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Titolo:
Methods to improve diagnostic accuracy in a community mental health setting
Autore:
Basco, MR; Bostic, JQ; Davies, D; Rush, AJ; Witte, B; Hendrickse, W; Barnett, V;
Indirizzi:
Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX USA Univ Texas Dallas TX USA exas, SW Med Ctr, Dept Psychiat, Dallas, TX USA Univ Texas, SW Med Ctr, Mental Hlth Connect Res Program, Dallas, TX USA Univ Texas Dallas TX USA Mental Hlth Connect Res Program, Dallas, TX USA
Titolo Testata:
AMERICAN JOURNAL OF PSYCHIATRY
fascicolo: 10, volume: 157, anno: 2000,
pagine: 1599 - 1605
SICI:
0002-953X(200010)157:10<1599:MTIDAI>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
STRUCTURED CLINICAL INTERVIEW; DSM-III DIAGNOSES; PSYCHIATRIC-DIAGNOSIS; RELIABILITY; SCHEDULE; DISORDER; VALIDITY; HISTORY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Basco, MR 2930 Cent Dr, Bedford, TX 76021 USA 2930 Cent Dr Bedford TX USA76021 ent Dr, Bedford, TX 76021 USA
Citazione:
M.R. Basco et al., "Methods to improve diagnostic accuracy in a community mental health setting", AM J PSYCHI, 157(10), 2000, pp. 1599-1605

Abstract

Objective: This study determined the extent to which adding structured procedures improved diagnostic accuracy for outpatients with severe mental illness in a community mental health setting. Method: The Structured Clinical Interview for DSM-III-R (SCID) was used tointerview 200 psychiatric outpatients. A research nurse reviewed medical records and amended the SCID diagnoses accordingly. A research psychiatrist or psychologist reviewed the diagnostic data and interviewed each patient to verify or further modify the previous findings. Diagnostic outcomes at each step of the procedure were compared to determine whether adding additional data improved diagnostic accuracy. The additional time required for eachelement of the diagnostic procedure was also assessed. Results: Kappa comparisons of the different diagnostic levels showed that adding additional data significantly improved accuracy. Diagnoses rendered by combining the SCID and review of the medical record were the most accurate, followed by the SCID alone, and then diagnoses made by psychiatrists during routine care. In addition, the SCID alone identified five times as many current and past secondary diagnoses as were documented routinely in patients' charts. Conclusions: Combining structured interviewing with a review of the medical record appears to produce more accurate primary diagnoses and to identifymore secondary diagnoses than routine clinical methods. The patients' knowledge of their diagnoses was limited, suggesting a need for patient education in this setting. Whether use of structured interviewing in routine practice improves patient outcomes deserves further study.

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Documento generato il 02/04/20 alle ore 19:09:20