Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice
Abstract Background Mental health clinicians have previously been reported to express reservations regarding the utility and accuracy of the psychiatric classification systems. In this study we aimed to examine clinicians’ experiences with instances of perceived inaccuracy of a schizophrenia diagnos...
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| Format: | Article |
| Language: | English |
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BMC
2018-09-01
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| Series: | BMC Psychiatry |
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| Online Access: | http://link.springer.com/article/10.1186/s12888-018-1897-2 |
| _version_ | 1818505562223017984 |
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| author | Dana Tzur Bitan Ariella Grossman Giron Gady Alon Shlomo Mendlovic Yuval Bloch Aviv Segev |
| author_facet | Dana Tzur Bitan Ariella Grossman Giron Gady Alon Shlomo Mendlovic Yuval Bloch Aviv Segev |
| author_sort | Dana Tzur Bitan |
| collection | DOAJ |
| description | Abstract Background Mental health clinicians have previously been reported to express reservations regarding the utility and accuracy of the psychiatric classification systems. In this study we aimed to examine clinicians’ experiences with instances of perceived inaccuracy of a schizophrenia diagnosis. Methods Mental health clinicians (N = 175) participated in an online survey assessing prevalence and perceived reasons for inaccuracies of a schizophrenia diagnosis. Respondents included psychiatric ward directors (13.1%), senior psychiatrists and psychologists (40.5%), and psychiatry and clinical psychology residents (36%). Results Fifty-three percent of respondents reported encountering instances where a schizophrenia diagnosis was assigned even though clinical presentation did not match diagnostic criteria. Seventy-three percent of senior psychiatrists in a position to determine a diagnosis declared assigning schizophrenia even when controversial among clinical staff, and 15% of them declared doing so frequently. The likelihood of frequently assigning a schizophrenia diagnosis even when clearly controversial was predicted by the perception that an inaccurate diagnosis is assigned due to the presence of negative symptoms (OR 2.20, 95% CI 1.04–4.66, p = 0.039) and due to patient-related factors, such as the need to facilitate rehabilitation (OR 1.77, 95% CI 1.07–2.90, p = 0.024). Conclusions Although a schizophrenia diagnosis is considered relatively stable and clear, our study indicates that, in clinical practice, the assignment of this diagnosis is frequently controversial. These controversies are associated with the perception that an inaccurate diagnosis is assigned due to diagnostic considerations, or due to the possibility that patients might benefit from such a diagnosis. Implications and limitations for psychiatric practice and discourse are discussed. |
| first_indexed | 2024-12-10T21:52:28Z |
| format | Article |
| id | doaj.art-20c1d320c2f14b9d861d1bcce3f4e51d |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-10T21:52:28Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-20c1d320c2f14b9d861d1bcce3f4e51d2022-12-22T01:32:08ZengBMCBMC Psychiatry1471-244X2018-09-011811910.1186/s12888-018-1897-2Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practiceDana Tzur Bitan0Ariella Grossman Giron1Gady Alon2Shlomo Mendlovic3Yuval Bloch4Aviv Segev5Department of Behavioral Sciences, Ariel UniversityDepartment of Behavioral Sciences, Ariel UniversityShalvata Mental Health CenterShalvata Mental Health CenterShalvata Mental Health CenterShalvata Mental Health CenterAbstract Background Mental health clinicians have previously been reported to express reservations regarding the utility and accuracy of the psychiatric classification systems. In this study we aimed to examine clinicians’ experiences with instances of perceived inaccuracy of a schizophrenia diagnosis. Methods Mental health clinicians (N = 175) participated in an online survey assessing prevalence and perceived reasons for inaccuracies of a schizophrenia diagnosis. Respondents included psychiatric ward directors (13.1%), senior psychiatrists and psychologists (40.5%), and psychiatry and clinical psychology residents (36%). Results Fifty-three percent of respondents reported encountering instances where a schizophrenia diagnosis was assigned even though clinical presentation did not match diagnostic criteria. Seventy-three percent of senior psychiatrists in a position to determine a diagnosis declared assigning schizophrenia even when controversial among clinical staff, and 15% of them declared doing so frequently. The likelihood of frequently assigning a schizophrenia diagnosis even when clearly controversial was predicted by the perception that an inaccurate diagnosis is assigned due to the presence of negative symptoms (OR 2.20, 95% CI 1.04–4.66, p = 0.039) and due to patient-related factors, such as the need to facilitate rehabilitation (OR 1.77, 95% CI 1.07–2.90, p = 0.024). Conclusions Although a schizophrenia diagnosis is considered relatively stable and clear, our study indicates that, in clinical practice, the assignment of this diagnosis is frequently controversial. These controversies are associated with the perception that an inaccurate diagnosis is assigned due to diagnostic considerations, or due to the possibility that patients might benefit from such a diagnosis. Implications and limitations for psychiatric practice and discourse are discussed.http://link.springer.com/article/10.1186/s12888-018-1897-2SchizophreniaDSMICDMisdiagnosisRehabilitationNegative symptoms |
| spellingShingle | Dana Tzur Bitan Ariella Grossman Giron Gady Alon Shlomo Mendlovic Yuval Bloch Aviv Segev Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice BMC Psychiatry Schizophrenia DSM ICD Misdiagnosis Rehabilitation Negative symptoms |
| title | Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice |
| title_full | Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice |
| title_fullStr | Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice |
| title_full_unstemmed | Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice |
| title_short | Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice |
| title_sort | attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice |
| topic | Schizophrenia DSM ICD Misdiagnosis Rehabilitation Negative symptoms |
| url | http://link.springer.com/article/10.1186/s12888-018-1897-2 |
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