title: Assessment of documentation of DSM-IV-TR Criteria A for diagnosis of schizophrenia in psychiatric unit, tertiary hospital, Malaysia.
abstract: OBJECTIVE
  The purposes of this study were to investigate the documentation of the DSM-IV-TR- Criteria A in diagnoses of schizophrenia and to identify the symptoms associated with over diagnosis of schizophrenia.
  
  
  METHODS
  This study involved a retrospective review and analysis of data from case notes.
  
  
  RESULTS
  Data of 107 newly diagnosed patients with schizophrenia were keyed in and analyzed using SPSS v 19. The cases were then evaluated for the use of the DSM-IV-TR- Criteria A. Over diagnosis was noted in 37.39% of the patients. Disorganised behaviour (12.5%), affective flattening (12.5%), hallucination (16%) and non-bizarre delusion (18.3%) significantly contributed to the over-diagnosis of schizophrenia. Symptoms such as non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia and were statistically significant with p ≤0.05.
  
  
  CONCLUSIONS
  There was a significant lack of DSM-IV-TR Criteria A among the data documented to diagnose schizophrenia and non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia. This key problem needs to be addressed. The reliability of a diagnosis is indispensable and achievable with the proper clinical application of DSM-IV-TR Criteria A. The DSM-IV-TR Criteria have been perceived to be useful and reliable and is most widely used throughout the world.
authors.affiliation: Department of Psychiatry, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, 25200 Kuantan, Pahang, Malaysia.
authors.forename: K
authors.initials: K
authors.lastname: Maung
authors.affiliation: Rehabilitation Unit, Department of Orthopaedics, University Kebangsaan Malaysia Medical Centre, Jalan Yacoob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysi.
authors.forename: H
authors.initials: H
authors.lastname: Ohnmar
authors.affiliation: Community Medicine Department, Mahsa University, Kuala Lumpur, Jalan Elmu, Off Jalan University, 59100, Kuala Lumpur, Malaysia.
authors.forename: W
authors.initials: W
authors.lastname: Than
authors.affiliation: Department of Psychiatry, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, 25200 Kuantan, Pahang, Malaysia.
authors.forename: M
authors.initials: M
authors.lastname: Ramli
authors.affiliation: Department of Psychiatry, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, 25200 Kuantan, Pahang, Malaysia.
authors.forename: M R
authors.initials: MR
authors.lastname: Najwa Hanim
authors.affiliation: Department of Psychiatry, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, 25200 Kuantan, Pahang, Malaysia.
authors.forename: R
authors.initials: R
authors.lastname: Ali Sabri
authors.affiliation: Department of Psychiatry, Hospital Tengku Ampuan Afzan, HTAA Kuantan 25150, Kuantan, Pahang, Malaysia.
authors.forename: A B
authors.initials: AB
authors.lastname: Ahmad Zafri
mesh_terms: D003951:Diagnostic Errors; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008296:Malaysia; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis*; D062606:Tertiary Care Centers
keywords: DSM-IV-TR; Delusion; Hallucination; Over-diagnosis; Psychopathology; Schizophrenia