Psychiatric Services Aargau, P.O. Box 432, CH-5201 Brugg, Switzerland.
Psychiatric Services Aargau, P.O. Box 432, CH-5201 Brugg, Switzerland; University of Berne, Department of Psychology, Fabrikstrasse 8, CH-3012 Berne, Switzerland.
Psychiatry Res. 2018 Jan;259:482-487. doi: 10.1016/j.psychres.2017.11.004. Epub 2017 Nov 6.
To examine the validity of diagnoses obtained by clinicians during routine clinical examination on acute psychiatric inpatient wards.
N=100 inpatients with a broad spectrum of major mental disorders were randomly selected in a mental hospital's department of general psychiatry. Patients were diagnosed by independent assessors within Md = 5 (Range: 1-18) days of admission using the SCID I in order to examine the validity of the diagnoses given by the clinical staff based on routine assessments.
The commonly used clinical examination technique had good overall agreement with the SCID I assessments regarding primary diagnoses at the level of ICD-10 main categories (F2, F30-31, F32-F33, F4; κ = 0.65). However, agreement between routine clinical diagnoses and the SCID I diagnoses tended to be low for some specific mental disorders (e.g., depressive disorders) and for secondary diagnoses.
The validity of routine clinical diagnoses established in acute inpatient settings is limited and should be improved.
检验精神科住院病房临床医生常规临床检查中获得的诊断的有效性。
在一家精神病院的普通精神病学部，随机选择了 100 名患有各种主要精神障碍的住院患者。患者在入院后 Md = 5（范围：1-18）天内，由独立评估者使用 SCID I 进行诊断，以检验基于常规评估的临床工作人员所做诊断的有效性。
常用的临床检查技术与 SCID I 评估在 ICD-10 主要类别（F2、F30-31、F32-F33、F4）的主要诊断方面具有良好的总体一致性（κ=0.65）。然而，常规临床诊断与 SCID I 诊断之间的一致性在某些特定的精神障碍（如抑郁障碍）和次要诊断方面往往较低。
急性住院环境中常规临床诊断的有效性有限，需要加以改进。
