Validity of routine clinical DSM-IV diagnoses (Axis I/II) in inpatients with mental disorders

Andreas, Sylke; Theisen, Pia; Mestel, Robert; Koch, Uwe; Schulz, Holger

doi:10.1016/j.psychres.2008.09.009

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Volume 170, Issue 2 , Pages 252-255, 30 December 2009

Validity of routine clinical DSM-IV diagnoses (Axis I/II) in inpatients with mental disorders

Sylke Andreas
- Department of Medical Psychology, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Germany
- Corresponding author. Department of Medical Psychology, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building S35, DE-20246 Hamburg, Germany. Tel.: +49 40 42803 7705; fax: +49 40 42803 4940.
- These authors contributed equally to this work.
Pia Theisen
- Department of Medical Psychology, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Germany
- These authors contributed equally to this work.
Robert Mestel
- Clinic for Psychosomatic Medicine, Bad Groenenbach, Germany
Uwe Koch
- Department of Medical Psychology, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Germany
Holger Schulz
- Department of Medical Psychology, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Germany

Received 23 February 2008; received in revised form 5 September 2008; accepted 30 September 2008.

Abstract

The assessment of diagnoses is a central issue in the treatment of patients with mental disorders. The aim of this study was to validate routine clinical diagnoses by means of a semi-standardized and structured interview. Semi-standardized and structured interview diagnoses were based on videos of 55 inpatients. The routine clinical diagnoses were given by therapists during the course of psychotherapy. Validation was carried out through proportional agreement, Cohen's kappa, Yule's Y, as well as the sensitivity and specificity of the diagnosis. Agreement rates between diagnoses given in semi-standardized structured interviews and those given in routine clinical assessment were low for the majority of specific disorders (e.g., major depressive disorder). Higher agreement rates were found for major diagnostic categories (e.g., eating disorders or adjustment disorders). In comparison to diagnoses according to structured interviews for inpatients with mental disorders, the validity of diagnoses given in routine clinical interviews is limited and should be improved.

Keywords: Clinical routine assessment, Structured interview, Diagnostic assessment