[Agreement between Clinical Evaluation and Structured Clinical Interviews in Psychosomatic Inpatients].
The goal of this study was to determine the agreement between axis I mental disorders assessed with a structured clinical interview (SCID) and independently obtained non-structured clinical diagnoses in 185 psychosomatic in-patients. Additionally, the study focuses on the detection of potential predictors for the level of agreement. Diagnostic agreement was poor to moderate for the mood, anxiety and somatoform disorder cluster (κ = 0.293-0.444). Only for eating disorders an almost complete concordance could be found (κ = 0.812). The predictor analysis indicated a significant positive association between the comorbidity rate and the agreement in mood disorders. Furthermore, the diagnostic agreement of anxiety disorders was significantly higher for female than for male patients. These results reveal that even a team-based clinical diagnosis, assessed over the period of a hospital stay, shows little agreement with SCID-diagnoses. The predictor analysis as well as the poor correlation in 3 of 4 diagnostic clusters suggest that conceptual differences of the disorder criteria as well as their clinical interpretation might influence the concordance between diagnoses. Further studies focusing on methodical factors might reveal further insights to the cause of the diagnostic discrepancies.
Klinik für Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover.
Cornelia
C
Reichert
Klinik für Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover.
Stephan
S
Henniger
Klinik für Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover.
Burkard
B
Jäger
Klinik für Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover.
Martina
M
de Zwaan
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D015897:Comorbidity; D003631:Day Care, Medical; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005858:Germany; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology*; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D015588:Observer Variation; D010343:Patient Admission; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012737:Sex Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D055815:Young Adult