The diagnostic stability of ICD-10 psychiatric diagnoses in clinical practice

Abstract

This study examines the stability of ICD-10 diagnoses of patients admitted to Al Ain (United Arab Emirates) inpatients psychiatric unit during the period from November 1993 to August 1995. Diagnostic stability is a measure of the degree to which diagnoses remained unchanged at a later hospital admission. One hundred and seven patients were admitted more than once during this period, accounting for 168 readmissions. High levels of diagnostic stability were found for ICD-10 Fl-psychiatric disorders (100%), F2-schizophrenia (87%), F3-bipolar disorders (87%) and F3-depressive disorders (73%). A poor level of stability was found for patients with neurotic, stress related and adjustment disorders (F4), ranging from zero for somatoform disorders to 50% for generalized anxiety and panic disorders. Poor levels of stability were also found for other psychoses (excluding schizophrenia and affective psychoses) and personality disorders. We conclude that the introduction of ICD-10 as a formal diagnostic system has greatly improved the temporal stability of the most commonly encountered psychiatric disorders (ICD-10 Fl to F3 disorders), confirming the construct validity of those psychiatric disorders. Further investigations are required to evaluate the diagnostic stability of neurotic and other psychotic disorders.

Diagnostic stability in subjects with multiple admissions for psychotic illness

“…Other conditions, including anxiety states, personality disorders and other psychoses were the least stable. Further stability studies have produced agreement with the high stability levels of schizophrenia, but have reported widely varying results for affective disorders and other conditions (Tsuang et al 1981 ;Lenz et al 1991 ;Marneros et al 1991 ;Rice et al 1992 ;Chen et al 1996Chen et al , 1998Daradkeh et al 1997).…”

Diagnosis of Adjustment Disorder: Reliability of Its Clinical Use and Long-Term Stability

“…Assuming that patients without a readmission had no further episode of severe mental illness and therefore retained the initial diagnosis of adjustment disorder, this finding would imply high diagnostic stability. Significantly lower stability rates were reported for diagnostic groups such as somatoform, generalized anxiety or panic disorders [26]. Due to the absence of a systematic follow-up procedure these conclusions should be taken with caution.…”

Adjustment disorder considered

“…For the ICD-10 group of neurotic and stress related disorders combined a low level of diagnostic stability (37%) has found in contrast to a level of 73% for depressive disorders. However numbers were small and AD was not examined separately (Daradkeh et al 1997). Another study found that adjustment and anxiety disorders were the least stable at around 34% but again AD was not examined on its own (Huquelet et al 2001).…”