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Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort

Identifieur interne : 000504 ( PascalFrancis/Corpus ); précédent : 000503; suivant : 000505

Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort

Auteurs : Kristiina Moilanen ; Juha Veijola ; Kristian L Ksy ; Taru M Kikyrö ; Jouko Miettunen ; Liisa Kantoj Rvi ; Pirkko Kokkonen ; Juha T. Karvonen ; Anne Herva ; Matti Joukamaa ; Marjo-Riitta J Rvelin ; Juha Moring ; Peter B. Jones ; Matti Isohanni

Source :

RBID : Pascal:03-0507064

Descripteurs français

English descriptors

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.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

pA  
A01 01  1    @0 0933-7954
A02 01      @0 SPPEEM
A03   1    @0 Soc. psychiatry psychiatr. epidemiol. : (Print)
A05       @2 38
A06       @2 6
A08 01  1  ENG  @1 Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort
A11 01  1    @1 MOILANEN (Kristiina)
A11 02  1    @1 VEIJOLA (Juha)
A11 03  1    @1 LÄKSY (Kristian)
A11 04  1    @1 MÄKIKYRÖ (Taru)
A11 05  1    @1 MIETTUNEN (Jouko)
A11 06  1    @1 KANTOJÄRVI (Liisa)
A11 07  1    @1 KOKKONEN (Pirkko)
A11 08  1    @1 KARVONEN (Juha T.)
A11 09  1    @1 HERVA (Anne)
A11 10  1    @1 JOUKAMAA (Matti)
A11 11  1    @1 JÄRVELIN (Marjo-Riitta)
A11 12  1    @1 MORING (Juha)
A11 13  1    @1 JONES (Peter B.)
A11 14  1    @1 ISOHANNI (Matti)
A14 01      @1 Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu @2 90014 @3 FIN @Z 1 aut. @Z 2 aut. @Z 3 aut. @Z 4 aut. @Z 5 aut. @Z 6 aut. @Z 7 aut. @Z 8 aut. @Z 9 aut. @Z 12 aut. @Z 14 aut.
A14 02      @1 Dept. of Social Psychiatry, Tampere School of Public Health @2 Tampere @3 FIN @Z 10 aut.
A14 03      @1 Dept. of Psychiatry, Tampere University Hospital @2 Tampere @3 FIN @Z 10 aut.
A14 04      @1 Dept. of Public Health Science and General Practice, University of Oulu @2 Oulu @3 FIN @Z 11 aut.
A14 05      @1 Dept. of Epidemiology and Public Health, Imperial College Faculty of Medicine @2 London @3 GBR @Z 11 aut. @Z 13 aut.
A20       @1 305-310
A21       @1 2003
A23 01      @0 ENG
A43 01      @1 INIST @2 13204 @5 354000118503030040
A44       @0 0000 @1 © 2003 INIST-CNRS. All rights reserved.
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A47 01  1    @0 03-0507064
A60       @1 P
A61       @0 A
A64 01  1    @0 Social psychiatry and psychiatric epidemiology : (Print)
A66 01      @0 DEU
C01 01    ENG  @0 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.
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C03 06  X  SPA  @0 Investigación científica @5 06
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Format Inist (serveur)

NO : PASCAL 03-0507064 INIST
ET : Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort
AU : MOILANEN (Kristiina); VEIJOLA (Juha); LÄKSY (Kristian); MÄKIKYRÖ (Taru); MIETTUNEN (Jouko); KANTOJÄRVI (Liisa); KOKKONEN (Pirkko); KARVONEN (Juha T.); HERVA (Anne); JOUKAMAA (Matti); JÄRVELIN (Marjo-Riitta); MORING (Juha); JONES (Peter B.); ISOHANNI (Matti)
AF : Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu/90014/Finlande (1 aut., 2 aut., 3 aut., 4 aut., 5 aut., 6 aut., 7 aut., 8 aut., 9 aut., 12 aut., 14 aut.); Dept. of Social Psychiatry, Tampere School of Public Health/Tampere/Finlande (10 aut.); Dept. of Psychiatry, Tampere University Hospital/Tampere/Finlande (10 aut.); Dept. of Public Health Science and General Practice, University of Oulu/Oulu/Finlande (11 aut.); Dept. of Epidemiology and Public Health, Imperial College Faculty of Medicine/London/Royaume-Uni (11 aut., 13 aut.)
DT : Publication en série; Niveau analytique
SO : Social psychiatry and psychiatric epidemiology : (Print); ISSN 0933-7954; Coden SPPEEM; Allemagne; Da. 2003; Vol. 38; No. 6; Pp. 305-310; Bibl. 20 ref.
LA : Anglais
EA : 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.
CC : 002B18B02; 002B18H05B
FD : Schizophrénie; Critère; Diagnostic; Diagnostic and Statistical Manual III; Discordance; Recherche scientifique; Hôpital psychiatrique; Psychiatre; Service santé; Santé mentale; Santé publique; Finlande; Homme
FG : Europe; Psychose
ED : Schizophrenia; Criterion; Diagnosis; Diagnostic and Statistical Manual III; Discordance; Scientific research; Psychiatric hospital; Psychiatrist; Health service; Mental health; Public health; Finland; Human
EG : Europe; Psychosis
SD : Esquizofrenia; Criterio; Diagnóstico; Diagnostic and Statistical Manual III; Discordancia; Investigación científica; Hospital psiquiátrico; Psiquiatra; Servicio sanidad; Salud mental; Salud pública; Finlandia; Hombre
LO : INIST-13204.354000118503030040
ID : 03-0507064

