Accuracy of psychiatric diagnosis performed under indirect supervision

Revista Brasileira de Psiquiatria

Cristina Marta Del-ben¹  Jaime Eduardo Cecílio Hallak¹  Alcion Sponholz Jr¹  João Mazzoncini De Azevedo Marques¹  Cybelli Morelo Labate¹  José Onildo Betioli Contel¹  Antonio Waldo Zuardi¹ 

[1] ,São Paulo University Faculty of Medicine of Ribeirão Preto Clinical Hospital,Brazil

关键词: Mental disorders;    Depression;    Schizophrenia;    Emergency services;    psychiatric;    Psychiatric status rating scales;    Interview;    psychological;    Transtornos mentais;    Depressão;    Esquizofrenia;    Serviços de emergência psiquiátrica;    Escalas de graduação psiquiátrica;    Entrevista psicológica;   

DOI  :  10.1590/S1516-44462005000100013

来源: SciELO

【 摘 要 】

This work aimed at comparing the accuracy of the psychiatric diagnoses made under indirect supervision to the diagnoses obtained through Structured Clinical Interview for DSM-III-R (SCID). The study was conducted in 3 university services (outpatient, inpatient and emergency). Data from the emergency service were collected 3 years later, after changes in the training process of the medical staff in psychiatric diagnosis. The sensitivity for Major Depression (outpatient 10.0%; inpatients 60.0%, emergency 90.0%) and Schizophrenia (44.4%; 55.0%; 80.0%) improved over time. The reliability was poor in the outpatient service (Kw = 0.18), and at admission to the inpatient service (Kw = 0.38). The diagnosis elaborated in the discharge of the inpatient service (Kw = 0.55) and in the emergency service (Kw = 0.63) was good. Systematic training of supervisors and residents in operational diagnostic criteria increased the accuracy of psychiatric diagnoses elaborated under indirect supervision, although excellent reliability was not achieved.

【 授权许可】

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