TY - JOUR
T1 - Reliability of psychiatric diagnosis in postmortem research
AU - Deep-Soboslay, Amy
AU - Akil, Mayada
AU - Martin, Catherine E.
AU - Bigelow, Llewelyn B.
AU - Herman, Mary M.
AU - Hyde, Thomas M.
AU - Kleinman, Joel E.
N1 - Funding Information:
This research was supported by the Section on Neuropathology of the Clinical Brain Disorders Branch, in the Intramural Research Program at the National Institute of Mental Health (NIMH) in Bethesda, Maryland.
PY - 2005/1/1
Y1 - 2005/1/1
N2 - Postmortem human brain research is an important approach for identifying the cellular, molecular, and genetic pathways involved in the pathophysiology of psychiatric disorders. One critical component in postmortem research is the reliability of psychiatric diagnoses used to define study cohorts. Finding reliable methods for assessing lifetime psychiatric diagnoses in subjects after death is extremely challenging. Two commonly used approaches were compared: psychiatric record reviews and postmortem family interviews. We hypothesized that these two methods would lead to more diagnostic agreement for subjects with schizophrenia than those with mood disorders. For 37 cases, psychiatric records were reviewed retrospectively using the Diagnostic Evaluation After Death, and family members were interviewed using the Structured Clinical Interview for DSM-IV. Comparison of diagnoses derived from these two approaches generated an overall kappa coefficient of. 67. Kappa coefficients for the schizophrenia cohort were. 94,. 68 for the major depressive disorder cohort, and. 58 for the bipolar disorder cohort. Thus, although it may be sufficient to establish the postmortem diagnosis of schizophrenia using one of the two methods, the best method for reaching an accurate postmortem diagnosis for mood disorders is more difficult to determine and requires further study.
AB - Postmortem human brain research is an important approach for identifying the cellular, molecular, and genetic pathways involved in the pathophysiology of psychiatric disorders. One critical component in postmortem research is the reliability of psychiatric diagnoses used to define study cohorts. Finding reliable methods for assessing lifetime psychiatric diagnoses in subjects after death is extremely challenging. Two commonly used approaches were compared: psychiatric record reviews and postmortem family interviews. We hypothesized that these two methods would lead to more diagnostic agreement for subjects with schizophrenia than those with mood disorders. For 37 cases, psychiatric records were reviewed retrospectively using the Diagnostic Evaluation After Death, and family members were interviewed using the Structured Clinical Interview for DSM-IV. Comparison of diagnoses derived from these two approaches generated an overall kappa coefficient of. 67. Kappa coefficients for the schizophrenia cohort were. 94,. 68 for the major depressive disorder cohort, and. 58 for the bipolar disorder cohort. Thus, although it may be sufficient to establish the postmortem diagnosis of schizophrenia using one of the two methods, the best method for reaching an accurate postmortem diagnosis for mood disorders is more difficult to determine and requires further study.
KW - Mood disorders
KW - postmortem diagnosis
KW - psychological autopsy
KW - record review
KW - schizophrenia
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U2 - 10.1016/j.biopsych.2004.10.016
DO - 10.1016/j.biopsych.2004.10.016
M3 - Article
C2 - 15607306
AN - SCOPUS:10644258955
SN - 0006-3223
VL - 57
SP - 96
EP - 101
JO - Biological psychiatry
JF - Biological psychiatry
IS - 1
ER -