Change in diagnosis at termination of psychiatric consultation

Changes in 358 initial diagnoses made by psychiatric consultants in a medical inpatient setting were examined. Initial diagnoses from five groups--major depression, adjustment disorder with depressed mood, dementia, delirium, and the somatoform disorders--were compared with diagnoses made at termination of consultation. Differences in stability of diagnosis between the groups failed to reach significance (pz = .078). However, a trend was found for diagnoses of major depression to be the least stable; 21.7 percent of initial diagnoses were changed by termination. The results emphasize the provisional nature of initial psychiatric diagnoses in the medical setting and suggest the need for repeated assessment of the patient before beginning potentially hazardous treatment, especially for major depression.