Stability of psychiatric diagnoses in New Zealand psychiatric hospitals.
This study examines the stability over a five year follow-up of first admission psychiatric diagnoses assigned in New Zealand psychiatric hospitals in 1980 and 1981. Diagnostic stability is a measure of the degree to which psychiatric diagnoses remained unchanged at a later hospital admission. Reasonably high levels of stability were found for the initial diagnoses of substance abuse disorders (86% stable), anorexia nervosa (70%), schizophrenia (67%), and affective disorder (67%). Poor levels of stability were noted for the initial diagnoses of personality disorder (36%), other psychosis (excluding schizophrenia and affective psychosis) (22%), and other neurosis (excluding neurotic depression) (20%). The major trends in diagnostic change are described. Factors influencing diagnostic instability are also examined. For patients with an initial diagnosis of schizophrenia, a change in hospital is found to be the strongest factor causing diagnostic instability, with time between admissions and age at first admission also having a significant influence. The implications of these findings are discussed.
Stanton
M W
MW
University Department of Psychological Medicine, Christchurch School of Medicine, New Zealand.
Joyce
P R
PR
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D009520:New Zealand; D010359:Patient Readmission; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012042:Registries; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis; D012565:Schizophrenic Psychology; D012737:Sex Factors