title: Validity of reaction to severe stress and adjustment disorder diagnoses in the Danish Psychiatric Central Research Registry.
abstract: OBJECTIVE
  To assess the validity of reaction to severe stress and adjustment disorder diagnoses registered in the Danish Psychiatric Central Research Register (DPCRR), to examine the documentation of stressful and traumatic events in the medical records, and to investigate the occurrence of stress diagnoses among persons not registered in the DPCRR.
  
  
  METHODS
  Among 101,633 patients diagnosed with International Classification of Diseases, 10th Edition (ICD-10) F43 diagnoses between 1995 and 2011, we selected 50 patients from two hospitals (100 total), comprising one above and one below median age for each diagnosis for five time periods, and reviewed their medical records. We calculated the positive predictive value, comparing registration in the DPCRR with the original medical records, and captured data on stressful life events. Two general practitioners were queried about 50 patients without a stress diagnosis in the DPCRR, regarding whether they had ever received a stress diagnosis.
  
  
  RESULTS
  The positive predictive value was 58% for acute stress reaction, 83% for posttraumatic stress disorder, 94% for adjustment disorder, 71% for other reactions to severe stress, and 68% for reaction to severe stress, unspecified. In 80% of the records, a stressful or traumatic event was noted. Of 100 patients without an F43 diagnosis in the DPCRR, seven had a stress diagnosis.
  
  
  CONCLUSIONS
  The DPCRR represents a valid and comprehensive resource for research on reaction to severe stress and adjustment disorders, particularly for posttraumatic stress disorder and adjustment disorder.
authors: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Elisabeth
authors: E
authors: Svensson
authors: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark ; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors: Timothy L
authors: TL
authors: Lash
authors: Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
authors: Patricia A
authors: PA
authors: Resick
authors: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Jens Georg
authors: JG
authors: Hansen
authors: National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA ; Department of Psychiatry, Boston University, Boston, MA, USA ; Department of Epidemiology, Boston University, Boston, MA, USA.
authors: Jaimie L
authors: JL
authors: Gradus
keywords: Denmark; stress disorders; traumatic; validity (epidemiology)