostic Interview: an instrument for measuring mental health outcome? In: Thornicroft G, Tansella M (eds) Mental health outcome measures. Springer, Heidelberg, pp 179–187Google Scholar
  57. Wittchen H-U, Pfister H (1997) Instruktionsmanual zur Durchführung von DIA-X-Interviews. Swets Test Services, FrankfurtGoogle Scholar
  58. Wittchen H-U, Pfister H (2004) DIA-X/M-CIDI. DIA-X/CIDI-Composite international diagnostic interview. In: Strauß B, Schumacher J (eds) Klinische Interviews und Ratingskalen. Hogrefe, GöttingenGoogle Scholar
  59. Wittchen H-U, Semler G (1990) Composite International Diagnostic Interview (CIDI, Version 1.0). Beltz Verlag, WeinheimGoogle Scholar
  60. Wittchen H-U, Burke JD, Semler G, Pfister H, von Cranach M, Zaudig M (1989) Recall and dating of psychiatric symptoms—test-retest reliability of time related symptom questions in a standardized psychiatric interview (CIDI/DIS). Arch Gen Psychiatry 46:437–443PubMedGoogle Scholar
  61. Wittchen H-U, Robins LN, Cottler L, Sartorius N, Burke J, Regier D (1991) Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). Br J Psychiatry 159:645–653PubMedCrossRefGoogle Scholar
  62. Wittchen H-U, Kessler RC, Zhao S, Abelson J (1995) Reliability and clinical validity of UM-CIDI DSM-III-R generalized anxiety disorder. J Psychiat Res 29:95–110PubMedCrossRefGoogle Scholar
  63. Wittchen H-U, Zhao S, Abelson JM, Abelson JL, Kessler RC (1996) Reliability and procedural validity of UM-CIDI DSM-III-R phobic disorders. Psychol Med 26:1169–1177PubMedCrossRefGoogle Scholar
  64. Wittchen H-U, Lachner G, Wunderlich U, Pfister H (1998) Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 33:568–578PubMedCrossRefGoogle Scholar
  65. Wittchen HU, Üstün TB, Kessler RC (1999) Diagnosing mental disorders in the community. A difference that matters? Editorial. Psychol Med 29:1021–1027PubMedCrossRefGoogle Scholar
  66. Wittchen H-U, Kessler RC, Üstün TB (2001) Properties of the Composite International Diagnostic Interview (CIDI) for measuring mental health outcome. In: Tansella M, Thornicroft G (eds) Mental health outcome measures, 2nd edn. Gaskell, London, pp 212–227Google Scholar
  67. Wittchen H-U, Becker E, Lieb R, Krause P (2002) Prevalence, incidence and stability of premestrual dysphoric disorder in the community. Psychol Med 32:119–132PubMedCrossRefGoogle Scholar
  68. World Health Organization (WHO) (1993) Thenth Revision of the International Classification of Diseases. Chapter V (F). Mental and Behavioral Disorders. Clinical descriptions and diagnostic guidelines . World Health Organization, GenevaGoogle Scholar
  69. Yonkers KA, McCunn KL (2007) Comorbidity of Premenstrual Syndrome and Premenstrual Dysphoric Disorder with other psychiatric conditions. In O’Brien PMS, Rapkin AJ, Schmidt PJ (eds.) The Premenstrual Disorders: PMS and PMDD. CRC, pp. 49–54Google Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Julia Martini
    • 1
  • Hans-Ulrich Wittchen
    • 1
  • Claudio N. Soares
    • 2
  • Amber Rieder
    • 2
  • Meir Steiner
    • 2
    Email author
  1. 1.Technische Universität DresdenDresdenGermany
  2. 2.McMaster UniversityHamiltonCanada

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