title: Diagnostic stability in depressive disorder as according to ICD-10 in clinical practice.
abstract: BACKGROUND
  The diagnostic stability of the ICD-10 diagnosis of depressive disorder has not been investigated in clinical practice.
  
  
  METHODS
  All patients who were diagnosed with depressive disorder at least once in a period from 1994 to 2002 in psychiatric out- or inpatient settings in Denmark were identified in a nationwide register.
  
  
  RESULTS
  A total of 39,741 patients were diagnosed with depressive disorder at least once; among these, 81% were diagnosed at the first contact. In approximately 56% of patients, the initial diagnosis of depressive disorder eventually changed during follow-up mainly to the schizophrenic spectrum (16%), but also to personality disorders (9%), neurotic, stress-related and somatoform disorders (8%) and to bipolar disorder (8%). Among the 18% of patients who were later diagnosed with depressive disorder, 23% initially had a diagnosis of adjustment disorder.
  
  
  CONCLUSIONS
  When the ICD-10 diagnoses are used in clinical practice, the diagnosis of depressive disorder has a low stability over time. These findings emphasize the need for a longitudinally based diagnostic process in the diagnostic systems.
authors.affiliation: Department of Psychiatry, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark. lars.kessing@rh.dk
authors.forename: Lars Vedel
authors.initials: LV
authors.lastname: Kessing
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012042:Registries / Q000706:statistics & numerical data*; D015203:Reproducibility of Results