Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia
Abstract Background There are limited studies on the prevalence of misdiagnosis as well as detection rates of severe psychiatric disorders in specialized and non-specialized healthcare settings. To the best of our knowledge, this is the first study to determine the prevalence of misdiagnosis and det...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2021-02-01
|
Series: | Annals of General Psychiatry |
Subjects: | |
Online Access: | https://doi.org/10.1186/s12991-021-00333-7 |
id |
doaj-26be51149c2d4136ad4eadf91cca2b87 |
---|---|
record_format |
Article |
spelling |
doaj-26be51149c2d4136ad4eadf91cca2b872021-02-07T12:19:44ZengBMCAnnals of General Psychiatry1744-859X2021-02-0120111010.1186/s12991-021-00333-7Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in EthiopiaGetinet Ayano0Sileshi Demelash1Zegeye yohannes2Kibrom Haile3Mikiyas Tulu4Dawit Assefa5Abel Tesfaye6Kelemua Haile7Melat Solomon8Asrat Chaka9Light Tsegay10Research and Training Department, Amanuel Mental Specialized HospitalEthiopian Public Health InstituteResearch and Training Department, Amanuel Mental Specialized HospitalResearch and Training Department, Amanuel Mental Specialized HospitalResearch and Training Department, Amanuel Mental Specialized HospitalResearch and Training Department, Amanuel Mental Specialized HospitalResearch and Training Department, Amanuel Mental Specialized HospitalResearch and Training Department, Amanuel Mental Specialized HospitalResearch and Training Department, Amanuel Mental Specialized HospitalResearch and Training Department, Amanuel Mental Specialized HospitalDepartment of Psychiatry, Axum UniversityAbstract Background There are limited studies on the prevalence of misdiagnosis as well as detection rates of severe psychiatric disorders in specialized and non-specialized healthcare settings. To the best of our knowledge, this is the first study to determine the prevalence of misdiagnosis and detection rates of severe psychiatric disorders including schizophrenia, schizoaffective, bipolar, and depressive disorders in a specialized psychiatric setting. Method In this cross-sectional study, a random sample of 309 patients with severe psychiatric disorders was selected by systematic sampling technique. Severe psychiatric disorders were assessed using the Structured Clinical Interview for DSM-IV (SCID). The potential determinates of misdiagnosis were explored using univariable and multivariable logistic regression models, adjusting for the potential confounding factors. Result This study revealed that more than a third of patients with severe psychiatric disorders were misdiagnosed (39.16%). The commonly misdiagnosed disorder was found to be a schizoaffective disorder (75%) followed by major depressive disorder (54.72%), schizophrenia (23.71%), and bipolar disorder (17.78%). Among the patients detected with the interview by SCID criteria, the highest level of the correct diagnosis was recorded in the medical record for schizophrenia (76.29%) followed by bipolar (72.22%), depressive (42.40%), and schizoaffective (25%) disorders with detection rate (sensitivity) of 0.76 (95% CI 0.69–0.84), 0.42 (95% CI 0.32–0.53), 0.72 (95% CI 0.60–0.84), and 0.25 (95% CI 0.09–0.41), respectively for schizophrenia, depressive, bipolar, and schizoaffective disorders. Patients with bipolar disorder were more likely to be misdiagnosed as having schizophrenia (60%), whereas schizophrenic patients were more likely to be misdiagnosed as having bipolar disorder (56.25%) and patients with depressive disorders were more likely to be misdiagnosed as having schizophrenia (54.72%). Having a diagnosis of schizoaffective and depressive disorders, as well as suicidal ideation, was found to be significant predictors of misdiagnosis. Conclusion This study showed that roughly four out of ten patients with severe psychiatric disorders had been misdiagnosed in a specialized psychiatric setting in Ethiopia. The highest rate of misdiagnosis was observed for schizoaffective disorder (3 out of 4), followed by major depressive disorder (1 out of 2), schizophrenia (1 out of 4), and bipolar disorders (1 in 5). The detection rates were highest for schizophrenia, followed by bipolar, depressive, and schizoaffective disorders. Having a diagnosis of schizoaffective and depressive disorders as well as suicidal ideation was found to be significant predictors of misdiagnosis.https://doi.org/10.1186/s12991-021-00333-7Severe psychiatric disorderMisdiagnosisSchizoaffective disorderBipolar disorderDepressive disorderSchizophrenia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Getinet Ayano Sileshi Demelash Zegeye yohannes Kibrom Haile Mikiyas Tulu Dawit Assefa Abel Tesfaye Kelemua Haile Melat Solomon Asrat Chaka Light Tsegay |
spellingShingle |
