Validity of routine clinical diagnoses in acute psychiatric inpatients

Aim: To examine the validity of diagnoses obtained by clinicians during routine clinical examination on acute psychiatric inpatient wards. Methods: N =100 inpatients with a broad spectrum of major mental disorders were randomly selected in a mental hospitals department of general psychiatry. Patients were diagnosed by independent assessors within Md = 5 (Range: 1-18) days of admission using the SCID I in order to examine the validity of the diagnoses given by the clinical staff based on routine assessments. Results: The commonly used clinical examination technique had good overall agreement with the SCID I assessments regarding primary diagnoses at the level of ICD-10 main categories (F2, F30-31, F32-F33, F4; k = 0.65). However, agreement between routine clinical diagnoses and the SCID I diagnoses tended to be low for some specific mental disorders (e.g., depressive disorders) and for secondary diagnoses. Conclusions: The validity of routine clinical diagnoses established in acute inpatient settings is limited and should be improved.