DIAGNOSTIC VALIDITY IN A COMMUNITY PSYCHIATRIC CENTER

An evaluation of the concurrent diagnostic validity at a psychiatric service centre before and after the implementation of community psychiatry is presented. One aim of this change in service was to improve the diagnostic process at screening of the patients. The ICD-8 centre diagnoses were compared with ICD-10 research diagnoses. The kappa-values ranged from 0.13 to 0.15 before the change in service and from 0.25 to 0.52 afterwards. Schizophrenia and related disorders and affective disorders were underdiagnosed by the centre compared with the research team diagnoses. The misdiagnosed patients had been diagnosed as having disorders due to psychoactive substance use and other non-psychotic disorders. The concurrent validity improved as a result of the change in service, especially for affective disorders. Consequently, the improvement of the diagnostic process at the screening procedure appears to have had a positive effect on the diagnostic validity. Diagnoses should mainly be obtained at the initial assessment of the patients by specialists in psychiatry.