A Study on Agreement Rate Between Psychiatric Residents in Diagnosing Axis IV. In DSM-IV Classficatic System

Abstract

Diagnosis of environmental and psychosocial problems in psychiatric patients is essential because of their significant role in causing or exacerbating psychiatric disorders. This study was carried out to assess the consensus rate in diagnosing axis IV (environmental and psychosocial problems) in DSM-IV system of classification among psychiatric residents. In this study one hundred and seventeen psychiatric patients were examined in daily morning in Razi Mental Hospital in Tabriz. The patients were evaluated individually by residents in regard to mental status and axis IV problems. The obtained datas were analysed by descriptive and inferential statistical methods. Results of the study revealed that consensus rate among residents in assessment of environmental and psychosocial problem(s) was low (ICC : 0.22). Demographic characteristics of the patients did not explain difference between residents. Sex and familiarity of residents with Azari Language were significantly important regarding diagnostic difference, so that consensus rate in female residents was more than male ones and in Azari speaking residents was more than non-Azari speaking ones. No part of mental status examination was remarkable in explaining diagnostic differences. Diagnoses in axis I and III were recognized as important elements in explaining the differences. Based on result of this study diagnosis of environmental and psychosocial problems in psychiatric patients by residents generally is not reliable and the issue warrant further attention.

Keywords

• environmental problems
• psychiatry
• psychosocial problems
• students