Cross-cultural study of conviction subtype Taijin Kyofu: proposal and reliability of Nagoya-Osaka diagnostic criteria for social anxiety disorder

Kinoshita, Yoshihiro, Chen, Junwen, Rapee, Ronald M., Bögels, Susan, Schneier, Franklin R., Choy, Yujuan, Kwon, Jung-Hye, Liu, Xinghua, Schramm, Elisabeth, Chavira, Denise A., Nakano, Yumi, Watanabe, Norio, Ietzugu, Tetsuji, Ogawa, Sei, Emmelkamp, Paul, Zhang, Jianxue, Kingdon, David, Nagata, Toshihiko and Furukawa, Toshi A. (2008) Cross-cultural study of conviction subtype Taijin Kyofu: proposal and reliability of Nagoya-Osaka diagnostic criteria for social anxiety disorder. Journal of Nervous and Mental Disease, 196 (4), 307-313. (doi:10.1097/NMD.0b013e31816a4952).

Abstract

Conviction subtype Taijin-Kyofu (c-TK) is a subgroup of mental disorder characterized by conviction and strong fear of offending others in social situations. Although the concept of c-TK overlaps with that of social anxiety disorder (SAD), patients with c-TK often may not be diagnosed as such within the current Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. We propose the Nagoya-Osaka criteria to amend this situation. This study examined the cross-cultural interrater reliability of the proposed criteria. Eighteen case vignettes of patients with a variety of complaints focused around social anxieties were collected from 6 different countries, and diagnosed by 13 independent raters from various nationalities according to the original DSM-IV and the expanded criteria. The average agreement ratio for the most frequent diagnostic category in each case was 61.5% with DSM-IV and 87.6% with the modified DSM-IV with Nagoya-Osaka criteria (p < 0.001). These findings indicate that the Nagoya-Osaka criteria for SAD can improve interrater reliability of SAD.

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