Skip to main content Accessibility help
×
Home

Diagnostic stability of psychiatric disorders in clinical practice

  • Enrique Baca-Garcia (a1), Maria M. Perez-Rodriguez (a2), Ignacio Basurte-Villamor (a3), Antonio L. Fernandez Del Moral (a4), Miguel A. Jimenez-Arriero (a5), Jose L. Gonzalez De Rivera (a6), Jeronimo Saiz-Ruiz (a7) and Maria A. Oquendo (a8)...

Abstract

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, 1992–2004 (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.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Diagnostic stability of psychiatric disorders in clinical practice
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Diagnostic stability of psychiatric disorders in clinical practice
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Diagnostic stability of psychiatric disorders in clinical practice
      Available formats
      ×

Copyright

Corresponding author

Professor Enrique Baca-Garcia, Department of Psychiatry, Fundacion Jimenez Diaz University Hospital, Autonomous University of Madrid, Avenida Reyes Catolicos 2, 28040 Madrid, Spain. Tel/fax: +34 91 550 49 87; email: ebacgar2@yahoo.es

Footnotes

Hide All

Declaration of interest

None.

Footnotes

References

Hide All
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision) (DSM-IV-TR). APA.
Andreasen, N. C. (1995) The validation of psychiatric diagnosis: new models and approaches (editorial). American Journal of Psychiatry, 152, 161162.
Barkow, K., Heun, R., Wittchen, H. U., et al (2004) Mixed anxiety-depression in a 1 year follow-up study: shift to other diagnosis or remission? Journal of Affective Disorders, 79, 235239.
Culverhouse, R., Bucholz, K. K., Crowe, R. R., et al (2005) Long-term stability of alcohol and other substance dependence diagnoses and habitual smoking. Archives of General Psychiatry, 62, 753760.
Grilo, C. M., Sanislow, C. A., Gunderson, J. G., et al (2004) Two-year stability and change of schizotypal, border ine, avoidant, and obsessive-compu sive personality disorders. Journal of consulting and clinical psychology, 72, 767775.
Kendell, R. & Jablensky, A. (2003) Distinguishing between the validity and utility of psychiatric diagnoses. American Journal of Psychiatry, 160, 412.
Kendler, K. S. (1980) The nosologic validity of paranoia (simple delusional disorder): areview. Archives of General Psychiatry, 37, 699706.
Kessing, L. V. (2005a) Diagnostic stability in depressive disorder as according to ICD-10 in clinical practice. Psychopathology, 38, 3237.
Kessing, L. V. (2005b) Diagnostic stability in bipolar disorder in clinical practise as according to ICD-10. Journal of Affective Disorders, 85, 293299.
Krishnan, K. R. (2005) Psychiatric disease in the genomic era: rational approach. Molecular Psychiatry, 10, 978984.
Lieb, R., Zimmermann, P., Friis, R. H., et al (2002) The natural course of DSM-IV somatoform disorders and syndromes among adolescents and young adults: a prospective-longitudinal community study. European Psychiatry, 17, 321331.
McGlashan, T. H., Grilo, C. M., Sanislow, C. A., et al (2005) Two-year prevalence and stability of individual DSM-IV criteria for schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders: toward a hybrid model of axis II disorders. American Journal of Psychiatry, 162, 883889.
Mojtabai, R., Susser, E. S. & Bromet, E. J. (2003) Clinical characteristics, 4-year course, and DSM–IV classification of patients with nonaffective acute remitting psychosis. American Journal of Psychiatry, 160, 21082115.
Mussigbrodt, H., Michels, R., Malchow, C. P., et al (2000) Use of the ICD–10 classification in psychiatry: an international survey. Psychopathology, 33, 9499.
Organizacion Mundial de la Salud (1993) CIE 10. Trastornos Mentales y del Comportamiento: Tablas de Conversion entre la CIE, la CIE-9 y la CIE-10. OMS.
Robins, E. & Guze, S. B. (1970) Establishment of diagnostic vaidity in psychiatric illness: its application to schizophrenia. American Journal of Psychiatry, 126, 983987.
Rufino, A. C., Uchida, R. R., Vilela, J. A., et al (2005) Stability of the diagnosis of first-episode psychosis made in an emergency setting. General Hospital Psychiatry, 27, 189193.
Schimmelmann, B. G., Conus, P., Edwards, J., et al (2005) Diagnostic stability 18 months after treatment initiation for first-episode psychosis. Journal of Clinical Psychiatry, 66, 12391246.
Schwartz, J. E., Fennig, S., Tanenberg-Karant, M., et al (2000) Congruence of diagnosis 2 years after a first-admission diagnosis of psychosis. Archives of General Psychiatry, 57, 593600.
Segal, S. P., Egley, L., Watson, M. A., et al (1995) Factors in the quality of patient evaluations in general hospital psychiatric emergency services. Psychiatric Services, 46, 11441148.
Shea, M. T., Stout, R., Gunderson, J., et al (2002) Short-term diagnostic stability of schizotypal, borderline, avoidant, and obsessive–compulsive personality disorders. American Journal of Psychiatry, 159, 20362041.
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–82.
Tsuang, M. T., Woolson, R. F., Winokur, G., et al (1981) Stability of psychiatric diagnosis. Schizophrenia and affective disorders followed up over a 30- to 40-year period. Archives of General Psychiatry, 38, 535539.
Veen, N. D., Selten, J. P., Schols, D., et al (2004) Diagnostic stability in a Dutch psychosis incidence cohort. British Journal of Psychiatry, 185, 460464.
World Health Organization (1978) International Statistical Classification of Diseases, Version 9 (ICD–9). WHO.
World Health Organization (1992) Tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD–10). WHO.
Type Description Title
PDF
Supplementary materials

Baca-Garcia et al. supplementary material
Supplementary Figure S1-S4

 PDF (455 KB)
455 KB
UNKNOWN
Supplementary materials

Baca-Garcia et al. supplementary material
Supplementary Material

 Unknown (556 bytes)
556 bytes

Diagnostic stability of psychiatric disorders in clinical practice

  • Enrique Baca-Garcia (a1), Maria M. Perez-Rodriguez (a2), Ignacio Basurte-Villamor (a3), Antonio L. Fernandez Del Moral (a4), Miguel A. Jimenez-Arriero (a5), Jose L. Gonzalez De Rivera (a6), Jeronimo Saiz-Ruiz (a7) and Maria A. Oquendo (a8)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Diagnostic stability of psychiatric disorders in clinical practice

  • Enrique Baca-Garcia (a1), Maria M. Perez-Rodriguez (a2), Ignacio Basurte-Villamor (a3), Antonio L. Fernandez Del Moral (a4), Miguel A. Jimenez-Arriero (a5), Jose L. Gonzalez De Rivera (a6), Jeronimo Saiz-Ruiz (a7) and Maria A. Oquendo (a8)...
Submit a response

eLetters

We encountered an error trying to retrieve eLetters for this article. Please try again or contact Customer Services

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *