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1533 – A Naturalistic Study Of The Diagnostic Evolution Of Schizophrenia

Published online by Cambridge University Press:  15 April 2020

E. Serrano-Drozdowskyj ,
J. Lopez-Castroman ,
J.M. Leiva-Murillo ,
H. Blasco-Fontecilla ,
R. Garcia-ieto ,
A. Artes-Rodriguez ,
C. Morant-Ginestar ,
C. Blanco ,
P. Courtet  and
E. Baca-Garcia
E. Serrano-Drozdowskyj
Affiliation:
Department of Psychiatry, IIS-Fundación Jimenez Díaz, Autonoma University, CIBERSAM, Madrid, Spain
J. Lopez-Castroman
Affiliation:
Department of Psychiatry, IIS-Fundación Jimenez Díaz, Autonoma University, CIBERSAM, Madrid, Spain INSERM U1061, Montpellier, France
J.M. Leiva-Murillo
Affiliation:
Department of Signal Theory and Communications,Telecommunication Engineering Faculty, Carlos III University
H. Blasco-Fontecilla
Affiliation:
Department of Psychiatry, IIS-Fundación Jimenez Díaz, Autonoma University, CIBERSAM, Madrid, Spain
R. Garcia-ieto
Affiliation:
Department of Psychiatry, IIS-Fundación Jimenez Díaz, Autonoma University, CIBERSAM, Madrid, Spain
A. Artes-Rodriguez
Affiliation:
Department of Signal Theory and Communications,Telecommunication Engineering Faculty, Carlos III University
C. Morant-Ginestar
Affiliation:
Department of Mental Health, Madrid Regional Health Council, Madrid, Spain
C. Blanco
Affiliation:
Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
P. Courtet
Affiliation:
INSERM U1061, Montpellier, France Emergency Psychiatry, CHRU Montpellier/University of Montpellier, Montpellier, France
E. Baca-Garcia
Affiliation:
Department of Psychiatry, IIS-Fundación Jimenez Díaz, Autonoma University, CIBERSAM, Madrid, Spain Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, New York, NY, USA

Abstract

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Introduction

In the absence of biological measures, diagnostic long-term stability provides the best evidence of diagnostic validity.Therefore,the study of diagnostic stability in naturalistic conditions may reflect clinical validity and utility of current schizophrenia diagnostic criteria.

Objectives

Describe the diagnostic evolution of schizophrenia in clinical settings.

Methods

We examined the stability of schizophrenia first diagnoses (n=26,163) in public mental health centers of Madrid (Spain).Probability of maintaining the diagnosis of schizophrenia was calculated considering the cumulative percentage of each diagnosis per month during 48 months after the initial diagnosis of schizophrenia.

Results

65% of the subjects kept the diagnosis of schizophrenia in subsequent assessments (Figure 1). Patients who changed (35%) did so in the first 4-8 months. After that time gap the rates of each diagnostic category remained stable. Diagnostic shift from schizophrenia was more commonly toward the following diagnoses: personality disorders (F60), delusional disorders (F22), bipolar disorder (F31), persistent mood disorders (F34), acute and transient psychotic disorders (F23) or schizoaffective disorder (F25).

Conclusions

Once it is confirmed, clinical assessment repeatedly maintains the diagnosis of schizophrenia.The time lapse for its confirmation agrees with the current diagnostic criteria in DSM-IV. We will discuss the implications of these findings for the categorical versus dimensional debate in the diagnosis of schizophrenia.

Type
Abstract
Information
European Psychiatry , Volume 28 , Issue S1: Abstracts of the 21th European Congress of Psychiatry , 2013 , 28-E834
Copyright
Copyright © European Psychiatric Association 2013
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