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April 1989

Psychiatric Diagnosis in an Outpatient Population: A Comparative Study of PSE-Catego and DSM-III

Author Affiliations

From the Department of Psychiatry, Rijksuniversiteit Groningen (the Netherlands) (Drs van den Brink, Ormel, Giel, and Slooff and Messrs Koeter and Dijkstra), and the Department of Social Psychiatry, Columbia University, New York (Ms Wohlfarth).

Arch Gen Psychiatry. 1989;46(4):369-372. doi:10.1001/archpsyc.1989.01810040075011

• Two diagnostic systems are compared in a psychiatric outpatient population of 175 patients. The Present State Examination (PSE)—Catego system identified 121 patients (69%) as "cases," whereas DSM-III identified 152 patients (87%) as cases. The two systems converged in 115 patients, yielding a K coefficient of only.32. Approximately one third of the DSM-III cases that were not detected by the PSE-Catego system was due to the restricted coverage of the latter system; the remaining two thirds could be attributed to differences in threshold and time framing. Compared with DSM-III, the PSE-Catego system showed a strong bias toward depression, and the system was extremely insensitive to the detection of social phobias and obsessive-compulsive disorders. Only 58% of cases of depression and 46% of cases of anxiety were diagnosed by both systems. The results are compared with other studies, and some consequences are discussed.

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