Stability of DSM-III-R Diagnoses: Study of a Case Register

• Published in: Psychopathology Vol. 34; no. 3; pp. 118 - 122
• Main Authors: Huguelet, Philippe, Schneider El Gueddari, Nora, Glauser, Daniel
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.05.2001; S. Karger AG
• Subjects: Adult; Biological and medical sciences; Female; Hospitalization - statistics & numerical data; Humans; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - rehabilitation; Observer Variation; Original Paper; Patient Admission - statistics & numerical data; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Registries; Reproducibility of Results; Severity of Illness Index; Techniques and methods; Schizophrenia; Stability; Diagnosis; Psychosis; Human; Diagnostic and Statistical Manual III; Mental disorder; Revised drafting
• ISSN: 0254-4962; 1423-033X
• DOI: 10.1159/000049293

We studied the diagnostic stability and the factors associated with it in 1,443 psychiatric patients with multiple admissions for a period of 45 months. We successively considered the whole population, the psychotic and then the schizophrenic patients. Demographic and DSM-III-R diagnostic information was collected on a computerized database. During the observation period, 1,443 patients were hospitalized twice or more. Diagnostic stability ranged from 34 to 86%. Psychotic disorder was the most stable, whereas adjustment and anxiety disorders were the least stable. Among schizophrenic patients, higher stability appeared for residual and disorganized types (83 and 71%, respectively). Statistical analysis did not show any variable associated with change, apart from the diagnoses themselves. The reasons that could explain changes are discussed, as well as the clinical consequences of these shifts.