Getinet Ayano Sileshi Demelash Zegeye yohannes Kibrom Haile Mikiyas Tulu Dawit Assefa Abel Tesfaye Kelemua Haile Melat Solomon Asrat Chaka Light Tsegay Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia Annals of General Psychiatry Severe psychiatric disorder Misdiagnosis Schizoaffective disorder Bipolar disorder Depressive disorder Schizophrenia |
author_facet |
Getinet Ayano Sileshi Demelash Zegeye yohannes Kibrom Haile Mikiyas Tulu Dawit Assefa Abel Tesfaye Kelemua Haile Melat Solomon Asrat Chaka Light Tsegay |
author_sort |
Getinet Ayano |
title |
Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_short |
Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_full |
Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_fullStr |
Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_full_unstemmed |
Misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in Ethiopia |
title_sort |
misdiagnosis, detection rate, and associated factors of severe psychiatric disorders in specialized psychiatry centers in ethiopia |
publisher |
BMC |
series |
Annals of General Psychiatry |
issn |
1744-859X |
publishDate |
2021-02-01 |
description |
Abstract Background There are limited studies on the prevalence of misdiagnosis as well as detection rates of severe psychiatric disorders in specialized and non-specialized healthcare settings. To the best of our knowledge, this is the first study to determine the prevalence of misdiagnosis and detection rates of severe psychiatric disorders including schizophrenia, schizoaffective, bipolar, and depressive disorders in a specialized psychiatric setting. Method In this cross-sectional study, a random sample of 309 patients with severe psychiatric disorders was selected by systematic sampling technique. Severe psychiatric disorders were assessed using the Structured Clinical Interview for DSM-IV (SCID). The potential determinates of misdiagnosis were explored using univariable and multivariable logistic regression models, adjusting for the potential confounding factors. Result This study revealed that more than a third of patients with severe psychiatric disorders were misdiagnosed (39.16%). The commonly misdiagnosed disorder was found to be a schizoaffective disorder (75%) followed by major depressive disorder (54.72%), schizophrenia (23.71%), and bipolar disorder (17.78%). Among the patients detected with the interview by SCID criteria, the highest level of the correct diagnosis was recorded in the medical record for schizophrenia (76.29%) followed by bipolar (72.22%), depressive (42.40%), and schizoaffective (25%) disorders with detection rate (sensitivity) of 0.76 (95% CI 0.69–0.84), 0.42 (95% CI 0.32–0.53), 0.72 (95% CI 0.60–0.84), and 0.25 (95% CI 0.09–0.41), respectively for schizophrenia, depressive, bipolar, and schizoaffective disorders. Patients with bipolar disorder were more likely to be misdiagnosed as having schizophrenia (60%), whereas schizophrenic patients were more likely to be misdiagnosed as having bipolar disorder (56.25%) and patients with depressive disorders were more likely to be misdiagnosed as having schizophrenia (54.72%). Having a diagnosis of schizoaffective and depressive disorders, as well as suicidal ideation, was found to be significant predictors of misdiagnosis. Conclusion This study showed that roughly four out of ten patients with severe psychiatric disorders had been misdiagnosed in a specialized psychiatric setting in Ethiopia. The highest rate of misdiagnosis was observed for schizoaffective disorder (3 out of 4), followed by major depressive disorder (1 out of 2), schizophrenia (1 out of 4), and bipolar disorders (1 in 5). The detection rates were highest for schizophrenia, followed by bipolar, depressive, and schizoaffective disorders. Having a diagnosis of schizoaffective and depressive disorders as well as suicidal ideation was found to be significant predictors of misdiagnosis. |
topic |
Severe psychiatric disorder Misdiagnosis Schizoaffective disorder Bipolar disorder Depressive disorder Schizophrenia |
url |
https://doi.org/10.1186/s12991-021-00333-7 |
work_keys_str_mv |
AT getinetayano misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT sileshidemelash misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT zegeyeyohannes misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT kibromhaile misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT mikiyastulu misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT dawitassefa misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT abeltesfaye misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT kelemuahaile misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT melatsolomon misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT asratchaka misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia AT lighttsegay misdiagnosisdetectionrateandassociatedfactorsofseverepsychiatricdisordersinspecializedpsychiatrycentersinethiopia |
_version_ |
1724281310473617408 |