title: Reliability of clinical ICD-10 schizophrenia diagnoses.
abstract: Concern has been expressed as to the reliability of clinical ICD-10 diagnosis of schizophrenia. This study was designed to assess the diagnostic reliability of the clinical ICD-10 diagnosis of schizophrenia in a random sample of Danish in- and outpatients with a history of psychosis. A sample of 100 subjects was assessed using the operational criteria OPCRIT checklist for psychotic and affective illness. The most recent principal and clinical ICD-10 diagnosis was compared with diagnoses generated by the OPCRIT instrument. Data documented very high sensitivity (93%) and positive predictive value (87%) of ICD-10 schizophrenia and an overall good agreement between clinical and OPCRIT-derived diagnoses (kappa=0.60). An even higher positive predictive value was obtained when diagnoses were amalgamated into a diagnostic entity of schizophrenia-spectrum disorders (98%). Near perfect agreement was seen between OPCRIT-derived ICD-10 and DSM-IV diagnoses (kappa=0.87). Thus, this study demonstrates high reliability of the clinical diagnosis of schizophrenia and even more so of the diagnosis of schizophrenia-spectrum disorder.
authors.affiliation: Research Institute of Biological Psychiatry, Sct. Hans Hospital, Roskilde, Denmark. klaus.damgaard.jakobsen@shh.hosp.dk
authors.forename: Klaus D
authors.initials: KD
authors.lastname: Jakobsen
authors.forename: Julie N
authors.initials: JN
authors.lastname: Frederiksen
authors.forename: Thomas
authors.initials: T
authors.lastname: Hansen
authors.forename: Lennart B
authors.initials: LB
authors.lastname: Jansson
authors.forename: Josef
authors.initials: J
authors.lastname: Parnas
authors.forename: Thomas
authors.initials: T
authors.lastname: Werge
mesh_terms: D000328:Adult; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012680:Sensitivity and Specificity