Stability of Diagnoses in a Cohort of Long-Term Mentally Ill Patients in Sweden

The aim of this study was to investigate diagnostic stability in a cohort of patients in Sweden over a 15-year follow-up period and to study the associations between diagnostic mobility and the patients’ utilization of care, their age, duration of their illness and factors related to the reorganization of psychiatric care. Information about psychiatric diagnoses was collected from medical records in all care settings utilized by the patients. There was a high level of instability. Fifty-five percent of the patients had a change of diagnosis. Age and duration of illness were the most important factors related to diagnostic stability/instability. Since the diagnosis constitutes the basis of prediction of course and outcome of the disease as well of choice of treatment, these results indicate that the current diagnostic system may have considerable limitations with regard to the clinical need for a holistic approach.