Factors influencing the stability of psychiatric diagnoses in the emergency setting: review of 934 consecutively inpatient admissions.
OBJECTIVE
This study aimed to examine the stability of psychiatric emergency diagnoses and factors influencing diagnostic concordance.


METHODS
The concordance between psychiatric emergency and inpatient diagnoses was calculated using kappa coefficient. The groups with and without psychiatric diagnostic stability were compared to determine factors influencing diagnostic stability.


RESULTS
Agreement between psychiatric emergency and inpatient diagnoses was fair (range of kappa=.48-.56) for bipolar, schizophrenia, schizoaffective and depressive disorders. Results indicated that patients with stable diagnoses between psychiatric emergency and inpatient settings are likely to arrive on legal holds and that patients without concurring diagnoses are likely to have a higher medical burden.


CONCLUSIONS
Further studies exploring ways to improve diagnostic stability in psychiatric emergency setting are warranted.
Woo
Benjamin K P
BK
UCLA-Kern Psychiatry Residency Program, Bakersfield, CA 93305, USA. bkpwoo@gmail.com <bkpwoo@gmail.com>
Sevilla
Conrado C
CC
Obrocea
Gabriela V
GV
D000046:Academic Medical Centers; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology; D002140:California; D003617:Dangerous Behavior; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004637:Emergency Services, Psychiatric; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D010343:Patient Admission; D010359:Patient Readmission / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D013223:Statistics as Topic