Validity of routine clinical diagnoses in acute psychiatric inpatients

Zander, Eduard; Wyder, Lea; grosse Holtforth, Martin; Schnyder, Ulrich; Hepp, Urs; Stulz, Niklaus (2018). Validity of routine clinical diagnoses in acute psychiatric inpatients. Psychiatry research, 259, pp. 482-487. Elsevier 10.1016/j.psychres.2017.11.004

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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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