Explaining diagnostic complexity in an intake setting

Horacio Fabrega, Paul Pilkonis, Juan Mezzich, Chul W. Ahn, Shawn Shea

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


A one patient-one illness paradigm is implicit in the history and theory of psychiatry, and in basic research. Yet, in clinical practice and treatment populations in general, more than one diagnosis per patient is frequently encountered. How clinicians formulate comorbidity by means of DSM-III has rarely been investigated. In this study, the ideas of clinical condition and that of its diagnostic complexity are used to analyze descriptive features of a large number of patients seen in an intake setting. Axis I of DSM-III is used to measure diagnostic complexity. Complexity is analyzed in relation to demographic variables, to ratings entered in the remaining axes of DSM-III formulations, to symptom levels of patients, and to decisions involving disposition. Results indicate that analysis of diagnostic complexity by means of DSM-III yields a definable structure and that it can be related meaningfully to clinical factors. The idea of information uncertainty in diagnosis, i.e., the opacity versus transparency of a clinical condition, is also used to explain results. The ideas introduced and studied are shown to have value for social psychiatric research.

Original languageEnglish (US)
Pages (from-to)5-14
Number of pages10
JournalComprehensive Psychiatry
Issue number1
StatePublished - 1990

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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