Diagnostic Stability of Primary Psychotic Disorders in a Research Sample.
Diagnostic Stability of Primary Psychotic Disorders in a Research Sample.
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DOI：
10.3389/fpsyt.2021.734272
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发表时间：
2021
影响因子：
4.7
通讯作者：
Lewandowski KE
中科院分区：
文献类型：
--
作者：
Wood AJ;Carroll AR;Shinn AK;Ongur D;Lewandowski KE
精神病学诊断在临床和研究中通常被视为一个稳定的结构；然而，一些证据表明，诊断变化可能是常见的，这可能会影响研究的有效性和临床护理。在目前的研究中，我们检查了精神病患者随时间推移的诊断稳定性。使用精神疾病诊断和统计手册结构化临床访谈在两个时间点对被诊断为精神障碍的参与者(n=142)进行评估。我们发现，在整个样本中，诊断更改率为25.4%。最初诊断为精神病的人和分裂样障碍的改变率最高，其次是精神分裂症和分裂情感障碍的人，双相情感障碍的改变率最低。大多数参与者最初诊断为精神分裂症、分裂样障碍、双相情感障碍或精神错乱，但没有明确诊断，最终诊断为分裂情感性障碍。最初诊断为分裂情感障碍不稳定的参与者最常被诊断为精神分裂症。我们的发现表明，诊断改变是相对常见的，发生在大约四分之一的患者中。最初诊断为精神分裂症谱系障碍的人更有可能发生诊断变化，这表明一些诊断比其他诊断更自然地稳定。
Psychiatric diagnosis is often treated as a stable construct both clinically and in research; however, some evidence suggests that diagnostic change may be common, which may impact research validity and clinical care. In the present study we examined diagnostic stability in individuals with psychosis over time. Participants with a diagnosis of any psychotic disorder (n = 142) were assessed at two timepoints using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. We found a 25.4% diagnostic change rate across the total sample. People with an initial diagnosis of psychosis not otherwise specified and schizophreniform disorder had the highest rates of change, followed by those with schizophrenia and schizoaffective disorder; people with bipolar disorder had the lowest change rate. Most participants with an unstable initial diagnosis of schizophrenia, schizophreniform disorder, bipolar disorder, or psychosis not otherwise specified converted to a final diagnosis of schizoaffective disorder. Participants with an unstable initial diagnosis of schizoaffective disorder most frequently converted to a diagnosis of schizophrenia. Our findings suggest that diagnostic change is relatively common, occurring in approximately a quarter of patients. People with an initial diagnosis of schizophrenia-spectrum disorder were more likely to have a diagnostic change, suggesting a natural stability of some diagnoses more so than others.
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通讯作者：
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通讯作者：
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