Original articlesReliability of psychiatric diagnosis in postmortem research
Section snippets
Subjects
The majority of human brain specimens were obtained following autopsy through the Offices of the Chief Medical Examiner of the District of Columbia or Northern Virginia. Four cases were obtained from hospitals or funeral homes through direct donations by the next of kin. Cases were referred directly from the medical examiner by telephone communication, and initial telephone contact with families was made within 48 hours of death. Informed consent was obtained for all subjects by either a
Results
The kappa coefficient of diagnostic reliability for the overall group (N = 37) was .67 (p < .001; see Table 2). Agreement between the two diagnostic methods generated a kappa coefficient of .94 (p < .001) for the schizophrenia cohort, which was a collapsed group including all subtypes of schizophrenia and schizoaffective disorder. Disagreement for schizophrenia occurred in only one subject, who had a psychiatric record diagnosis of psychosis not otherwise specified (which for the purposes of
Discussion
While the rate of agreement between psychiatric diagnoses derived from record reviews and diagnoses derived from postmortem family interviews was relatively high for subjects with a diagnosis of schizophrenia, the rate of agreement for subjects with mood disorders was only moderate. This replicates the finding in a previous study by Kelly and Mann (1996) in which 100% agreement was achieved for nine subjects with schizophrenia. Because individuals with schizophrenia generally have more frequent
References (19)
- et al.
The psychological autopsyMethodological considerations for the study of adolescent suicide
J Am Acad Child Adolesc Psychiatry
(1988) Psychological autopsy studies—a review
Eur Psychiatry
(2001)- et al.
Reliability of post-mortem chart diagnoses of schizophrenia and dementia
Schizophr Res
(1995) The human brain revisitedOpportunities and challenges in postmortem studies of psychiatric disorders
Neuropsychopharmacology
(2002)- et al.
Inpatient diagnostic assessments: 1. Accuracy of structured vs. unstructured interviews.
Psychiatry Res
(2001) Diagnostic and Statistical Manual for Mental Disorders
(1994)- et al.
Prospective clinicopathologic studies of schizophreniaAccrual and assessment of patients
Am J Psychiatry
(1995) - et al.
The validity of diagnoses obtained through psychological autopsy procedure in adolescent suicide victimsUse of family history
Acta Psychiatr Scand
(1993) - et al.
Microarray technologyA review of new strategies to discover candidate vulnerability genes in psychiatric disorders
Am J Psychiatry
(2003)