Limited agreement between criteria-based diagnoses of postconcussional syndrome.
The objectives of this study were to compare diagnoses of postconcussional syndrome between the International Classification of Diseases, 10th revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV). The patient sample was comprised of 178 adults with mild-moderate traumatic brain injury (TBI). The study design was inception cohort, and the main outcome measure was a structured interview 3 months after injury. The results were that, despite concordance of DSM-IV and ICD-10 symptom criteria (kappa=0.73), agreement between overall DSM-IV and ICD-10 diagnoses was slight (kappa=0.13) because fewer patients met the DSM-IV cognitive deficit and clinical significance criteria. Agreement between DSM-IV postconcussional disorder and ICD-10 postconcussional syndrome appears limited by different prevalences and thresholds.
Boake
Corwin
C
Baylor College of Medicine/University of Texas-Houston Medical School Department of Physical Medicine, Houston, Texas, USA. corwin.boake@uth.tmc.edu <corwin.boake@uth.tmc.edu>
McCauley
Stephen R
SR
Levin
Harvey S
HS
Contant
Charles F
CF
Song
James X
JX
Brown
Sharon A
SA
Goodman
Heather S
HS
Brundage
Susan I
SI
Diaz-Marchan
Pedro J
PJ
Merritt
Shirley G
SG
D000328:Adult; D001924:Brain Concussion / Q000473:pathology; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000175:diagnosis*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D009626:Terminology as Topic