Pontizovsky et al. (2006)
- Looked at agreement in diagnosis on admission and on release
- 998 patients
- Israeli hospital
- Kappa for mood disorder = 0.68
- Psychotic patients = 0.62
Reliability is high as a kappa of 1 would mean complete agreement in diagnosis
Kirk and Kutchins (1992)
- Looked at methodological problems with studies testing DSM
- Use of interviews and questionnaires: interviewers training was poor- lacked commitment and skills
- research setting- can't be generalised to setting of clinic- meaning diagnosis is NOT accurate
Cooper et al. (1997)
- Affect of culture on diagnosis
- Psychiatrists in NYC = 2x as likely to diagnose SCHIZOPHRENIA
- Psychiatrists in London = 2x as likely to diagnose MANIA or DEPRESSION
- Both were shown same video taped clinical interview!!
Cultural factors may affect reliability of diagnosis due to difference in beliefs and norms.
- Reliability of DSM III
- Researchers looked at histories of patients previously diagnosed with schizo
- High level of agreement for diagnosis (re-hospitalisation)
Highlights the RELIABILITY of the DSM III
Subjectivity of diagnosis
- there have been different diagnosis' which show psychiatrists may be SUBJECTIVE when giving diagnosis- personal opinion
- Misdiagnosis may also be deliberate- some institutions only admit people with certain problems, may misdiagnose to admit someone or to send them away?
DSM NOT RELIABLE
Why is RELIABILITY important?
- If there is unreliability in classification system- could result in unreliable diagnosis
- Severe consequences- could affect selection of treatment and also communication with patient
E.g; could be given treatment for no reason...or not given treatment when need it