Consistency in the diagnosis of the functional psychoses

A review of the case books of 868 patients who had been admitted into a psychiatric hospital from January 1, 1970, to December 31, 1973, was carried out for consistency in the pattern of diagnosis by the same or different psychiatrists. Of these, 16.5% had a revision in diagnosis. The pertinent literature was reviewed. The possible factors that contribute to the observed inconsistency in diagnosis in this and other investigations are discussed. It is concluded that the problems as reflected in the significant change in diagnosis in this study are multifactorial. It is suggested that these problems may be related to the unknown etiology of the functional psychoses and the absence of identifiable specific lesions.