Blind raters applied research criteria to the charts of patients whose
discharge diagnosis changed through several hospital admissions from
depression to schizophrenia and to the charts of matched control patients.
Fewer diagnostically unstable patients than control patients satisfied
research criteria for depression despite matching discharge diagnoses. The
use of operational criteria, then, can be expected to reduce diagnostic
instability in depression and thus improve prognostic accuracy. Some
patients satisfied the research criteria for depression when they were
initially admitted and for schizophrenia at their final admission. This
suggests that diagnostic error may not account for all cases of major
diagnostic instability.Abstract Teaser