Misdiagnosis common among psych inpatients.
Indeed, 26 of the first 100 adults admitted in 2008 to the Cleveland Clinic Center for Mood Disorders at Lutheran Hospital with the diagnosis of a primary mood disorder proved upon closer scrutiny to instead have a primary anxiety disorder, thought disorder, or personality disorder, according to Dr. Sethi of the clinic.
The routine use of a structured diagnostic interview such as the Mini-International Neuropsychiatric Interview (MINI-Plus) is of great value in highlighting the inconsistencies that suggest psychiatric misdiagnosis, he added.
The 100 patients in this series were moderately symptomatic and relatively high functioning rather than in acute crisis. The admitting diagnosis was unipolar major depression in 70 patients and bipolar disorder in 30.
The final diagnosis, however, which was based upon results of the MINI-Plus as conducted by a blinded research assistant and considered with a clinician interview, was unipolar major depression in 56 patients, bipolar disorder in 18, anxiety disorder in 10, a thought disorder in 5, and assorted other psychiatric conditions in 11.
The biggest shift involved the diagnosis of bipolar disorder. Only 11 of 30 patients with that admitting diagnosis ended up with it. The most common reclassification was to anxiety disorder.
Eight patients admitted with bipolar disorder and two who carried a diagnosis of primary unipolar major depression were determined to have a primary anxiety disorder instead.
BY BRUCE JANCIN Denver Bureau
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|Title Annotation:||EVIDENCE-BASED PSYCHIATRIC MEDICINE|
|Publication:||Clinical Psychiatry News|
|Date:||Nov 1, 2008|
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