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Diagnostic consultation to a state hospital
1Dammash State Hospital, Wilsonville, Oregon 97070.
Hospital & Community Psychiatry
|December 1, 1989
Summary
Psychiatric consultations for 101 chronically ill patients revealed diagnostic shifts. Fewer schizophrenia diagnoses were made, with more patients diagnosed with organic mental disorders or affective syndromes, highlighting the need for reassessment.
Area of Science:
- Psychiatry
- Mental Health Services
- Diagnostic Assessment
Background:
- State hospitals face closure, necessitating patient needs assessment.
- Chronically ill patients require ongoing diagnostic evaluation.
- Previous diagnoses may not accurately reflect current patient conditions.
Purpose of the Study:
- To assess the diagnostic needs of chronically ill patients in a closing state hospital.
- To compare consultant diagnoses with prior hospital diagnoses.
- To identify potential misdiagnoses and recommend further evaluation.
Main Methods:
- Psychiatric consultation provided for 101 chronically ill patients.
- Principal diagnosis formulated using Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) criteria.
- Comparison of consultant diagnoses with historical hospital diagnoses.
Main Results:
- Fewer patients diagnosed with schizophrenia compared to previous hospital diagnoses.
- Increased diagnoses of organic mental disorders, affective syndromes, and pervasive developmental disorders.
- Many patients no longer diagnosed with schizophrenia received diagnoses of psychosis not otherwise specified or organic mental disorder, warranting further assessment.
Conclusions:
- Psychiatric consultation programs facilitate a re-evaluation of long-term state hospital patients.
- Diagnostic reassessment can lead to more accurate patient classifications.
- Such consultations offer valuable training experiences for psychiatric residents.