Article1989

Psychiatric Diagnosis in an Outpatient Population

39 citations0/0 files storedArchives of General Psychiatry

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Mental Health and Psychiatry Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Psychological Testing and Assessment

Abstract

Two diagnostic systems are compared in a psychiatric outpatient population of 175 patients. The Present State Examination (PSE)-Catego system identified 121 patients (69%) as "cases," whereas DSM-III identified 152 patients (87%) as cases. The two systems converged in 115 patients, yielding a kappa coefficient of only .32. Approximately one third of the DSM-III cases that were not detected by the PSE-Catego system was due to the restricted coverage of the latter system; the remaining two thirds could be attributed to differences in threshold and time framing. Compared with DSM-III, the PSE-Catego system showed a strong bias toward depression, and the system was extremely insensitive to the detection of social phobias and obsessive-compulsive disorders. Only 58% of cases of depression and 46% of cases of anxiety were diagnosed by both systems. The results are compared with other studies, and some consequences are discussed.

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References

1978Research Diagnostic Criteria 1972Diagnostic Criteria for Use in Psychiatric Research 1975Book Review: Measurement and Classification of Psychiatric Symptoms 1978The concept of a ‘case’ in psychiatric population surveys 1983Comparison of Research Diagnostic Systems in an Edinburgh Community Sample 1979Severity of Psychiatric Disorder and the 30-Item General Health Questionnaire 1983Use and Misuse of the PSE 1982A Comparative Study of Pse/Catego and Diasika: Two Psychiatric Computer Diagnostic Systems

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