Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning

Figures & data

Table 1 DSM-IV diagnosis scoring guide for Axis I and Axis II

Diagnostic DSM-IV Axes	Diagnosis (dependent variables including items in the differential)	Scoring (minimum–maximum)
Axis I	Major depression, recurrent, generalized anxiety and obsessive-compulsive disorder (or symptoms), history of bereavement, alcohol dependence, and cocaine abuse	(0–6)
Axis III	Severe hyponatremia, likely due to abnormal antidiuretic hormone excretion syndrome	(0–1)

Abbreviation: DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

Table 2 Results of the Mann–Whitney test comparing diagnostic accuracy between experts and novices

Mann–Whitney test U value for P	CCs (n = 4)		EPs (n = 5)
	MR	SR	MR	SR
Odds of correct primary diagnosis (Axis I) 2.5 0.025	3.13	12.50	6.5	32.5
Odds of correct medical diagnosis (Axis II) 0.0001 0.005	2.5	10.0	7.0	35.0
Number of diagnoses on Axis I differential 1.5 0.029	7.13	28.5	3.3	16.5
Time to complete experiment 00 0.014	7.5	30.0	3.0	15.0

Abbreviations: CCs, clinical clerks; EPs, expert psychiatrists; MR, mean rank; SR, sum of ranks.

Table

Axis I: Psychiatric diagnosis…………………………………………………………
Axis Ill: Medical diagnosis…..………………………………………………………
Demographics
Age:		Gender: M/F		Faculty/Student (circle)
Duration in minutes:………….. Years of experience…………. Signature………….