RELIABILITY OF DIAGNOSES MADE BY PSYCHIATRIC-RESIDENTS IN A GENERAL EMERGENCY DEPARTMENT

The reliability of psychiatric diagnoses made by psychiatric residents in the general emergency department of a university hospital was asse ssed by comparing those diagnoses with the inpatient discharge diagnos es of patients referred to the hospital's inpatient service from the e mergency department. In both settings diagnoses were based on DSM-III- R criteria, but structured diagnostic instruments were not used. Retro spective review of the records of 190 inpatients over a six-month Peri od showed excellent to moderate concordance between principal axis I d iagnoses in four categories-major depression, schizophrenic disorders, bipolar disorder, and substance abuse and dependence disorders. Kappa values ranged from .64 for major depression to .87 for substance abus e and dependence disorders.