The reliability and clinical utility of ICD-11 schizoaffective disorder: A field trial

SCHIZOPHRENIA RESEARCH

卷:208

Article

Peterson, Destiny L.¹  Webb, Christopher A.¹  Keeley, Jared W.²  Gaebel, Wolfgang³  Zielasek, Juergen^4,5  Rebello, Tahilia J.^6,7  Robles, Rebeca⁸  Matsumoto, Chihiro⁹  Kogani, Cary S.¹⁰  Kulygina, Maya¹¹  Farooq, Saeed¹²  Green, Michael F.¹³  Falkai, Peter¹⁴  Hasan, Alkomiet¹⁴  Galderisi, Silvana¹⁵  Larach, Veronica¹⁶  Krasnov, Valery¹¹  Reed, Geoffrey M.^6,17 

[1] Mississippi State Univ, Starkville, MS USA

[2] Virginia Commonwealth Univ, Richmond, VA USA

[3] Heinrich Heine Univ, Dept Psychiat & Psychotherapy, Fac Med, LVR Klinikum, Dusseldorf, Germany

[4] LVR Inst Healthcare Res, Cologne, Germany

[5] Heinrich Heine Univ, Fac Med, Dusseldorf, Germany

[6] Columbia Univ Coll Phys & Surg, Dept Psychiat, 722 W 168th St, New York, NY 10032 USA

[7] New York State Psychiat Inst & Hosp, New York, NY 10032 USA

[8] Natl Inst Psychiat Ramon de la Fuente Muniz, Mexico City, DF, Mexico

[9] Japanese Soc Psychiat & Neurol, Tokyo, Japan

[10] Univ Ottawa, Sch Psychol, Ottawa, ON, Canada

[11] Natl Med Res Ctr Psychiat & Narcol, Moscow Res Inst Psychiat, Moscow, Russia

[12] Keele Univ, Res Inst Primary Care & Hlth Sci, Keele, Staffs, England

[13] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Geffen Sch Med, Los Angeles, CA 90024 USA

[14] Klinikum Univ Munchen, Dept Psychiat & Psychotherapy, Munich, Germany

[15] Univ Campania Luigi Vanvitelli, Naples, Italy

[16] Univ Andres Bello, Santiago, Chile

[17] WHO, Dept Mental Hlth & Subst Abuse, Geneva, Switzerland

关键词: ICD-11;    Diagnosis;    Schizoaffective disorder;    Schizophrenia;    Mood disorders;    Reliability;   

DOI  :  10.1016/j.schres.2019.02.011

来源: Elsevier

【 摘 要 】

A major goal for the revision of the International Classification of Diseases and Related Health Problems, Tenth Edition (ICD-10) is to increase the clinical utility of the diagnostic system. Schizoaffective disorder has a history of poor diagnostic reliability due to the similarities and overlap in symptoms that it shares with other disorders, especially primary psychotic and mood disorders. The present study was part of the case-controlled field trials for ICD-11 and examines how the proposed changes for schizoaffective disorder may improve differential diagnosis and diagnostic accuracy. Clinicians from around the globe (n = 873) were provided with either ICD-10 or ICD-11 diagnostic guidelines and asked to apply them to case vignettes comparing schizoaffective disorder to schizophrenia and mood disorders with psychotic symptoms. Participants were asked to respond to follow-up diagnostic questions to determine which components of the diagnostic guidelines affected diagnostic accuracy. Overall, clinicians showed small improvements in accurately diagnosing vignettes using ICD-11 over ICD-10. Results suggest the discrepancy in diagnosing schizoaffective disorder is related primarily to the presence of mood symptoms and discrepancies about whether those symptoms are more consistent with schizoaffective disorder or a mood disorder diagnosis. Continuing to identify ways to more accurately capture this symptom picture will be important in the future as well as systematic efforts to educate clinicians about differential diagnosis. (C) 2019 Elsevier B.V. All rights reserved.

【 授权许可】

Free