Modifying and Validating the Composite International Diagnostic Interview (CIDI) for Use in Nepal

This paper describes the translation and validation process of converting the Composite International Diagnostic Interview (CIDI) V3.0, a widely-used research psychiatric diagnostic interview, into Nepali for use in a planned psychiatric epidemiological survey in Nepal. The CIDI was designed and has been extensively used to assess the prevalence and correlates of mental disorders in general population surveys around the world using fully-structured questions administered by lay interviewers who have no clinical training. Concerns have been raised, though, that standard translation, back-translation, and harmonization procedures are inadequate to produce a culturally valid version of the instrument in non-Western countries. In order to address these concerns, we took a more locally tailored approach in translating the CIDI that incorporated Nepali idioms and cultural understandings of psychiatric symptoms combined with a rigorous psychometric analysis of validation compared to expert medical evaluation. This paper reports on this approach and provides results from both the process and the resulting pilot study of 400 respondents selected to be representative of the Nepalese general population.