title: Do we agree about when patients are psychotic?
abstract: OBJECTIVE
  To investigate into the use of the term 'psychotic' as defined by ICD-10 or by the concept of impaired reality testing, among psychiatric staff members.
  
  
  METHODS
  Questionnaire investigation using 11 short case vignettes.
  
  
  RESULTS
  Responses were received from 266 psychiatric staff members: psychiatrists, nursing staff and psychologists. When using ICD-10, patients were identified as psychotic with a sensitivity ranging from 90% to 55%. Specificity ranged from 60% to 75%. According to the concept of impaired reality testing, all three groups showed a sensitivity of about 60%, whereas specificity ranged from 65% to 50%. The combined use of the terms correlated significantly with responses regarding indication for legal detention for psychiatrists and nursing staff.
  
  
  CONCLUSIONS
  In identifying a patient as 'psychotic' a broad concept of impaired reality testing was widely used particularly in cases with legal issues. Psychotic symptoms, however, were identified with high sensitivity and specificity.
authors.affiliation: Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg, Denmark. jin@rn.dk
authors.forename: J
authors.initials: J
authors.lastname: Nielsen
authors.forename: B
authors.initials: B
authors.lastname: Mogensen
authors.forename: K
authors.initials: K
authors.lastname: Martiny
authors.forename: K B
authors.initials: KB
authors.lastname: Stage
authors.forename: J K
authors.initials: JK
authors.lastname: Larsen
authors.forename: A
authors.initials: A
authors.lastname: Lindhardt
authors.forename: A
authors.initials: A
authors.lastname: Bertelsen