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Pascal:03-0507064

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<name sortKey="Kantoj Rvi, Liisa" sort="Kantoj Rvi, Liisa" uniqKey="Kantoj Rvi L" first="Liisa" last="Kantoj Rvi">Liisa Kantoj Rvi</name>
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<s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1>
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<name sortKey="Jones, Peter B" sort="Jones, Peter B" uniqKey="Jones P" first="Peter B." last="Jones">Peter B. Jones</name>
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<s1>Dept. of Epidemiology and Public Health, Imperial College Faculty of Medicine</s1>
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<s1>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu</s1>
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<title level="j" type="main">Social psychiatry and psychiatric epidemiology : (Print)</title>
<title level="j" type="abbreviated">Soc. psychiatry psychiatr. epidemiol. : (Print)</title>
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<title level="j" type="main">Social psychiatry and psychiatric epidemiology : (Print)</title>
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<term>Finland</term>
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<term>Human</term>
<term>Mental health</term>
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<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>
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<s0>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.</s0>
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<ET>Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort</ET>
<AU>MOILANEN (Kristiina); VEIJOLA (Juha); LÄKSY (Kristian); MÄKIKYRÖ (Taru); MIETTUNEN (Jouko); KANTOJÄRVI (Liisa); KOKKONEN (Pirkko); KARVONEN (Juha T.); HERVA (Anne); JOUKAMAA (Matti); JÄRVELIN (Marjo-Riitta); MORING (Juha); JONES (Peter B.); ISOHANNI (Matti)</AU>
<AF>Dept. of Psychiatry, University of Oulu, P. O. 5000, University of Oulu/90014/Finlande (1 aut., 2 aut., 3 aut., 4 aut., 5 aut., 6 aut., 7 aut., 8 aut., 9 aut., 12 aut., 14 aut.); Dept. of Social Psychiatry, Tampere School of Public Health/Tampere/Finlande (10 aut.); Dept. of Psychiatry, Tampere University Hospital/Tampere/Finlande (10 aut.); Dept. of Public Health Science and General Practice, University of Oulu/Oulu/Finlande (11 aut.); Dept. of Epidemiology and Public Health, Imperial College Faculty of Medicine/London/Royaume-Uni (11 aut., 13 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Social psychiatry and psychiatric epidemiology : (Print); ISSN 0933-7954; Coden SPPEEM; Allemagne; Da. 2003; Vol. 38; No. 6; Pp. 305-310; Bibl. 20 ref.</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>002B18B02; 002B18H05B</CC>
<FD>Schizophrénie; Critère; Diagnostic; Diagnostic and Statistical Manual III; Discordance; Recherche scientifique; Hôpital psychiatrique; Psychiatre; Service santé; Santé mentale; Santé publique; Finlande; Homme</FD>
<FG>Europe; Psychose</FG>
<ED>Schizophrenia; Criterion; Diagnosis; Diagnostic and Statistical Manual III; Discordance; Scientific research; Psychiatric hospital; Psychiatrist; Health service; Mental health; Public health; Finland; Human</ED>
<EG>Europe; Psychosis</EG>
<SD>Esquizofrenia; Criterio; Diagnóstico; Diagnostic and Statistical Manual III; Discordancia; Investigación científica; Hospital psiquiátrico; Psiquiatra; Servicio sanidad; Salud mental; Salud pública; Finlandia; Hombre</SD>
<LO>INIST-13204.354000118503030040</LO>
<ID>03-0507064</ID>
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