Readmitted nonpsychotic patients and their eventual diagnoses. A retrospective study on 64 first-timers of inpatient care in the Psychiatric Clinic of Turku, Finland

Korkeila, J. A.; Karlsson, Hasse; Kujari, Harry

doi:10.1016/s0924-9338(98)80033-3

Cited by 1 publication

(2 citation statements)

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“…It was somewhat surprising that we did not nd any systematic tendency for clinicians to use ''minor diagnoses'' in rst-episode patients (see (13)). On the contrary, the relative proportion of false-positive diagnoses was particularly high in both schizophrenic disorders (44%) and psychotic depression (47%).…”

Section: Discussionmentioning

confidence: 78%

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Comparison of clinical and best-estimate research DSM-IV diagnoses in a Finnish sample of first-admission psychosis and severe affective disorder

Taiminen¹,

Ranta²,

Karlsson³

et al. 2001

Nordic Journal of Psychiatry

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The purpose of this study was to investigate diagnostic agreement between clinicians and a research group in a sample of first-admission psychosis and severe affective disorder patients. Clinical DSM-IV discharge diagnoses and best-estimate DSM-IV research diagnoses were compared in 116 first-episode patients in the city of Turku, Finland. The best-estimate research diagnoses were made at consensus meetings by integrating longitudinal data; patients' medical records; and findings of a clinical interview, the structured SCAN-interview, and symptom severity ratings. Overall diagnostic agreement was moderate, with a kappa value 0.51 (95% confidence interval (CI), 0.39- 0.63). Of the diagnostic groups, schizophrenic disorders had the lowest kappa value of 0.44 (95% CI, 0.26-0.63). Clinicians had a tendency to miss depressive symptoms in psychotic patients; to overdiagnose psychotic symptoms in depressive patients; and to fail to discover earlier hypomanic or depressive episodes in depressive patients. In conclusion, hospital diagnoses were not reliable in first-episode patients. Inappropriate diagnoses may compromise both treatment and epidemiologic findings based on discharge diagnoses.

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Section: Discussionmentioning

confidence: 78%

“…This may be partly due to their implicit tendency to use ''minor diagnosis'' at rst admission (13). Isohanni et al (8) found that the sensitivity for a hospital diagnosis of schizophrenia was 0.52 and the speci city 1.…”

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confidence: 99%