Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort
Identifieur interne : 001F41 ( Main/Exploration ); précédent : 001F40; suivant : 001F42Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort
Auteurs : Kristiina Moilanen [Finlande] ; Juha Veijola [Finlande] ; Kristian L Ksy [Finlande] ; Taru M Kikyrö [Finlande] ; Jouko Miettunen [Finlande] ; Liisa Kantoj Rvi [Finlande] ; Pirkko Kokkonen [Finlande] ; Juha T. Karvonen [Finlande] ; Anne Herva [Finlande] ; Matti Joukamaa [Finlande] ; Marjo-Riitta J Rvelin [Finlande, Royaume-Uni] ; Juha Moring [Finlande] ; Peter B. Jones [Royaume-Uni] ; Matti Isohanni [Finlande]Source :
- Social psychiatry and psychiatric epidemiology : (Print) [ 0933-7954 ] ; 2003.
Descripteurs français
- Pascal (Inist)
- Wicri :
- geographic : Finlande.
- topic : Recherche scientifique, Santé mentale, Santé publique, Homme.
English descriptors
- KwdEn :
Abstract
Background The diagnosis of schizophrenia by clinicians is not always accurate in terms of opera tional diagnostic criteria despite the fact that these diagnoses form the basis of case registers and routine statistics. This poses a challenge to psychiatric research. We studied the reasons for diagnostic discordance between clinicians and researchers. Methods The Northern Fin land 1966 Birth Cohort (n = 11,017) was followed from mid-gestation to the end of the 31st year. Psychiatric outcome was ascertained through linkage to the national hospital discharge register containing clinical diagnoses made by the attending physician. The hospital notes of all subjects admitted to hospital during the period 1982-1997 due to psychiatric disorder were reviewed and 475 research, operational DSM-III-R diagnoses were formulated. Results Ninety-six cases met operational crite ria for schizophrenia. Fifty-five (57%) had concordant diagnoses: both the clinical and research diagnoses were schizophrenia. Forty-one (43%) had discordant diagnoses: the clinical diagnosis was other than schizophrenia (mainly schizophreniform or other psychosis). Discordant cases were more likely to be older at onset, experience a shorter treatment duration,fewer treatment episodes, and to have a comorbid diagnosis mental retardation. Conclusions Clinicians do not make the diagnosis of schizophrenia as often as the application of operational criteria would suggest they should. The discordance between clinical diagnosis and the research, operational diagnosis is especially likely in cases having late onset and few contacts to psychiatric hospital.
Affiliations:
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O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Kokkonen, Pirkko" sort="Kokkonen, Pirkko" uniqKey="Kokkonen P" first="Pirkko" last="Kokkonen">Pirkko Kokkonen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Karvonen, Juha T" sort="Karvonen, Juha T" uniqKey="Karvonen J" first="Juha T." last="Karvonen">Juha T. Karvonen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. 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Jones</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Dept. of Epidemiology and Public Health, Imperial College Faculty of Medicine</s1><s2>London</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Isohanni, Matti" sort="Isohanni, Matti" uniqKey="Isohanni M" first="Matti" last="Isohanni">Matti Isohanni</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. 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O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Veijola, Juha" sort="Veijola, Juha" uniqKey="Veijola J" first="Juha" last="Veijola">Juha Veijola</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="L Ksy, Kristian" sort="L Ksy, Kristian" uniqKey="L Ksy K" first="Kristian" last="L Ksy">Kristian L Ksy</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="M Kikyro, Taru" sort="M Kikyro, Taru" uniqKey="M Kikyro T" first="Taru" last="M Kikyrö">Taru M Kikyrö</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Miettunen, Jouko" sort="Miettunen, Jouko" uniqKey="Miettunen