Factors influencing the stability of psychiatric diagnoses in the emergency setting: review of 934 consecutively inpatient admissions.

Objective: This study aimed to examine the stability of psychiatric emergency diagnoses and factors influencing diagnostic concordance.

Methods: The concordance between psychiatric emergency and inpatient diagnoses was calculated using kappa coefficient. The groups with and without psychiatric diagnostic stability were compared to determine factors influencing diagnostic stability.

Results: Agreement between psychiatric emergency and inpatient diagnoses was fair (range of kappa=.48-.56) for bipolar, schizophrenia, schizoaffective and depressive disorders. Results indicated that patients with stable diagnoses between psychiatric emergency and inpatient settings are likely to arrive on legal holds and that patients without concurring diagnoses are likely to have a higher medical burden.

Conclusion: Further studies exploring ways to improve diagnostic stability in psychiatric emergency setting are warranted.