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Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia
BACKGROUND: There are limited studies on the prevalence of misdiagnosis as well as detection rates of severe psychiatric disorders in specialized and non-specialized healthcare settings. To the best of our knowledge, this is the first study to determine the prevalence of misdiagnosis and detection r...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856725/ https://www.ncbi.nlm.nih.gov/pubmed/33531016 http://dx.doi.org/10.1186/s12991-021-00333-7 |
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author | Ayano, Getinet Demelash, Sileshi yohannes, Zegeye Haile, Kibrom Tulu, Mikiyas Assefa, Dawit Tesfaye, Abel Haile, Kelemua Solomon, Melat Chaka, Asrat Tsegay, Light |
author_facet | Ayano, Getinet Demelash, Sileshi yohannes, Zegeye Haile, Kibrom Tulu, Mikiyas Assefa, Dawit Tesfaye, Abel Haile, Kelemua Solomon, Melat Chaka, Asrat Tsegay, Light |
author_sort | Ayano, Getinet |
collection | PubMed |
description | BACKGROUND: There are limited studies on the prevalence of misdiagnosis as well as detection rates of severe psychiatric disorders in specialized and non-specialized healthcare settings. To the best of our knowledge, this is the first study to determine the prevalence of misdiagnosis and detection rates of severe psychiatric disorders including schizophrenia, schizoaffective, bipolar, and depressive disorders in a specialized psychiatric setting. METHOD: In this cross-sectional study, a random sample of 309 patients with severe psychiatric disorders was selected by systematic sampling technique. Severe psychiatric disorders were assessed using the Structured Clinical Interview for DSM-IV (SCID). The potential determinates of misdiagnosis were explored using univariable and multivariable logistic regression models, adjusting for the potential confounding factors. RESULT: This study revealed that more than a third of patients with severe psychiatric disorders were misdiagnosed (39.16%). The commonly misdiagnosed disorder was found to be a schizoaffective disorder (75%) followed by major depressive disorder (54.72%), schizophrenia (23.71%), and bipolar disorder (17.78%). Among the patients detected with the interview by SCID criteria, the highest level of the correct diagnosis was recorded in the medical record for schizophrenia (76.29%) followed by bipolar (72.22%), depressive (42.40%), and schizoaffective (25%) disorders with detection rate (sensitivity) of 0.76 (95% CI 0.69–0.84), 0.42 (95% CI 0.32–0.53), 0.72 (95% CI 0.60–0.84), and 0.25 (95% CI 0.09–0.41), respectively for schizophrenia, depressive, bipolar, and schizoaffective disorders. Patients with bipolar disorder were more likely to be misdiagnosed as having schizophrenia (60%), whereas schizophrenic patients were more likely to be misdiagnosed as having bipolar disorder (56.25%) and patients with depressive disorders were more likely to be misdiagnosed as having schizophrenia (54.72%). Having a diagnosis of schizoaffective and depressive disorders, as well as suicidal ideation, was found to be significant predictors of misdiagnosis. CONCLUSION: This study showed that roughly four out of ten patients with severe psychiatric disorders had been misdiagnosed in a specialized psychiatric setting in Ethiopia. The highest rate of misdiagnosis was observed for schizoaffective disorder (3 out of 4), followed by major depressive disorder (1 out of 2), schizophrenia (1 out of 4), and bipolar disorders (1 in 5). The detection rates were highest for schizophrenia, followed by bipolar, depressive, and schizoaffective disorders. Having a diagnosis of schizoaffective and depressive disorders as well as suicidal ideation was found to be significant predictors of misdiagnosis. |
format | Online Article Text |
id | pubmed-7856725 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-78567252021-02-04 Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia Ayano, Getinet Demelash, Sileshi yohannes, Zegeye Haile, Kibrom Tulu, Mikiyas Assefa, Dawit Tesfaye, Abel Haile, Kelemua Solomon, Melat Chaka, Asrat Tsegay, Light Ann Gen Psychiatry Primary Research BACKGROUND: There are limited studies on the prevalence of misdiagnosis as well as detection rates of severe psychiatric disorders in specialized and non-specialized healthcare settings. To the best of our knowledge, this is the first study to determine the prevalence of misdiagnosis and detection rates of severe psychiatric disorders including schizophrenia, schizoaffective, bipolar, and depressive disorders in a specialized psychiatric setting. METHOD: In this cross-sectional study, a random sample of 309 patients with severe psychiatric disorders was selected by systematic sampling technique. Severe psychiatric disorders were assessed using the Structured Clinical Interview for DSM-IV (SCID). The potential determinates of misdiagnosis were explored using univariable and multivariable logistic regression models, adjusting for the potential confounding factors. RESULT: This study revealed that more than a third of patients with severe psychiatric disorders were misdiagnosed (39.16%). The commonly misdiagnosed disorder was found to be a schizoaffective disorder (75%) followed by major depressive disorder (54.72%), schizophrenia (23.71%), and bipolar disorder (17.78%). Among the patients detected with the interview by SCID criteria, the highest level of the correct diagnosis was recorded in the medical record for schizophrenia (76.29%) followed by bipolar (72.22%), depressive (42.40%), and schizoaffective (25%) disorders with detection rate (sensitivity) of 0.76 (95% CI 0.69–0.84), 0.42 (95% CI 0.32–0.53), 0.72 (95% CI 0.60–0.84), and 0.25 (95% CI 0.09–0.41), respectively for schizophrenia, depressive, bipolar, and schizoaffective disorders. Patients with bipolar disorder were more likely to be misdiagnosed as having schizophrenia (60%), whereas schizophrenic patients were more likely to be misdiagnosed as having bipolar disorder (56.25%) and patients with depressive disorders were more likely to be misdiagnosed as having schizophrenia (54.72%). Having a diagnosis of schizoaffective and depressive disorders, as well as suicidal ideation, was found to be significant predictors of misdiagnosis. CONCLUSION: This study showed that roughly four out of ten patients with severe psychiatric disorders had been misdiagnosed in a specialized psychiatric setting in Ethiopia. The highest rate of misdiagnosis was observed for schizoaffective disorder (3 out of 4), followed by major depressive disorder (1 out of 2), schizophrenia (1 out of 4), and bipolar disorders (1 in 5). The detection rates were highest for schizophrenia, followed by bipolar, depressive, and schizoaffective disorders. Having a diagnosis of schizoaffective and depressive disorders as well as suicidal ideation was found to be significant predictors of misdiagnosis. BioMed Central 2021-02-02 /pmc/articles/PMC7856725/ /pubmed/33531016 http://dx.doi.org/10.1186/s12991-021-00333-7 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Primary Research Ayano, Getinet Demelash, Sileshi yohannes, Zegeye Haile, Kibrom Tulu, Mikiyas Assefa, Dawit Tesfaye, Abel Haile, Kelemua Solomon, Melat Chaka, Asrat Tsegay, Light Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title | Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_full | Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_fullStr | Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_full_unstemmed | Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_short | Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_sort | misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in ethiopia |
topic | Primary Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856725/ https://www.ncbi.nlm.nih.gov/pubmed/33531016 http://dx.doi.org/10.1186/s12991-021-00333-7 |
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