Do we agree about when patients are psychotic?

Objective:  To investigate into the use of the term ‘psychotic’ as defined by ICD‐10 or by the concept of impaired reality testing, among psychiatric staff members. Method:  Questionnaire investigation using 11 short case vignettes. Results:  Responses were received from 266 psychiatric staff member...

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Bibliographic Details
Published in:Acta Psychiatrica Scandinavica 2008-10, Vol.118 (4), p.330-333
Main Authors: Nielsen, J., Mogensen, B., Martiny, K., Stage, K. B., Larsen, J. K., Lindhardt, A., Bertelsen, A.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Denmark
Female
Health staff related problems. Vocational training
Humans
impaired reality testing
insanity
Male
Medical diagnosis
Medical sciences
Mental disorders
Middle Aged
Psychiatric-mental health nursing
Psychiatrists
Psychologists
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
psychotic
Psychotic Disorders - classification
Psychotic Disorders - diagnosis
Psychotic Disorders - psychology
Questionnaires
Reality Testing
Sensitivity and Specificity
Social psychiatry. Ethnopsychiatry
Surveys and Questionnaires - standards
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Summary:Objective:  To investigate into the use of the term ‘psychotic’ as defined by ICD‐10 or by the concept of impaired reality testing, among psychiatric staff members. Method:  Questionnaire investigation using 11 short case vignettes. Results:  Responses were received from 266 psychiatric staff members: psychiatrists, nursing staff and psychologists. When using ICD‐10, patients were identified as psychotic with a sensitivity ranging from 90% to 55%. Specificity ranged from 60% to 75%. According to the concept of impaired reality testing, all three groups showed a sensitivity of about 60%, whereas specificity ranged from 65% to 50%. The combined use of the terms correlated significantly with responses regarding indication for legal detention for psychiatrists and nursing staff. Conclusion:  In identifying a patient as ‘psychotic’ a broad concept of impaired reality testing was widely used particularly in cases with legal issues. Psychotic symptoms, however, were identified with high sensitivity and specificity.
ISSN:0001-690X
1600-0447
0065-1591
DOI:10.1111/j.1600-0447.2008.01254.x