Diagnostic stability in depressive disorder as according to ICD-10 in clinical practice

Psychopathology. Jan-Feb 2005;38(1):32-7. doi: 10.1159/000083968. Epub 2005 Feb 15.

Abstract

Background: The diagnostic stability of the ICD-10 diagnosis of depressive disorder has not been investigated in clinical practice.

Sampling and methods: All patients who were diagnosed with depressive disorder at least once in a period from 1994 to 2002 in psychiatric out- or inpatient settings in Denmark were identified in a nationwide register.

Results: A total of 39,741 patients were diagnosed with depressive disorder at least once; among these, 81% were diagnosed at the first contact. In approximately 56% of patients, the initial diagnosis of depressive disorder eventually changed during follow-up mainly to the schizophrenic spectrum (16%), but also to personality disorders (9%), neurotic, stress-related and somatoform disorders (8%) and to bipolar disorder (8%). Among the 18% of patients who were later diagnosed with depressive disorder, 23% initially had a diagnosis of adjustment disorder.

Conclusions: When the ICD-10 diagnoses are used in clinical practice, the diagnosis of depressive disorder has a low stability over time. These findings emphasize the need for a longitudinally based diagnostic process in the diagnostic systems.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology*
  • Diagnosis, Differential
  • Disease Progression
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales*
  • Recurrence
  • Registries / statistics & numerical data*
  • Reproducibility of Results