Clinical assessment of psychiatric consultations in a medical long‐term care facility: Interrater reliability for DSM‐III diagnostic groups

Abstract

SUMMARYThe reliability of the DSM-111 diagnostic system was assessed in a medical long-term care facility population that was recently seen in psychiatric consultation. Six standard rating scales were used to determine interrater agreement for perceiving psychopathology prior to selecting diagnoses. The findings were that six major diagnostic groups could be accurately distinguished from one another: no disorder; organic mental disorders; affective disorders; paranoid disorders; schizophrenia and psychotic disorders not elsewhere classified; and a mixed group of other diagnoses that occurred in low frequency in this study population. The interrater reliability (kappa = 0.64-0.70) was comparable to that found in the general psychiatric population.

Pathways to false allegations of sexual harassment

“…The context for the implication of personalogical factors assumes that the normal individual in the normal situation does not make a false allegation and therefore something must perturb this normal state of affairs. One caveat when considering these personality disorders and mental conditions is that the reliability of the disorders themselves has been called into question (Brown, Di Nardo, Lehman, & Campbell, 2001;Campbell, 1999;Foster, Rubenstein, Welkowitz, & Boksay, 1989;Kirk & Kutchins, 1994;Kutchins & Kirk, 1986;Svanum & McGrew, 1996;Vitiello, Malone, Buschle, & Delaney, 1990;Werry, Methven, Fitzpatrick, & Dixon, 1983). One way around this controversy is to look at behaviors associated with these disorders as descriptive and not necessarily indicative of a full-blown syndrome.…”

Diagnostic field reliability in forensic mental health evaluations.

“…Although it is important to understand how often professionals might agree diagnostically on an artificially generated set of symptoms, that reliability may not translate to real practice. Many studies have examined the diagnostic reliability of individual disorders, as well as the criterion validity of each DSM edition (Foster, Rubenstein, Welkowitz, Boksay, & Seeland, 1989), but fewer have examined reliability in the field. This highlights the importance of diagnostic field reliability , or the reliability of diagnoses made by professionals on cases in the course of their regular practice.…”