[Consistency in the evaluation of mental status of patients with diagnosed delusional schizophrenia and depression]. / Zgodnosc ocen stanu psychicznego w Skali AMDP u chorych z rozpoznaniem schizofrenii urojeniowej oraz w depresjach.

ABSTRACT

The dispersion of the AMDP scores was compared. Each of 10 patients was evaluated by a group of 5-9 physicians. There were 20 physicians who took part in the study. The scale items evaluated in paranoid and depressive syndromes with very high and very low level of agreement were analyzed. The comparison of the ratings by different physicians indicates that a long professional training in psychiatry facilitates more precise diagnosis of formal thought disorders and increases tolerability towards schizophrenic emotional disturbances. During the consecutive evaluations the reliability was improving. The divergences concerned the scale items difficult to separate (severe hypochondriacal symptoms and hypochondriacal delusions) and the difficulties in rating of subjective symptoms. In depressive syndromes the rating discrepancies concerned an overestimation of the first rank symptoms and also an interchangeable coding of some symptoms as well as a difficulty to grade some symptoms. The comparison of the score dispersion width seems to be a good measure of reliability of psychopathological scales. Using the AMDP scale it is important to analyze presence and severity of individual symptoms, not a group of them.