COMPARISON BETWEEN REGISTER AND STRUCTURED INTERVIEW DIAGNOSES OF SCHIZOPHRENIA - A CASE FOR LONGITUDINAL DIAGNOSTIC PROFILES

Objective: Mental health registers contain diagnoses from serial conta cts with mental health facilities over many years. This study examines the relationship between longitudinal diagnostic profiles and structu red interview diagnoses. The aim is to improve the definition of diagn oses drawn from clinical case registers. Method: The Tasmanian Mental Health Case Register includes 1922 individuals, each with at least one diagnosis of schizophrenia between 1965 and 1990. A representative su bsample of 29 individuals were assessed by the structured diagnostic i nterview for DSM-III-R (SCID). Diagnostic agreement between Register a nd SCID diagnoses was compared. Results: Twenty-four subjects (82.8%) received a lifetime diagnosis of schizophrenia on the SCID. For each s ubject, 'schizophrenia diagnostic dominance', the percentage of regist er entries with schizophrenia diagnoses over total entries, was calcul ated. Agreement between register and SCID correlated positively with s chizophrenia diagnostic dominance and negatively with register mood di agnoses. Conclusions: Longitudinal diagnostic profiles on databases ma y be superior to cross-sectional clinical diagnoses in predicting stru ctured interview diagnoses, and may be useful in defining caseness in epidemiological studies using register diagnoses.