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Evaluation of diagnostic procedures in Swedish patients with schizophrenia and related psychoses.
Nord J Psychiatry. 2005; 59(6):457-64.NJ

Abstract

We aimed to estimate the value of structured interviews, medical records and Swedish register diagnoses for assessing lifetime diagnosis of patients with schizophrenia. Psychiatric records and diagnostic interviews of 143 Swedish patients diagnosed by their treating physician with schizophrenia and related disorders were scrutinized. Based on record analysis only, or a combined record and interview analysis, DSM-IV diagnoses were obtained by the OPCRIT algorithm. Independent of the OPCRIT algorithm, a standard research DSM-IV diagnosis, based on both record and interview analysis, was given by the research psychiatrist. Concordance rates for the different psychosis diagnoses were calculated. DSM-IV diagnoses based on records only, showed a good to excellent agreement with diagnoses based on records and interviews. Swedish register diagnoses displayed generally poor agreement with the research diagnoses. Nevertheless, 94% of subjects sometimes registered with a diagnosis of schizophrenic psychoses (i.e. schizophrenia, schizoaffective psychosis or schizophreniform disorder) displayed a standard research DSM-IV diagnosis of these disorders. For patients in long-term treatment for schizophrenia in Sweden, psychiatric record reviews should be optimal, cost effective and sufficient for assessment of lifetime research diagnoses of schizophrenia. For these patients a research interview adds little new information. The results further indicate that a Swedish register diagnosis of schizophrenic psychoses has a high positive predictive power to a standard research DSM-IV diagnosis of the disorders. It is concluded that for future Swedish large-scale genetic studies focusing on a broad definition of schizophrenia, it would be sufficient to rely on the Swedish register diagnoses of schizophrenic psychosis.

Authors+Show Affiliations

Department of Clinical Neuroscience, Karolinska Institutet and Hospital, R5:00, SE-171 76, Stockholm, Sweden. birgit.ekholm@nlpo.sll.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16316898

Citation

Ekholm, Birgit, et al. "Evaluation of Diagnostic Procedures in Swedish Patients With Schizophrenia and Related Psychoses." Nordic Journal of Psychiatry, vol. 59, no. 6, 2005, pp. 457-64.
Ekholm B, Ekholm A, Adolfsson R, et al. Evaluation of diagnostic procedures in Swedish patients with schizophrenia and related psychoses. Nord J Psychiatry. 2005;59(6):457-64.
Ekholm, B., Ekholm, A., Adolfsson, R., Vares, M., Osby, U., Sedvall, G. C., & Jönsson, E. G. (2005). Evaluation of diagnostic procedures in Swedish patients with schizophrenia and related psychoses. Nordic Journal of Psychiatry, 59(6), 457-64.
Ekholm B, et al. Evaluation of Diagnostic Procedures in Swedish Patients With Schizophrenia and Related Psychoses. Nord J Psychiatry. 2005;59(6):457-64. PubMed PMID: 16316898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of diagnostic procedures in Swedish patients with schizophrenia and related psychoses. AU - Ekholm,Birgit, AU - Ekholm,Andreas, AU - Adolfsson,Rolf, AU - Vares,Maria, AU - Osby,Urban, AU - Sedvall,Göran C, AU - Jönsson,Erik G, PY - 2005/12/1/pubmed PY - 2006/5/10/medline PY - 2005/12/1/entrez SP - 457 EP - 64 JF - Nordic journal of psychiatry JO - Nord J Psychiatry VL - 59 IS - 6 N2 - We aimed to estimate the value of structured interviews, medical records and Swedish register diagnoses for assessing lifetime diagnosis of patients with schizophrenia. Psychiatric records and diagnostic interviews of 143 Swedish patients diagnosed by their treating physician with schizophrenia and related disorders were scrutinized. Based on record analysis only, or a combined record and interview analysis, DSM-IV diagnoses were obtained by the OPCRIT algorithm. Independent of the OPCRIT algorithm, a standard research DSM-IV diagnosis, based on both record and interview analysis, was given by the research psychiatrist. Concordance rates for the different psychosis diagnoses were calculated. DSM-IV diagnoses based on records only, showed a good to excellent agreement with diagnoses based on records and interviews. Swedish register diagnoses displayed generally poor agreement with the research diagnoses. Nevertheless, 94% of subjects sometimes registered with a diagnosis of schizophrenic psychoses (i.e. schizophrenia, schizoaffective psychosis or schizophreniform disorder) displayed a standard research DSM-IV diagnosis of these disorders. For patients in long-term treatment for schizophrenia in Sweden, psychiatric record reviews should be optimal, cost effective and sufficient for assessment of lifetime research diagnoses of schizophrenia. For these patients a research interview adds little new information. The results further indicate that a Swedish register diagnosis of schizophrenic psychoses has a high positive predictive power to a standard research DSM-IV diagnosis of the disorders. It is concluded that for future Swedish large-scale genetic studies focusing on a broad definition of schizophrenia, it would be sufficient to rely on the Swedish register diagnoses of schizophrenic psychosis. SN - 0803-9488 UR - https://www.unboundmedicine.com/medline/citation/16316898/Evaluation_of_diagnostic_procedures_in_Swedish_patients_with_schizophrenia_and_related_psychoses_ L2 - https://www.tandfonline.com/doi/full/10.1080/08039480500360906 DB - PRIME DP - Unbound Medicine ER -