Diagnostic stability among patients readmitted with serious mental illnesses in a referral psychiatric university hospital in Tabriz, Iran,in 2016

Abstract

Introduction: Regarding mental disorders, one of the important factors in the validity of clinical diagnosis is its consistency in consecutive evaluations. This varies from 29% in personality disorders to 70% in schizophrenia. This survey was conducted to study clinical diagnosis stability among readmitted patients in referral psychiatric university hospital. Methods: In this study, 1000 records were evaluated retrospectively. Data were gathered by educated clinical psychologist with a prepared checklist. The checklist consisted of demographic data, clinical interview data, primary and final diagnosis, and process of care. The collected data were analyzed using SPSS software and presented as descriptive and proportion measures. Results: The mean age of patients in the first hospitalization was 31.23 years. Since the first admission, 26.6% of patients’ life time was spent in hospitals. The clinical diagnosis of cases at discharge was bipolar mood disorder I (BMD I) and schizophrenia in 49.5 and 40.4 percent of cases, respectively. Generally, concordance between admission and discharge diagnosis was 94.9 and 84.4 percent among the women and men, respectively. 66.0% of patients with BMD I and 71.4% of patients schizophrenia received the same diagnosis in at least 75% of their next hospital admissions. Furthermore, the prospective consistency was 80 and 60 percent in schizophrenia and BMD I, respectively. Conclusion: The findings of the present study showed that in psychiatric studies, clinical diagnosis can be challenging especially in short term evaluations.

Keywords: Diagnosis, Severe Mental Disorders, Inpatients, Hospitals, Iran