In 1952, the American Psychiatric Association published the “Diagnostic and Statistical Manual of Mental Disorders”. Four revisions have come since then, adding new mental disorders, while others have been removed. The fifth edition is currently in progress.

Comparing the diagnosis given to patients admitted for the first time to an Acute Mental Health Unit, over a period of 10 years.

Systematic review of first admission patients in our Unit in 2000 and 2010, comparing initial diagnosis.

Of a total of 60 patients found in 2000 and 69 patients in 2010, we found these differences: firstly the increased number of admissions seen in 2010; secondly the initial diagnosis, being Schizophrenia the main diagnosis in 2000 and Bipolar Disorder the most prominent in 2010. There's also a larger prevalence of Psychotic episode secondary to drug abuse in 2010.

Since the introduction of DSM-criteria more than 30 years ago, the aim to validate the syndromes and finding of common etiologies have been difficult to reach. Despite many “proposed candidates”, no laboratory findings have proved to be specific to identify any of the syndromes of DSM. Epidemiological and clinical studies have shown high comorbidity amongst the disorders, discounting the hypothesis that the syndromes represent different etiologies. Besides, epidemiological data have brought the fact of high degree short-term diagnostic instability for many disorders.

In our study we’ve reached the conclusion that there appears to be a clear diagnostic variability during the last decade.