Use of the Brief Psychiatric Rating Scale to facilitate differential diagnosis at acute inpatient admission.
BACKGROUND
The advent of managed care has necessitated strategies for quickly and accurately diagnosing psychiatric disorders. The aim of the present study was to ascertain whether the Brief Psychiatric Rating Scale-Anchored (BPRS-A) would be a useful adjunct to more traditional diagnostic strategies at acute inpatient admission.


METHODS
Using a sample of 207 inpatients admitted during an 8-month index period, we examined the utility of the BPRS-A in predicting whether patients were more likely to be diagnosed with schizophrenia, bipolar disorder, or major depression (DSM-IV).


RESULTS
Discriminant function analyses were used to correctly predict 68%, 60%, and 74% of patients diagnosed with schizophrenia, bipolar disorder, and major depression, respectively. The main predictors of diagnostic category, in descending order. were BPRS-A depressed mood item, BPRS-A positive symptoms scale, BPRS-A excitement item, BPRS-A guilt feelings item, BPRS-A mannerisms and posturing item, and number of previous episodes.


CONCLUSIONS
As efforts are directed toward continuous quality improvement within mental health settings, an emphasis must be placed on improving the efficiency and accuracy of diagnostic procedures. The BPRS-A shows promise as a time-efficient assessment instrument that may be useful in facilitating differential diagnosis at inpatient admission and may increase the likelihood that efficacious prerelease interventions and appropriate aftercare services are implemented.
Hopko
D R
DR
University of Texas-Houston Medical School, Mental Sciences Institute, 77030-3497, USA. Derek.R.Hopko@uth.tmc.edu
Averill
P M
PM
Small
D
D
Greenlee
H
H
Varner
R V
RV
D000208:Acute Disease; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis; D010054:Brief Psychiatric Rating Scale / Q000592:standards* / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D003866:Depressive Disorder / Q000175:diagnosis; D003937:Diagnosis, Differential; D016002:Discriminant Analysis; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis*; D010343:Patient Admission; D011237:Predictive Value of Tests; D011594:Psychometrics / Q000592:standards; D044469:Racial Groups; D012559:Schizophrenia / Q000175:diagnosis; D012737:Sex Factors