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Do we agree about when patients are psychotic?
Author(s) -
Nielsen J.,
Mogensen B.,
Martiny K.,
Stage K. B.,
Larsen J. K.,
Lindhardt A.,
Bertelsen A.
Publication year - 2008
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.2008.01254.x
Subject(s) - psychiatry , medicine , clinical psychology , psychology , nursing staff , nursing
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.

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