Diagnostic Agreement in Schizophrenia Using OPCRIT 3.31 Checklist

Objectives: To determine the degree of agreement of the OPCRIT diagnostic systems in the diagnosis of Schizophrenia. Method: A total of 112 case notes (67.9% men and 32.1% women), of Bahraini Schizophrenic patients with ICD-10 classification formed the Schizophrenic population for this study. These 112 patients who were analyzed attended the out-patient department at the Psychiatric Hospital in Bahrain until the year 2008. The OPCRIT 3.31 checklist was applied as a diagnostic tool. The kappa coefficient and percentage of agreement were used to measure the concordance and absolute agreement of the OPCRIT diagnostic systems of Schizophrenia. Results: The diagnoses of Schizophrenia using ICD 10, DSMIII-R. Research Diagnostic Criteria (RDC) and Tsung and Winokur (TS and WI) all have strong and excellent agreement with each other. The strongest is between RDC and TS WI (Kappa 0.936). The diagnosis of Schneider (SCHN), French (FREN), CROW and Farmer (FARM) all have low kappa values of agreement (less than 0.4) with other diagnoses except FREN with DSMIII-R (0.451). The absolute percentages were high for all diagnostic systems except for the diagnosis of CROW. Conclusion: The diagnostic systems of ICD-10, DSMIII-R, RDC, and TS and W1 have strong diagnostic agreements (kappa 0.780). The strongest is between RDC and TS W1 (kappa 0.936), while Schneider French, Crow, and Farmer have low diagnostic agreements (Kappa 0.4) However, French and DSM/III-R maintained higher diagnostic agreement (Kappa 0.451). Results direct the need for a cautious level of confidence and validity of officially designated classification systems.