title: Diagnostic stability of psychiatric disorders in clinical practice.
abstract: BACKGROUND
  Psychiatric disorders are among the top causes worldwide of disease burden and disability. A major criterion for validating diagnoses is stability over time.
  
  
  OBJECTIVE
  To evaluate the long-term stability of the most prevalent psychiatric diagnoses in a variety of clinical settings.
  
  
  METHODS
  A total of 34 368 patients received psychiatric care in the catchment area of one Spanish hospital (1992-2004). This study is based on 10 025 adult patients who were assessed on at least ten occasions (360 899 psychiatric consultations) in three settings: in-patient unit, 2000-2004 (n=546); psychiatric emergency room, 2000-2004 (n=1408); and out-patient psychiatric facilities, 1992-2004 (n=10 016). Prospective consistency, retrospective consistency and the proportion of patients who received each diagnosis in at least 75% of the evaluations were calculated for each diagnosis in each setting and across settings.
  
  
  RESULTS
  The temporal consistency of mental disorders was poor, ranging from 29% for specific personality disorders to 70% for schizophrenia, with stability greatest for in-patient diagnoses and least for out-patient diagnoses.
  
  
  CONCLUSIONS
  The findings are an indictment of our current psychiatric diagnostic practice.
authors.affiliation: Department of Psychiatry, Fundacion Jimenez Diaz University Hospital, Autonomous University of Madrid, Avenida Reyes Catolicos 2, 28040 Madrid, Spain. ebacgar2@yahoo.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca-Garcia
authors.forename: Maria M
authors.initials: MM
authors.lastname: Perez-Rodriguez
authors.forename: Ignacio
authors.initials: I
authors.lastname: Basurte-Villamor
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Fernandez del Moral
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Jimenez-Arriero
authors.forename: Jose L
authors.initials: JL
authors.lastname: Gonzalez de Rivera
authors.forename: Jeronimo
authors.initials: J
authors.lastname: Saiz-Ruiz
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology