Diagnostic stability of schizophrenia in psychiatric emergency room patients.
Diagnoses obtained from the hospital computer system were compared at two consecutive visits in 286 psychiatric emergency room patients within a 7-month period. Diagnostic agreement of schizophrenia and changes from and to schizophrenia were examined. There was moderate stability for a schizophrenic diagnosis in patients at two consecutive visits (kappa 0.5). schizophrenia was a more stable diagnosis in males (kappa 0.6) than females (0.4). Underdiagnosis of schizophrenia in females may be due to initial diagnostic confusion with affective illnesses. Further studies are needed in other settings to assess if underdiagnosis is associated with undertreatment of schizophrenia in females.
Dhossche
D M
DM
Department of Psychiatry, University of South Alabama College of Medicine, Mobile 36693, USA. ddhossch@jaguar1.usouthal.edu
Ghani
S O
SO
D000341:Affective Disorders, Psychotic / Q000175:diagnosis / Q000453:epidemiology; D003199:Computer Systems / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D004637:Emergency Services, Psychiatric / Q000592:standards* / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D012008:Recurrence; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D017678:Sex Distribution; D012737:Sex Factors; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000652:urine