Accuracy of the clinical diagnosis of 'psychogenic disorders' in the presence of physical symptoms suggesting a general medical condition: a 5-year follow-up in 162 patients.
OBJECTIVE
The range of unnoticed physical disorders in patients diagnosed with a psychogenic disorder varies widely. We investigated the accuracy of the clinical diagnosis of 'psychogenic disorder' where physical symptoms suggesting a somatic condition (PDPS) are present.


METHODS
All 162 cases of PDPS diagnosed between 01.01.1986 and 31.12.1987 in a medical clinic specializing in psychosomatic medicine were reviewed after 5 years. 148 follow-ups were complete. Initial diagnoses had been established using positive criteria for psychogenic diagnosis in a semistructured interview and a comprehensive clinical workup by trained clinicians.


RESULTS
In 2 (1.35%) foreign-language patients of 148 an orthopedic diagnosis had been missed. In 6 patients, the family physician gave formerly known findings a different interpretation. Half of these patients were foreigners; 5 were men; none improved; 5 had back pain.


CONCLUSIONS
A semistructured interview and positive criteria for psychogenic diagnosis permitted high diagnostic accuracy with an error of 1.35% in 148 cases.
Schuepbach
W M Michael
WM
Medical Division C.L. Lory-Haus, Inselspital, University of Berne, Switzerland. marzio.sabbioni@insel.ch
Adler
Rolf H
RH
Sabbioni
Marzio E E
ME
D000328:Adult; D000368:Aged; D003291:Conversion Disorder / Q000175:diagnosis* / Q000523:psychology; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology