OBJECTIVE: Very few studies have quantified the level of agreement among alternative diagnostic procedures that use a common set of fixed operational criteria. The authors examined the procedural validity of four independent methods of assigning DSM-III-R diagnoses of psychotic disorders. METHOD: The research was conducted as a satellite study to the DSM-IV Field Trial for Schizophrenia and Related Psychotic Disorders. The setting was the National Health and Medical Research Council Schizophrenia Research Unit's Early Psychosis Prevention and Intervention Centre, which focuses on first-episode psychosis. Consecutively admitted patients (N = 50) were assessed by independent raters who used four different procedures to determine a DSM-III-R diagnosis. These procedures were 1) the diagnostic instrument developed for the DSM-IV field trial, 2) the Royal Park Multidiagnostic Instrument for Psychosis, 3) the Munich Diagnostic Checklists, and 4) a consensus DSM-III-R diagnosis assigned by a team of clinician researchers who were expert in the use of diagnostic criteria. RESULTS: Concordance between pairs of diagnostic procedures was only moderate. Corresponding levels of percent agreement, however, ranged from 66% to 76%, with converse misclassification rates of 24%-34% (assuming one procedure to be "correct"). CONCLUSIONS: These findings have significant research and clinical implications. Despite the introduction of operationally defined diagnoses, there remained an appreciable level of differential classification or misclassification arising from variability in the method of assigning the diagnostic criteria rather than the criteria themselves. Such misclassification may impede neurobiological research and have harmful clinical effects on patients with first-episode psychosis.
OBJECTIVE: Very few studies have quantified the level of agreement among alternative diagnostic procedures that use a common set of fixed operational criteria. The authors examined the procedural validity of four independent methods of assigning DSM-III-R diagnoses of psychotic disorders. METHOD: The research was conducted as a satellite study to the DSM-IV Field Trial for Schizophrenia and Related Psychotic Disorders. The setting was the National Health and Medical Research Council Schizophrenia Research Unit's Early Psychosis Prevention and Intervention Centre, which focuses on first-episode psychosis. Consecutively admitted patients (N = 50) were assessed by independent raters who used four different procedures to determine a DSM-III-R diagnosis. These procedures were 1) the diagnostic instrument developed for the DSM-IV field trial, 2) the Royal Park Multidiagnostic Instrument for Psychosis, 3) the Munich Diagnostic Checklists, and 4) a consensus DSM-III-R diagnosis assigned by a team of clinician researchers who were expert in the use of diagnostic criteria. RESULTS: Concordance between pairs of diagnostic procedures was only moderate. Corresponding levels of percent agreement, however, ranged from 66% to 76%, with converse misclassification rates of 24%-34% (assuming one procedure to be "correct"). CONCLUSIONS: These findings have significant research and clinical implications. Despite the introduction of operationally defined diagnoses, there remained an appreciable level of differential classification or misclassification arising from variability in the method of assigning the diagnostic criteria rather than the criteria themselves. Such misclassification may impede neurobiological research and have harmful clinical effects on patients with first-episode psychosis.
Authors: Anthony P Morrison; Paul French; Sophie Parker; Morwenna Roberts; Helen Stevens; Richard P Bentall; Shôn W Lewis Journal: Schizophr Bull Date: 2006-09-14 Impact factor: 9.306
Authors: Emanuel Schwarz; Rauf Izmailov; Michael Spain; Anthony Barnes; James P Mapes; Paul C Guest; Hassan Rahmoune; Sandra Pietsch; F Markus Leweke; Matthias Rothermundt; Johann Steiner; Dagmar Koethe; Laura Kranaster; Patricia Ohrmann; Thomas Suslow; Yishai Levin; Bernhard Bogerts; Nico Jm van Beveren; George McAllister; Natalya Weber; David Niebuhr; David Cowan; Robert H Yolken; Sabine Bahn Journal: Biomark Insights Date: 2010-05-12
Authors: Shile Qi; Gunter Schumann; Juan Bustillo; Jessica A Turner; Rongtao Jiang; Dongmei Zhi; Zening Fu; Andrew R Mayer; Victor M Vergara; Rogers F Silva; Armin Iraji; Jiayu Chen; Eswar Damaraju; Xiaohong Ma; Xiao Yang; Michael Stevens; Daniel H Mathalon; Judith M Ford; James Voyvodic; Bryon A Mueller; Aysenil Belger; Steven G Potkin; Adrian Preda; Chuanjun Zhuo; Yong Xu; Congying Chu; Tobias Banaschewski; Gareth J Barker; Arun L W Bokde; Erin Burke Quinlan; Sylvane Desrivières; Herta Flor; Antoine Grigis; Hugh Garavan; Penny Gowland; Andreas Heinz; Jean-Luc Martinot; Marie-Laure Paillère Martinot; Eric Artiges; Frauke Nees; Dimitri Papadopoulos Orfanos; Tomáš Paus; Luise Poustka; Sarah Hohmann; Juliane H Fröhner; Michael N Smolka; Henrik Walter; Robert Whelan; Vince D Calhoun; Jing Sui Journal: Biol Psychiatry Date: 2021-01-30 Impact factor: 12.810