J" first="Jouko" last="Miettunen">Jouko Miettunen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Kantoj Rvi, Liisa" sort="Kantoj Rvi, Liisa" uniqKey="Kantoj Rvi L" first="Liisa" last="Kantoj Rvi">Liisa Kantoj Rvi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Kokkonen, Pirkko" sort="Kokkonen, Pirkko" uniqKey="Kokkonen P" first="Pirkko" last="Kokkonen">Pirkko Kokkonen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Karvonen, Juha T" sort="Karvonen, Juha T" uniqKey="Karvonen J" first="Juha T." last="Karvonen">Juha T. Karvonen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Herva, Anne" sort="Herva, Anne" uniqKey="Herva A" first="Anne" last="Herva">Anne Herva</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Joukamaa, Matti" sort="Joukamaa, Matti" uniqKey="Joukamaa M" first="Matti" last="Joukamaa">Matti Joukamaa</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Dept. of Social Psychiatry, Tampere School of Public Health</s1><s2>Tampere</s2><s3>FIN</s3><sZ>10 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Tampere</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Dept. of Psychiatry, Tampere University Hospital</s1><s2>Tampere</s2><s3>FIN</s3><sZ>10 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Tampere</wicri:noRegion></affiliation></author><author><name sortKey="J Rvelin, Marjo Riitta" sort="J Rvelin, Marjo Riitta" uniqKey="J Rvelin M" first="Marjo-Riitta" last="J Rvelin">Marjo-Riitta J Rvelin</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Dept. of Public Health Science and General Practice, University of Oulu</s1><s2>Oulu</s2><s3>FIN</s3><sZ>11 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Oulu</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Dept. of Epidemiology and Public Health, Imperial College Faculty of Medicine</s1><s2>London</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Moring, Juha" sort="Moring, Juha" uniqKey="Moring J" first="Juha" last="Moring">Juha Moring</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author><author><name sortKey="Jones, Peter B" sort="Jones, Peter B" uniqKey="Jones P" first="Peter B." last="Jones">Peter B. Jones</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Dept. of Epidemiology and Public Health, Imperial College Faculty of Medicine</s1><s2>London</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Isohanni, Matti" sort="Isohanni, Matti" uniqKey="Isohanni M" first="Matti" last="Isohanni">Matti Isohanni</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1><s2>90014</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>90014</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Social psychiatry and psychiatric epidemiology : (Print)</title><title level="j" type="abbreviated">Soc. psychiatry psychiatr. epidemiol. : (Print)</title><idno type="ISSN">0933-7954</idno><imprint><date when="2003">2003</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Social psychiatry and psychiatric epidemiology : (Print)</title><title level="j" type="abbreviated">Soc. psychiatry psychiatr. epidemiol. : (Print)</title><idno type="ISSN">0933-7954</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Criterion</term><term>Diagnosis</term><term>Diagnostic and Statistical Manual III</term><term>Discordance</term><term>Finland</term><term>Health service</term><term>Human</term><term>Mental health</term><term>Psychiatric hospital</term><term>Psychiatrist</term><term>Public health</term><term>Schizophrenia</term><term>Scientific research</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Schizophrénie</term><term>Critère</term><term>Diagnostic</term><term>Diagnostic and Statistical Manual III</term><term>Discordance</term><term>Recherche scientifique</term><term>Hôpital psychiatrique</term><term>Psychiatre</term><term>Service santé</term><term>Santé mentale</term><term>Santé publique</term><term>Finlande</term><term>Homme</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Finlande</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Recherche scientifique</term><term>Santé mentale</term><term>Santé