Eduard Zander1, Lea Wyder2, Martin Grosse Holtforth3, Ulrich Schnyder4, Urs Hepp5, Niklaus Stulz2. 1. Psychiatric Services Aargau, P.O. Box 432, CH-5201 Brugg, Switzerland. 2. Psychiatric Services Aargau, P.O. Box 432, CH-5201 Brugg, Switzerland; University of Berne, Department of Psychology, Fabrikstrasse 8, CH-3012 Berne, Switzerland. 3. University of Berne, Department of Psychology, Fabrikstrasse 8, CH-3012 Berne, Switzerland; Inselspital, Psychosomatic Competence Center, Haus C.L. Lory, CH-3010 Berne, Switzerland. 4. University Hospital Zurich, Department of Psychiatry and Psychotherapy, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland. 5. Integrated Psychiatric Services Winterthur - Zurcher Unterland, Wieshofstrasse 102, P.O. Box 144, CH-8408 Winterthur, Switzerland.
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.
RCT Entities:
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.
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