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Accuracy of register-based schizophrenia diagnoses in a genetic study

Published online by Cambridge University Press:  16 April 2020

T Mäkikyrö ,
M Isohanni ,
J Moring ,
H Hakko ,
I Hovatta  and
J Lönnqvist
T Mäkikyrö
Affiliation:
Department of Psychiatry, University of Oulu, Peltolantie 5, 90220, Oulu
M Isohanni
Affiliation:
Department of Psychiatry, University of Oulu, Peltolantie 5, 90220, Oulu
J Moring
Affiliation:
Department of Psychiatry, University of Oulu, Peltolantie 5, 90220, Oulu
H Hakko
Affiliation:
Department of Psychiatry, University of Oulu, Peltolantie 5, 90220, Oulu
I Hovatta
Affiliation:
Department of Human Molecular Genetics, Helsinki, Finland Department of Mental Health, National Public Health Institute, Helsinki, Finland
J Lönnqvist
Affiliation:
Department of Mental Health, National Public Health Institute, Helsinki, Finland
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Summary

In order to assess the accuracy of schizophrenia diagnoses for genetic studies, we identified all schizophrenia patients (n = 492) in an isolated community with a diagnosis of schizophrenia in the Finnish Hospital Discharge Register (HDR) between 1969-1991. For the accuracy study we identified a sample of 73 patients from registers with Diagnostic and Statistical Manual (DSM)-III-R for schizophrenia (codes 295.10, 295.30, 295.60, 295.90) (n = 62) or “schizophrenia spectrum” diagnoses (295.40, 295.70, 297.10, 301.20, 301.22) (n = 11). When the operational criteria (DSM-III-R) were applied by two senior researchers using information from the original mental hospital records, 93% (68/73) of the cases fulfilled criteria for schizophrenia or schizophrenia spectrum. The results demonstrate that the schizophrenia diagnoses of the registers are accurate when a broad concept of schizophrenia is applied. When using operational DSM-III-R schizophrenia criteria, eight false positive cases were found among the 62 mental hospital schizophrenia diagnoses. Consequently, there may be a need to reassess schizophrenia diagnoses depending on the purpose of the study. We also found good agreement between DSM-III-R (kappa 0.93) and operational criteria (OPCRIT) diagnostic system (kappa 0.89) diagnoses, made by one researcher, compared with operational diagnoses. This indicates the possibility for the reliable use of one of these methods alone for diagnostic reassessment. The information in the HDR on primary diagnoses and on the dates of admission and discharge was accurately transferred from the hospital records.

Keywords

schizophreniadiagnosisaccuracyreliability
Type
Original article
Information
European Psychiatry , Volume 13 , Issue 2 , 1998 , pp. 57 - 62
Copyright
Copyright © Elsevier, Paris 1998

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