Journal Title
Title of Journal: Soc Psychiatry Psychiatr Epidemiol
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Abbravation: Social Psychiatry and Psychiatric Epidemiology
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Publisher
Springer Berlin Heidelberg
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Authors: Julie Nordgaard Kasper Jessen Ditte Sæbye Josef Parnas
Publish Date: 2016/07/14
Volume: 51, Issue: 9, Pages: 1293-1299
Abstract
The diagnostic variability reflected by the diagnostic differences between the departments and by the diagnostic homogeneity within each department remained similar in the two historical periods with no evidence of an increased homogeneity of diagnostic habits after the introduction of the ICD10The release of DSMIV and DSM5 made it clear that the operational DSMIII promise and goal of an etiologyanchored classification failed to materialize 1 2 A need for etiological research progress and its prerequisite the diagnostic reliability was the justifying and motivating factor behind abandoning a prototypebased classification eg ICD8 DSMII in favor of a criteriabased polythetic operational diagnosis in the DSMIII its subsequent editions and ICD10 3 Current realization of etiological stagnation stimulated a lot of criticisms against the contemporary DSM/ICD diagnostic systems eg as lacking validity being unfit or even counterproductive for research and with limited clinical utility 1 2 4 5 and an avalanche of theoretical reflections on the nature of psychiatric classification 6 7 8 9 10Despite these criticisms the operational systems as such are widely considered as being essentially epistemologically sound and as having indeed improved the diagnostic reliability in a daily clinical setting In a series of empirical and conceptual publications 3 11 12 13 14 we questioned the first assumption concerning the epistemological foundationsIn this study we wish to explore the empirical evidence for the second assumption of an improved diagnostic homogeneity in a daily routine clinical activity The available information typically deals with diagnostic reliabilities that are reported as interrater agreements for selected disorders in the socalled “fieldtrials” accompanying the construction of diagnostic criteria or in research studies 15 16 17 18 19 Although both types of reports field and research trials stem from somewhat artificially constructed situations the reliabilities from field studies for ICD10 and DSM5 are far from being adequate 16 17 18 19 20 Most importantly however such reports do not provide information on a daily routine reliability across different historical time periods To the best of our knowledge there are no published data on the general quality of everyday diagnostic activity interclinician reliability of different diagnostic systems
Keywords:
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- Putting the ‘Q’ in depression QALYs: a comparison of utility measurement using EQ-5D and SF-6D health related quality of life measures
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