Comparison between register and structured interview diagnoses of schizophrenia: a case for longitudinal diagnostic profiles.
OBJECTIVE
Mental health registers contain diagnoses from serial contacts with mental health facilities over many years. This study examines the relationship between longitudinal diagnostic profiles and structured interview diagnoses. The aim is to improve the definition of diagnoses drawn from clinical case registers.


METHODS
The Tasmanian Mental Health Case Register includes 1922 individuals, each with at least one diagnosis of schizophrenia between 1965 and 1990. A representative subsample of 29 individuals were assessed by the structured diagnostic interview for DSM-III-R (SCID). Diagnostic agreement between Register and SCID diagnoses was compared.


RESULTS
Twenty-four subjects (82.8%) received a lifetime diagnosis of schizophrenia on the SCID. For each subject, 'schizophrenia diagnostic dominance', the percentage of register entries with schizophrenia diagnoses over total entries, was calculated. Agreement between register and SCID correlated positively with schizophrenia diagnostic dominance and negatively with register mood diagnoses.


CONCLUSIONS
Longitudinal diagnostic profiles on databases may be superior to cross-sectional clinical diagnoses in predicting structured interview diagnoses, and may be useful in defining caseness in epidemiological studies using register diagnoses.
Psychiatry, Division of Clinical Sciences, Hobart, Tasmania, Australia.
K C
KC
Kirkby
D A
DA
Hay
B A
BA
Daniels
I H
IH
Jones
B J
BJ
Mowry
D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D019992:Databases as Topic; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D003937:Diagnosis, Differential; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D012042:Registries / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis*; D012565:Schizophrenic Psychology