Patterns of psychiatric diagnosis in general practice: the Second National Morbidity Survey

Dunn, Graham

doi:10.1017/s0033291700010333

Cited by 7 publications

(4 citation statements)

References 17 publications

(24 reference statements)

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“…Psychodynamic and phenomenological elements can also play a role in the process between physician and patient when making diagnoses [15]. Therefore, the diagnostic process is much more complex and includes many facets, amongst others the need to understand patients [3,[41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

“…In practice, however, the process of making a diagnosis is not exclusively based on empirical facts but depends on multiple factors. They may depend on the disease concept of the physician or of the patient, the physician's overall diagnostic goal, the physician's age and general diagnostic style and behavior, the consideration of what the impact of the diagnosis on the patient might be and aspects of the health care system [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Motives and modifying factors for giving or rejecting psychiatric diagnoses in general medicine and psychiatry – a qualitative interview study

Tebartz van Elst,

Niehoff,

Steinhäuser

2024

BMC Psychiatry

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Background There is a discussion among general practitioners and psychiatrists regarding over-diagnosing versus under-reporting of psychiatric diagnoses. A deeper understanding of this topic is relevant for providing reasonable health care and for planning future studies. A crucial factor to understanding this discussion is the difference in the prevalence of a disease in each sector. One way to attain knowledge about such prevalences is the analysis of routine care data of the sector in question. However, diagnosis-related data might be modified by several additional influencing factors. Aims This study aims to explore what kind of motives and modifying factors play a role for or against giving psychiatric diagnoses in psychiatric and general medical settings. Methods Twenty-six semi-structured interviews were conducted with German physicians in the fields of general medicine and psychiatry. Interviews were analysed using content analysis. Results The analysis revealed three major motivational categories for finding a diagnosis: (1) “objective matters” such as “categorisation for research”; (2) “functional and performance-related factors” such as “requirement for medication”, “billing aspects” that go with certain diagnoses or “access to adequate care” and (3) “Individual factors” such as the “personality of a physician”. Similarly, factors emerged that lead to not making psychiatric diagnoses like “fear of stigmatization among patients” or “detrimental insurance status with psychiatric diagnosis”. Additionally participants mentioned other reasons for “not diagnosing a psychiatric diagnosis“, such as “coding of other clinical pictures”. Conclusion The diagnostic process is a complex phenomenon that goes far beyond the identification of medical findings. This insight should be considered when processing and interpreting secondary data for designing health care systems or designing a study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Motives and modifying factors for giving or rejecting psychiatric diagnoses in general medicine and psychiatry – a qualitative interview study

Tebartz van Elst,

Niehoff,

Steinhäuser

2024

BMC Psychiatry

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“…Correspondence analysis was used here to find a low-dimensional graphical representation of (1) associations between the childcare categories, (2) associations (and oppositions) between individuals according to their response profiles; and (3) associations between individuals and childcare categories. The readers who are interested in having more details about the technique or comparison to other methods can refer to: Greenacre, 1984;Lebart, Morineau and Warwick, 1984;Dunn, 1986;Benzecri, 1992;Rouanet and Le Roux, 1993;Bernard, 1994.…”

Section: Discussionmentioning

confidence: 99%

Childcare Patterns of Mothers of Twins During the First Year

Robin

Corroyer

Casati

1996

Child Psychology Psychiatry

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This study aims to describe the ways in which mothers of twins organize their childcare activities during the first year after a twin birth and to determine what factors might affect these mothering practices. The mother's physical and psychological state, support and help from the father and others in the surroundings, and the type of twinship were among the factors studied. Data on the organization of feeding, sleeping and waking routines were gathered from 51 families. A correspondence analysis and a cluster analysis showed that twin mothering practices can be described along two dimensions: individualized care vs collective care, and level of organization of daily routines. The mother's state of fatigue only partially accounts for the different types of maternal behavior. Likewise, the presence of several caregivers does not lead to greater individualization in care routines. Nor does there seem to be a clear link between the type of maternal behaviour and the type of twinship. The discussion deals with the mother's emotional investment, her personal capacity for adjusting to the "triadic motherhood' process, and the nature of the father's involvement in that process. Another consideration is the impact of the type of childcare pattern on twin development.

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“…Graphical displays provide a useful support for the construction of a model that accounts for empirical relationships found in the data. In spite of a certain amount of literature on graphical displays in various medical areas (Tukey, 1977;Cleveland and McGill, 1984;Chambers, Cleveland, Kleiner and Tukey, 1983;Wilkinson, 1992;Everitt, 1994;Powsner and Tufte, 1994;Sasieni and Royston, 1996), the use of graphical techniques in epidemiological psychiatry is scanty (Dunn, 1983(Dunn, , 1986.…”

Section: Introductionmentioning

confidence: 99%

Multidimensional assessment of outcome in psychiatry: the use of graphical displays. The South‐Verona Project 2

Ruggeri

Riani

Rucci

et al. 1998

Int J Methods Psych Res

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In psychiatry, the assessment of outcome, to be relevant for clinical practice, should be multidimensional. This demands suitable statistical tools both to represent and to analyse the complex relationships between variables. This paper aims to provide guidelines for selecting graphical displays of multidimensional data that enable better capturing of the relationships between variables and summarize information available for individual cases as well as for groups of patients. Multivariate graphical techniques such as Chernoff faces, stars, parallel co-ordinates and Andrews plots are applied to a set of data drawn from the South Verona Outcome Project, a naturalistic study based on a multidimensional model for the assessment of outcomes, routinely conducted at the Institute of Psychiatry of the University of Verona, Italy. The assessment includes global functioning, psychopathology, social disability, subjective quality of life, and satisfaction with services, number of service contacts and days of hospitalization.The selected sequence of graphical displays allows a quick understanding of the multivariate data set not otherwise obtainable with numerical indexes and specifically enabled us to: (a) picture the characteristics of the data set on each single variable; (b) identify relationships between two or more variables; (c) identify peculiarities of individual patients and of group of patients. In psychiatry and in other areas of medicine a graphical approach to multidimensional data is a useful analytical tool for increasing the impact of outcome studies, in everyday clinical practice and in monitoring and evaluating of services.

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Patterns of psychiatric diagnosis in general practice: the Second National Morbidity Survey

Cited by 7 publications

References 17 publications

Motives and modifying factors for giving or rejecting psychiatric diagnoses in general medicine and psychiatry – a qualitative interview study

Motives and modifying factors for giving or rejecting psychiatric diagnoses in general medicine and psychiatry – a qualitative interview study

Childcare Patterns of Mothers of Twins During the First Year

Multidimensional assessment of outcome in psychiatry: the use of graphical displays. The South‐Verona Project 2

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