Diagnóstico del trastorno límite de la personalidad: concordancia entre el juicio clínico y la entrevista semiestructurada / Borderline personality disorder diagnosis: concordance between clinical and semiestructured interview evaluation

Fundamento y objetivo. Ningún estudio en España ha analizado la diferencia en la frecuencia del diagnóstico realizada a partir del juicio clínico y del uso de la entrevista semiestructurada en el diagnóstico del trastorno límite de la personalidad (TLP). Los objetivos del presente trabajo son: estudiarla concordancia diagnóstica del TLP en pacientes previamente diagnosticados a partir del juicio clínico mediante el uso de la entrevista clínica semiestructurada para el eje II del DSM-IV (SCID-II) y analizar si existen diferencias en la distribución de frecuencias de los trastornos psiquiátricos en función de la observación o no de concordancia diagnóstica. Material y método. En el estudio participaron 146 pacientes derivados al Programa del Trastorno Límite de Personalidad del Servicio de Psiquiatría del Hospital Universitari Vall d’Hebron durante su primer año de funcionamiento. Se realizó un estudio descriptivo de la concordancia diagnóstica del trastorno mediante la utilización de la SCID-II por profesionales con experiencia en su uso en pacientes previamente diagnosticados a partir del juicio clínico. Resultados. No se observó concordancia diagnóstica en el 30% de los pacientes incluidos en el estudio. Los resultados muestran un elevado número de trastornos en todos los pacientes en el momento del diagnóstico. Se observa un mayor número de diagnósticos de trastornos de personalidad (Z= 3,36; p=0,01) y de trastornos de ansiedad (Z=3,04; p=0,002) en el grupo de concordancia diagnóstica que en el grupo de no concordancia diagnóstica. Conclusiones. Mediante el uso de entrevistas semiestructuradas se observa un 30% menos de diagnósticos de TLP que mediante el juicio clínico (AU)

Background and objective. No study in Spain has analyzed the difference in frequencies of the diagnoses made based on clinical evaluation and semistructured interview in borderline personality disorder diagnosis (BPD). This present study aims to analyze diagnostic concordance in BPD patients previous diagnosed based on clinical evaluations using clinical semistructured interviews for DSM-IV axis II (SCID-II), and to analyze if there are differences in the distribution of frequencies of the psychiatry disorders in the diagnostic concordance group and the non-diagnostic concordance one. Material and method. The study was carried out with 146 patients referred to the Borderline Personality Disorder Program of the Psychiatric Department at the Hospital Universitari Vall d’Hebron during its first year of service. A descriptive study was designed to analyze diagnostic concordance between previous BPD clinical evaluation and semistructured interview SCID-II administered by clinical experienced interviewers. Results. Diagnostic concordance was not observed in30% of the final study patients. The results indicated that all the study patients presented a great number of psychiatry disorders. There were significant differences between the diagnostic concordance group and the non-diagnostic concordance one. A higher number of personality disorder (Z=3.36; p=0.01) and anxiety disorder (Z=3.04; p=0.002) was observed in the diagnostic concordance group. Conclusions. BPD was diagnosed 30% less when using semistructured interviews than with clinical evaluations (AU)

[Borderline personality disorder diagnosis: concordance between clinical and semiestructured interview evaluation]. / Diagnóstico del trastorno límite de la personalidad: concordancia entre el juicio clínico y la entrevista semiestructurada.

BACKGROUND AND OBJECTIVE: No study in Spain has analyzed the difference in frequencies of the diagnoses made based on clinical evaluation and semistructured interview in borderline personality disorder diagnosis (BPD). This present study aims to analyze diagnostic concordance in BPD patients previous diagnosed based on clinical evaluations using clinical semistructured interviews for DSM-IV axis II (SCID-II), and to analyze if there are differences in the distribution of frequencies of the psychiatry disorders in the diagnostic concordance group and the non-diagnostic concordance one. MATERIAL AND METHOD: The study was carried out with 146 patients referred to the Borderline Personality Disorder Program of the Psychiatric Department at the Hospital Universitari Vall d'Hebron during its first year of service. A descriptive study was designed to analyze diagnostic concordance between previous BPD clinical evaluation and semistructured interview SCID-II administered by clinical experienced interviewers. RESULTS: Diagnostic concordance was not observed in 30% of the final study patients. The results indicated that all the study patients presented a great number of psychiatry disorders. There were significant differences between the diagnostic concordance group and the non-diagnostic concordance one. A higher number of personality disorder (Z=3.36; p=0.01) and anxiety disorder (Z=3.04; p=0.002) was observed in the diagnostic concordance group. CONCLUSIONS: BPD was diagnosed 30% less when using semistructured interviews than with clinical evaluations.