The quality of severe mental disorder diagnoses in a national health registry as compared to research diagnoses based on structured interview

BMC Psychiatry

Research Article

Thomas D. Bjella¹  Erik G. Jönsson²  Ingrid Melle³  Ole A. Andreassen³  Ragnar Nesvåg⁴  Gun Peggy Knudsen⁴  Inger Johanne Bakken⁴  Ted Reichborn-Kjennerud⁵ 

[1] Norwegian Center for Mental Health Research (NORMENT), Oslo University Hospital & University of Oslo, P.O. Box 4956, Nydalen, N-0424, Oslo, Norway;Norwegian Center for Mental Health Research (NORMENT), Oslo University Hospital & University of Oslo, P.O. Box 4956, Nydalen, N-0424, Oslo, Norway;Department of Clinical Neuroscience, Centre of Psychiatric Research, Karolinska Institutet, Administration, Tomtebodavägen 18A, 5th floor, 171 77, Stockholm, Sweden;Norwegian Center for Mental Health Research (NORMENT), Oslo University Hospital & University of Oslo, P.O. Box 4956, Nydalen, N-0424, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, N-0319, Oslo, Norway;Norwegian Institute of Public Health, P.O. Box 4044, Nydalen, N-0403, Oslo, Norway;Norwegian Institute of Public Health, P.O. Box 4044, Nydalen, N-0403, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, N-0319, Oslo, Norway;

关键词: Psychosis;    Schizophrenia;    Bipolar disorder;    Registry;    ICD-10;    DSM-IV;   

DOI  :  10.1186/s12888-017-1256-8

 received in 2016-09-10, accepted in 2017-03-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundUtilization of diagnostic information from national patient registries rests on the quality of the registered diagnoses. We aimed to investigate the agreement and consistency of diagnoses of psychotic and bipolar disorders in the Norwegian Patient Registry (NPR) compared to structured interview-based diagnoses given as part of a clinical research project.MethodsDiagnostic data from NPR were obtained for the period 01.01.2008–31.12.2013 for all patients who had been included in the Thematically Organized Psychosis (TOP) study between 18.10.2002 and 01.09.2014 with a Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of schizophrenia (n = 537), delusional disorder (n = 48), schizoaffective disorder (n = 118) or bipolar disorder (n = 408). Diagnostic agreement between the primary DSM-IV diagnosis in TOP and the International Classification of Diseases, 10th revision (ICD-10) diagnoses in NPR was evaluated using Cohen’s unweighted nominal kappa (κ). Diagnostic consistency was calculated as the proportion of all registered severe mental disorder diagnoses in NPR that were equivalent to the primary diagnosis given in the TOP study.ResultsThe proportion of patients registered with the equivalent ICD-10 diagnosis as the primary DSM-IV diagnosis given in TOP was 84.2% for the schizophrenia group, 68.8% for the delusional disorder group, 76.3% for the schizoaffective disorder group, and 78.4% for the bipolar disorder group. Diagnostic agreement was good for schizophrenia (κ = 0.74) and bipolar disorder (κ = 0.72), fair for schizoaffective disorder (κ = 0.63), and poor for delusional disorder (κ = 0.39). Among patients with DSM-IV schizophrenia, 4.7% were diagnosed with ICD-10 bipolar disorder, and among patients with DSM-IV bipolar disorder, 2.5% were diagnosed with ICD-10 schizophrenia. Diagnostic consistency was 84.9% for schizophrenia, 59.1% for delusional disorder, 65.9% for schizoaffective disorder, and 91.0% for bipolar disorder.ConclusionsWhen compared to research-based diagnoses, clinical diagnoses of schizophrenia and bipolar disorder in the NPR are accurate and consistent, with minimal diagnostic overlap between the two disorders.

【 授权许可】

CC BY   
© The Author(s). 2017