Psychiatric diagnosis in an outpatient population. A comparative study of PSE-Catego and DSM-III.
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.
van den Brink
W
W
Department of Psychiatry, Rijksuniversiteit Groningen, The Netherlands.
Koeter
M W
MW
Ormel
J
J
Dijkstra
W
W
Giel
R
R
Slooff
C J
CJ
Wohlfarth
T D
TD
D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D011569:Psychiatric Status Rating Scales