Accuracy of psychiatric diagnosis performed under indirect supervision

Braz J Psychiatry. 2005 Mar;27(1):58-62. doi: 10.1590/s1516-44462005000100013. Epub 2005 Apr 18.

Abstract

This work aimed at comparing the accuracy of the psychiatric diagnoses made under indirect supervision to the diagnoses obtained through Structured Clinical Interview for DSM-III-R (SCID). The study was conducted in 3 university services (outpatient, inpatient and emergency). Data from the emergency service were collected 3 years later, after changes in the training process of the medical staff in psychiatric diagnosis. The sensitivity for Major Depression (outpatient 10.0%; inpatients 60.0%, emergency 90.0%) and Schizophrenia (44.4%; 55.0%; 80.0%) improved over time. The reliability was poor in the outpatient service (Kw = 0.18), and at admission to the inpatient service (Kw = 0.38). The diagnosis elaborated in the discharge of the inpatient service (Kw = 0.55) and in the emergency service (Kw = 0.63) was good. Systematic training of supervisors and residents in operational diagnostic criteria increased the accuracy of psychiatric diagnoses elaborated under indirect supervision, although excellent reliability was not achieved.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Depressive Disorder, Major / diagnosis
  • Emergency Services, Psychiatric
  • Female
  • Humans
  • Interview, Psychological / methods*
  • Male
  • Mental Disorders / diagnosis*
  • Psychiatric Status Rating Scales*
  • Schizophrenia / diagnosis
  • Sensitivity and Specificity