Validity of routine clinical diagnoses in acute psychiatric inpatients. (January 2018)

• Record Type: Journal Article
• Authors: Zander, Eduard; Wyder, Lea; Holtforth, Martin grosse; Schnyder, Ulrich; Hepp, Urs; Stulz, Niklaus
• Is Part Of: Psychiatry research. Volume 259(2018)
• Page Start: 482
• Page End: 487
• Publication Date: 2018-01
• Subjects: Assessment -- Interview -- Examination -- Psychiatry -- ICD-10 -- DSM-IV -- DSM-5; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2017.11.004
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: Aim: To examine the validity of diagnoses obtained by clinicians during routine clinical examination on acute psychiatric inpatient wards. Methods: N=100 inpatients with a broad spectrum of major mental disorders were randomly selected in a mental hospital's department of general psychiatry. Patients were diagnosed by independent assessors within Md = 5 (Range: 1–18) days of admission using the SCID I in order to examine the validity of the diagnoses given by the clinical staff based on routine assessments. Results: The commonly used clinical examination technique had good overall agreement with the SCID I assessments regarding primary diagnoses at the level of ICD-10 main categories (F2, F30-31, F32-F33, F4; κ = 0.65). However, agreement between routine clinical diagnoses and the SCID I diagnoses tended to be low for some specific mental disorders (e.g., depressive disorders) and for secondary diagnoses. Conclusions: The validity of routine clinical diagnoses established in acute inpatient settings is limited and should be improved. Highlights: The overall diagnostic agreement between routine examination and structured assessment in psychiatric inpatients is good. But the agreement is low for some specific diagnoses (e.g. depressive disorders) and for secondary diagnoses. The validity of routine clinical diagnoses should be improved.