Use of the Brief Psychiatric Rating Scale to Facilitate Differential Diagnosis at Acute Inpatient Admission
J Clin Psychiatry 2001;62(4):304-312
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Background: The advent of managed care has
necessitated strategies for quickly and accurately diagnosing
psychiatric disorders. The aim of the present study was to
ascertain whether the Brief Psychiatric Rating Scale-Anchored
(BPRS-A) would be a useful adjunct to more traditional diagnostic
strategies at acute inpatient admission.
Method: Using a sample of 207 inpatients
admitted during an 8-month index period, we examined the utility
of the BPRS-A in predicting whether patients were more likely to
be diagnosed with schizophrenia, bipolar disorder, or major
Results: Discriminant function analyses were
used to correctly predict 68%, 60%, and 74% of patients diagnosed
with schizophrenia, bipolar disorder, and major depression,
respectively. The main predictors of diagnostic category, in
descending order, were BPRS-A depressed mood item, BPRS-A
positive symptoms scale, BPRS-A excitement item, BPRS-A guilt
feelings item, BPRS-A mannerisms and posturing item, and number
of previous episodes.
Conclusion: As efforts are directed toward
continuous quality improvement within mental health settings, an
emphasis must be placed on improving the efficiency and accuracy
of diagnostic procedures. The BPRS-A shows promise as a
time-efficient assessment instrument that may be useful in
facilitating differential diagnosis at inpatient admission and
may increase the likelihood that efficacious prerelease
interventions and appropriate aftercare services are implemented.