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Psychiatric disorders are among the top causes worldwide of disease
burden and disability. A major criterion for validating diagnoses is
stability over time.
To evaluate the long-term stability of the most prevalent psychiatric
diagnoses in a variety of clinical settings.
A total of 34 368 patients received psychiatric care in the catchment
area of one Spanish hospital (1992–2004). This study is based on 10 025
adult patients who were assessed on at least ten occasions (360 899
psychiatric consultations) in three settings: in-patient unit, 2000–2004
(n=546); psychiatric emergency room, 2000–2004
(n=1408); and out-patient psychiatric facilities,
1992–2004 (n=10 016). Prospective consistency,
retrospective consistency and the proportion of patients who received
each diagnosis in at least 75% of the evaluations were calculated for
each diagnosis in each setting and across settings.
The temporal consistency of mental disorders was poor, ranging from 29%
for specific personality disorders to 70% for schizophrenia, with
stability greatest for in-patient diagnoses and least for out-patient
The findings are an indictment of our current psychiatric diagnostic
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