PMID- 32414335 OWN - NLM STAT- MEDLINE DCOM- 20201026 LR - 20201026 IS - 1471-244X (Electronic) IS - 1471-244X (Linking) VI - 20 IP - 1 DP - 2020 May 15 TI - Validity and reliability of social anxiety disorder diagnoses in the Swedish National Patient Register. PG - 242 LID - 10.1186/s12888-020-02644-7 [doi] LID - 242 AB - BACKGROUND: Population-based administrative registers are often used for research purposes. However, their potential usefulness depends on the validity of the registered information. This study assessed the validity of the recorded codes for social anxiety disorder (SAD), also known as social phobia, in the Swedish National Patient Register (NPR). METHODS: The personal identification numbers of 300 randomly selected individuals with a diagnosis of SAD recorded in the NPR were obtained from the Swedish National Board of Health and Welfare. The medical files of these individuals were then requested from clinics nationally. A total of 117 files were received and two independent raters reviewed each file to assess the presence or absence of SAD, according to the definition of the International Classification of Diseases, Tenth Edition (ICD-10) and the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). When disagreements between the two raters were found, a third rater reviewed the file to establish a best estimate diagnosis. Positive predictive values (PPV) and agreement between the two initial raters (using Cohen's kappa) were calculated. Additionally, raters completed the Clinical Global Impression - Severity (CGI-S) and the Global Assessment of Functioning (GAF) rating scales for each file. Inter-rater agreement for the CGI-S and the GAF was assessed using intraclass correlation coefficients (ICC). RESULTS: After exclusion of files not containing sufficient information, 95 files were included in the analyses. Of these, 77 files (81.05%) were considered to be 'true positive' cases (PPV = 0.81, 95% confidence interval = 0.72-0.88). Inter-rater agreement regarding the presence or absence of SAD was substantial (kappa = 0.72). CGI-S and GAF scores indicated that patients were in the moderate range of severity and functional impairment. Inter-rater agreement for the CGI-S and the GAF was moderate to good (ICC = 0.72 and ICC = 0.82, respectively). CONCLUSIONS: The ICD-10 codes for SAD in the Swedish NPR are generally valid and reliable, but we recommend sensitivity analyses in future register-based studies to minimise the impact of potential diagnostic misclassification. Most patients were moderately severe and impaired, suggesting that results from register-based studies of SAD may be generalizable. FAU - Vilaplana-Perez, Alba AU - Vilaplana-Perez A AUID- ORCID: 0000-0002-9501-8160 AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. alba.vilaplana@ki.se. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. alba.vilaplana@ki.se. AD - Departament de Personalitat, Avaluacio i Tractaments Psicologics, Universitat de Valencia, Valencia, Spain. alba.vilaplana@ki.se. FAU - Isung, Josef AU - Isung J AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Krig, Sonja AU - Krig S AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Vigerland, Sarah AU - Vigerland S AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Jolstedt, Maral AU - Jolstedt M AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Bjureberg, Johan AU - Bjureberg J AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Hogstrom, Jens AU - Hogstrom J AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Isomura, Kayoko AU - Isomura K AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Rautio, Daniel AU - Rautio D AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Serlachius, Eva AU - Serlachius E AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Ruck, Christian AU - Ruck C AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Mataix-Cols, David AU - Mataix-Cols D AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. FAU - Fernandez de la Cruz, Lorena AU - Fernandez de la Cruz L AD - Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Gavlegatan 22 (Entre B), floor 8, SE-11330, Stockholm, Sweden. AD - Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. LA - eng GR - 20180078/Stockholms Lans Landsting/International PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200515 PL - England TA - BMC Psychiatry JT - BMC psychiatry JID - 100968559 SB - IM MH - Diagnostic and Statistical Manual of Mental Disorders MH - Humans MH - International Classification of Diseases MH - Phobia, Social/*diagnosis MH - *Registries/standards MH - Reproducibility of Results MH - Sensitivity and Specificity MH - Sweden PMC - PMC7227192 OTO - NOTNLM OT - Epidemiology OT - Reliability OT - Social anxiety disorder OT - Social phobia OT - Validity COIS- JB receives book royalties from Natur & Kultur. DMC receives royalties for contributing articles to UpToDate, Wolters Kluwer Health and Elsevier. LFC receives royalties for contributing articles to UpToDate, Wolters Kluwer Health. The rest of authors declare that they have no competing interests to declare. EDAT- 2020/05/18 06:00 MHDA- 2020/10/27 06:00 PMCR- 2020/05/15 CRDT- 2020/05/17 06:00 PHST- 2019/10/03 00:00 [received] PHST- 2020/04/30 00:00 [accepted] PHST- 2020/05/17 06:00 [entrez] PHST- 2020/05/18 06:00 [pubmed] PHST- 2020/10/27 06:00 [medline] PHST- 2020/05/15 00:00 [pmc-release] AID - 10.1186/s12888-020-02644-7 [pii] AID - 2644 [pii] AID - 10.1186/s12888-020-02644-7 [doi] PST - epublish SO - BMC Psychiatry. 2020 May 15;20(1):242. doi: 10.1186/s12888-020-02644-7.