Changes in stability of first-admission psychiatric diagnoses over 14 years, based on cross-sectional data at three time points.
BACKGROUND
Stability of diagnoses over time is an important criterion of reliability of any diagnostic system.


OBJECTIVE
To compare the stability of diagnoses among hospitalized psychiatric patients over 14 years, based on cross-sectional data at three time points.


METHODS
Diagnoses extracted from the National Psychiatric Case Register concerning psychiatric patients first admitted during 1989 (n=2996) were compared to those who were admitted during 1996 (n=3021) and 2003 (n=4041). Stability of diagnostic categories was measured by positive predictive value of admission diagnosis at discharge from hospital.


RESULTS
There was no significant difference in diagnostic stability for most diagnostic categories between 1989 and 1996 patient cohorts. However, over the seven following years (cohort 2003) the diagnostic stability had been substantially increased: by 19% for affective disorders, by 18% for childhood disorders, by 17% for organic conditions, by 14% for neurotic disorders, by 12% for both schizophrenia and drug and alcohol dependence.


CONCLUSIONS
In long-term perspective, reliability of most diagnostic categories of mental disorders has clearly improved.
Ponizovsky
Alexander M
AM
Mental Health Services, Department of Research and Evaluation, Ministry of Health, Jerusalem, Israel. alexander.ponizovsky@moh.health.gov.il
Grinshpoon
Alexander
A
Pugachev
Inna
I
Nahon
Daniela
D
Ritsner
Michael
M
Abramowitz
Moshe Z
MZ
D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D013997:Time Factors