publique</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background The diagnosis of schizophrenia by clinicians is not always accurate in terms of opera tional diagnostic criteria despite the fact that these diagnoses form the basis of case registers and routine statistics. This poses a challenge to psychiatric research. We studied the reasons for diagnostic discordance between clinicians and researchers. Methods The Northern Fin land 1966 Birth Cohort (n = 11,017) was followed from mid-gestation to the end of the 31st year. Psychiatric outcome was ascertained through linkage to the national hospital discharge register containing clinical diagnoses made by the attending physician. The hospital notes of all subjects admitted to hospital during the period 1982-1997 due to psychiatric disorder were reviewed and 475 research, operational DSM-III-R diagnoses were formulated. Results Ninety-six cases met operational crite ria for schizophrenia. Fifty-five (57%) had concordant diagnoses: both the clinical and research diagnoses were schizophrenia. Forty-one (43%) had discordant diagnoses: the clinical diagnosis was other than schizophrenia (mainly schizophreniform or other psychosis). Discordant cases were more likely to be older at onset, experience a shorter treatment duration,fewer treatment episodes, and to have a comorbid diagnosis mental retardation. Conclusions Clinicians do not make the diagnosis of schizophrenia as often as the application of operational criteria would suggest they should. The discordance between clinical diagnosis and the research, operational diagnosis is especially likely in cases having late onset and few contacts to psychiatric hospital.</div></front></TEI><affiliations><list><country><li>Finlande</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Finlande"><noRegion><name sortKey="Moilanen, Kristiina" sort="Moilanen, Kristiina" uniqKey="Moilanen K" first="Kristiina" last="Moilanen">Kristiina Moilanen</name></noRegion><name sortKey="Herva, Anne" sort="Herva, Anne" uniqKey="Herva A" first="Anne" last="Herva">Anne Herva</name><name sortKey="Isohanni, Matti" sort="Isohanni, Matti" uniqKey="Isohanni M" first="Matti" last="Isohanni">Matti Isohanni</name><name sortKey="J Rvelin, Marjo Riitta" sort="J Rvelin, Marjo Riitta" uniqKey="J Rvelin M" first="Marjo-Riitta" last="J Rvelin">Marjo-Riitta J Rvelin</name><name sortKey="Joukamaa, Matti" sort="Joukamaa, Matti" uniqKey="Joukamaa M" first="Matti" last="Joukamaa">Matti Joukamaa</name><name sortKey="Joukamaa, Matti" sort="Joukamaa, Matti" uniqKey="Joukamaa M" first="Matti" last="Joukamaa">Matti Joukamaa</name><name sortKey="Kantoj Rvi, Liisa" sort="Kantoj Rvi, Liisa" uniqKey="Kantoj Rvi L" first="Liisa" last="Kantoj Rvi">Liisa Kantoj Rvi</name><name sortKey="Karvonen, Juha T" sort="Karvonen, Juha T" uniqKey="Karvonen J" first="Juha T." last="Karvonen">Juha T. Karvonen</name><name sortKey="Kokkonen, Pirkko" sort="Kokkonen, Pirkko" uniqKey="Kokkonen P" first="Pirkko" last="Kokkonen">Pirkko Kokkonen</name><name sortKey="L Ksy, Kristian" sort="L Ksy, Kristian" uniqKey="L Ksy K" first="Kristian" last="L Ksy">Kristian L Ksy</name><name sortKey="M Kikyro, Taru" sort="M Kikyro, Taru" uniqKey="M Kikyro T" first="Taru" last="M Kikyrö">Taru M Kikyrö</name><name sortKey="Miettunen, Jouko" sort="Miettunen, Jouko" uniqKey="Miettunen J" first="Jouko" last="Miettunen">Jouko Miettunen</name><name sortKey="Moring, Juha" sort="Moring, Juha" uniqKey="Moring J" first="Juha" last="Moring">Juha Moring</name><name sortKey="Veijola, Juha" sort="Veijola, Juha" uniqKey="Veijola J" first="Juha" last="Veijola">Juha Veijola</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="J Rvelin, Marjo Riitta" sort="J Rvelin, Marjo Riitta" uniqKey="J Rvelin M" first="Marjo-Riitta" last="J Rvelin">Marjo-Riitta J Rvelin</name></region><name sortKey="Jones, Peter B" sort="Jones, Peter B" uniqKey="Jones P" first="Peter B." last="Jones">Peter B. Jones</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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