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1 Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
The usefulness of our diagnostic categories is just as dependent on temporal stability as on reliability in the observer agreement situation with which most reliability studies have been concerned. The stability of the diagnoses attributed by the staff of English psychiatric hospitals to their in-patients was examined by extracting from the Department of Health's records the diagnosis at each admission of a sample of 2,000 patients first admitted to a psychiatric bed in England and Wales in 1964, and readmitted at least once before the end of 1969. Although the major diagnostic categories of schizophrenia, depression, mania, dementia and alcoholism were relatively stable, less than half those with initial diagnoses of anxiety state, paranoid state, confusional state, personality disorder or hysteria retained the same diagnosis on subsequent occasions. Paranoid states tended to be rediagnosed as schizophrenia, confusional states to be rediagnosed as dementia, and anxiety states to be rediagnosed as depression. On the other hand, there was no evidence of any transition from depressive illness schizophrenia with the passage of time.
Submitted on May 1, 1973
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