Full Title: Psychiatric misdiagnoses in patients with chronic fatigue syndrome
Authors: Tara Lawn, Praveen Kumar, Bernice Knight, Michael Sharpe and Peter D White on behalf of the PACE trial management group
Publication: Journal of the Royal Society of Medicine
Publication Date: September 2010
Correspondence to: Peter D White. E-mail: p.d.white@qmul.ac.uk
Objectives
The aim of this study was to examine the accuracy of doctors at diagnosing co-morbid psychiatric disorders in patients with chronic fatigue syndrome (CFS).
Design
Case series comparing clinical diagnoses with a standardized structured psychiatric interview.
Setting
Secondary care specialist chronic fatigue syndrome clinic.
Participants
One hundred and thirty-five participants of a randomized controlled trial of non-pharmacological treatments at one centre in the PACE trial.
Main outcome measures
Current psychiatric diagnoses made by CFS specialist doctors, compared with current psychiatric diagnoses made independently using a structured psychiatric interview.
Results
Clinicians identified 59 (44%, 95% CI 39–56%) of patients as suffering from a co-morbid psychiatric disorder compared to 76 (56%, CI 53–69%) by structured interview. Depressive and anxiety disorders were most common. Clinicians were twice as likely to miss diagnoses (30 patients, 22%) than misdiagnose them (13, 10%). Psychiatrists were less likely to miss diagnoses than other clinicians, but were as likely to misdiagnose them.
Conclusions
Doctors assessing patients in a chronic fatigue syndrome clinic miss psychiatric diagnoses more often than misdiagnosing them. Missed diagnoses are common. CFS clinic doctors should be trained to diagnose psychiatric disorders.
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