Validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the Swedish National Patient Register: a retrospective chart review
Objectives In the International Classification of Diseases, Tenth Edition (ICD-10), hypochondriasis (illness anxiety disorder) and dysmorphophobia (body dysmorphic disorder) share the same diagnostic code (F45.2). However, the Swedish ICD-10 allows for these disorders to be coded separately (F45.2 a...
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BMJ Publishing Group
2021-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/12/e051853.full |
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| author | David Mataix-Cols Oskar Flygare Volen Z Ivanov Christian Rück Lorena Fernández de la Cruz Kayoko Isomura Jens Högström Daniel Rautio Alba Vilaplana-Pérez Martina Gumpert Johanna Linde Susanna Österman Josef Isung Sonja Krig |
| author_facet | David Mataix-Cols Oskar Flygare Volen Z Ivanov Christian Rück Lorena Fernández de la Cruz Kayoko Isomura Jens Högström Daniel Rautio Alba Vilaplana-Pérez Martina Gumpert Johanna Linde Susanna Österman Josef Isung Sonja Krig |
| author_sort | David Mataix-Cols |
| collection | DOAJ |
| description | Objectives In the International Classification of Diseases, Tenth Edition (ICD-10), hypochondriasis (illness anxiety disorder) and dysmorphophobia (body dysmorphic disorder) share the same diagnostic code (F45.2). However, the Swedish ICD-10 allows for these disorders to be coded separately (F45.2 and F45.2A, respectively), potentially offering unique opportunities for register-based research on these conditions. We assessed the validity and reliability of their ICD-10 codes in the Swedish National Patient Register (NPR).Design Retrospective chart review.Methods Six hundred individuals with a diagnosis of hypochondriasis or dysmorphophobia (300 each) were randomly selected from the NPR. Their medical files were requested from the corresponding clinics, located anywhere in Sweden. Two independent raters assessed each file according to ICD-10 definitions and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and Fifth Edition criteria. Raters also completed the Clinical Global Impression–Severity (CGI-S) and the Global Assessment of Functioning (GAF).Primary outcome measure Per cent between-rater agreement and positive predictive value (PPV). Intraclass correlation coefficients for the CGI-S and the GAF.Results Eighty-four hypochondriasis and 122 dysmorphophobia files were received and analysed. The inter-rater agreement rate regarding the presence or absence of a diagnosis was 95.2% for hypochondriasis and 92.6% for dysmorphophobia. Sixty-seven hypochondriasis files (79.8%) and 111 dysmorphophobia files (91.0%) were considered ‘true positive’ cases (PPV=0.80 and PPV=0.91, respectively). CGI-S scores indicated that symptoms were moderately to markedly severe, while GAF scores suggested moderate impairment for hypochondriasis cases and moderate to serious impairment for dysmorphophobia cases. CGI-S and GAF inter-rater agreement were good for hypochondriasis and moderate for dysmorphophobia.Conclusions The Swedish ICD-10 codes for hypochondriasis and dysmorphophobia are sufficiently valid and reliable for register-based studies. The results of such studies should be interpreted in the context of a possible over-representation of severe and highly impaired cases in the register, particularly for dysmorphophobia. |
| format | Article |
| id | doaj-art-9a326e4798fb4ff790e9fa89151ab462 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-9a326e4798fb4ff790e9fa89151ab4622025-08-20T01:55:46ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-051853Validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the Swedish National Patient Register: a retrospective chart reviewDavid Mataix-Cols0Oskar Flygare1Volen Z Ivanov2Christian Rück3Lorena Fernández de la Cruz4Kayoko Isomura5Jens Högström6Daniel Rautio7Alba Vilaplana-Pérez8Martina Gumpert9Johanna Linde10Susanna Österman11Josef Isung12Sonja Krig13Department of Clinical Sciences, Lund University, Lund, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenStockholm Health Care Services, Region Stockholm, Stockholm, SwedenObjectives In the International Classification of Diseases, Tenth Edition (ICD-10), hypochondriasis (illness anxiety disorder) and dysmorphophobia (body dysmorphic disorder) share the same diagnostic code (F45.2). However, the Swedish ICD-10 allows for these disorders to be coded separately (F45.2 and F45.2A, respectively), potentially offering unique opportunities for register-based research on these conditions. We assessed the validity and reliability of their ICD-10 codes in the Swedish National Patient Register (NPR).Design Retrospective chart review.Methods Six hundred individuals with a diagnosis of hypochondriasis or dysmorphophobia (300 each) were randomly selected from the NPR. Their medical files were requested from the corresponding clinics, located anywhere in Sweden. Two independent raters assessed each file according to ICD-10 definitions and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and Fifth Edition criteria. Raters also completed the Clinical Global Impression–Severity (CGI-S) and the Global Assessment of Functioning (GAF).Primary outcome measure Per cent between-rater agreement and positive predictive value (PPV). Intraclass correlation coefficients for the CGI-S and the GAF.Results Eighty-four hypochondriasis and 122 dysmorphophobia files were received and analysed. The inter-rater agreement rate regarding the presence or absence of a diagnosis was 95.2% for hypochondriasis and 92.6% for dysmorphophobia. Sixty-seven hypochondriasis files (79.8%) and 111 dysmorphophobia files (91.0%) were considered ‘true positive’ cases (PPV=0.80 and PPV=0.91, respectively). CGI-S scores indicated that symptoms were moderately to markedly severe, while GAF scores suggested moderate impairment for hypochondriasis cases and moderate to serious impairment for dysmorphophobia cases. CGI-S and GAF inter-rater agreement were good for hypochondriasis and moderate for dysmorphophobia.Conclusions The Swedish ICD-10 codes for hypochondriasis and dysmorphophobia are sufficiently valid and reliable for register-based studies. The results of such studies should be interpreted in the context of a possible over-representation of severe and highly impaired cases in the register, particularly for dysmorphophobia.https://bmjopen.bmj.com/content/11/12/e051853.full |
| spellingShingle | David Mataix-Cols Oskar Flygare Volen Z Ivanov Christian Rück Lorena Fernández de la Cruz Kayoko Isomura Jens Högström Daniel Rautio Alba Vilaplana-Pérez Martina Gumpert Johanna Linde Susanna Österman Josef Isung Sonja Krig Validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the Swedish National Patient Register: a retrospective chart review BMJ Open |
| title | Validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the Swedish National Patient Register: a retrospective chart review |
| title_full | Validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the Swedish National Patient Register: a retrospective chart review |
| title_fullStr | Validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the Swedish National Patient Register: a retrospective chart review |
| title_full_unstemmed | Validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the Swedish National Patient Register: a retrospective chart review |
| title_short | Validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the Swedish National Patient Register: a retrospective chart review |
| title_sort | validity and reliability of the diagnostic codes for hypochondriasis and dysmorphophobia in the swedish national patient register a retrospective chart review |
| url | https://bmjopen.bmj.com/content/11/12/e051853.full |
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