[Diagnostic careers]

Careers of diagnoses: The case history of 80 schizophrenics, 40 borderline personalities and 20 persons with bipolar disorders, who were treated in the Basle University Psychiatric Outpatient Department for at least 5 years, were examined concerning the first diagnosis and the change of the diagnostic evaluation. On one hand the aim was to evaluate on which factors the first diagnosis was based (heredity, anamnesis, previous hospitalizations, actual psychostatus), on the other hand, how these changes of diagnosis could happen (course, new evaluation of psychopathology). It appeared that 60% of the evaluated schizophrenics and 40% of the evaluated patients with bipolar disorders had the same diagnosis at their first consultation as 5 years afterwards, but the same applied only to 12.5% of the patients with borderline personalities. These differences are significant. The average period between first contact and today's definitive diagnosis was 2.2 years for schizophrenics, 7 years for patients with bipolar disorders and 8.8 years for patients with borderline personalities. Also these differences are significant. Furthermore the first diagnosis but also the change of diagnosis and today's diagnosis were evaluated. Thereby it was examined if the original diagnosis and the diagnosis 5 years later can be understood or if they cannot be understood at all or have been made incompletely. The therapy of that time as well as the one of today have been examined and evaluated.