Diagnostic stability of psychiatric disorders in clinical practice
Diagnostic stability of psychiatric disorders in clinical practice
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DOI：
10.1192/bjp.bp.106.024026
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发表时间：
2007-03-01
影响因子：
10.5
通讯作者：
Oquendo, Maria A.
中科院分区：
文献类型：
--
作者：
Baca-Garcia, Enrique;Perez-Rodriguez, Maria M.;Oquendo, Maria A.
背景精神疾病是世界范围内疾病负担和残疾的主要原因之一。验证诊断的一个主要标准是稳定性随着时间的推移。目的是评估最普遍的精神病诊断在各种临床settings.Method的长期稳定性，共34 368例患者接受精神病护理的集水区的一家西班牙医院（1992-2004年）。本研究基于10025名成人患者，他们在三种情况下至少接受了10次评估（360899次精神科咨询）：住院部，2000-2004年（n=546）;精神科急诊室，2000-2004年（n=1408）;和门诊精神科设施，1992 - 2004年（n= 10016）。前瞻性的一致性，回顾性的一致性和比例的患者谁收到每个诊断至少75%的评价计算每个诊断在每个设置和跨settings.Results的时间一致性精神障碍是穷人，范围从29%的特定人格障碍的70%精神分裂症，住院诊断的稳定性最高，门诊诊断的稳定性最低。结论该研究结果是对我们目前精神病诊断实践的控诉。
Background Psychiatric disorders are among the top causes worldwide of disease burden and disability. A major criterion for validating diagnoses is stability over time.Aims To evaluate the long-term stability of the most prevalent psychiatric diagnoses in a variety of clinical settings.Method A total of 34 368 patients received psychiatric care in the catchment area of one Spanish hospital (1992-2004). This study is based on 10 025 adult patients who were assessed on at least ten occasions (360 899 psychiatric consultations) in three settings: in-patient unit, 2000-2004 (n=546); psychiatric emergency room, 2000-2004 (n=1408); and out-patient psychiatric facilities, 19922004(n=10 016). Prospective consistency, retrospective consistency and the proportion of patients who received each diagnosis in at least 75% of the evaluations were calculated for each diagnosis in each setting and across settings.Results The temporal consistency of mental disorders was poor, ranging from 29% for specific personality disorders to 70% for schizophrenia, with stability greatest for in-patient diagnoses and least for out-patient diagnoses.Conclusions The findings are an indictment of our current psychiatric diagnostic practice.Declaration of interest None.