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Documenting diagnosis in child and adolescent mental healthcare: A content analysis of diagnostic statements in a psychiatric case register

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  • O'Connor, Cliodhna
  • Downs, Johnny
  • McNicholas, Fiona
  • Cross, Lauren
  • Shetty, Hitesh

Abstract

Understanding clinical practice in relation to psychiatric diagnosis is important for identifying avenues for service improvement, developing clinically valid research methods and informing debate about prevailing diagnostic systems. Minimal research has explored psychiatric diagnostic practice by studying the diagnostic information present in clinical records. This study identifies, quantifies and descriptively analyses the range of contexts in which diagnostic terms appear in free-text child and adolescent clinical notes. Text segments containing a diagnostic term (N = 2993) were extracted from children’s electronic health records and subjected to content analysis. Segments were coded as indicating: definite diagnostic confirmations (49.4%), qualified diagnostic confirmations (6.4%), diagnostic queries/assessment (16.9%), definite diagnostic exclusions (3.1%), qualified diagnostic exclusions (2.2%), diagnostic status of another person (13.5%), or clinically irrelevant text (8.6%). Qualitative content analysis explored the linguistic patterns characterising these contexts of use. Results are considered in terms of their implications for service delivery, sociological analyses of psychiatric diagnosis, and the opportunities and challenges posed by applications of natural language processing techniques to electronic health records.

Suggested Citation

  • O'Connor, Cliodhna & Downs, Johnny & McNicholas, Fiona & Cross, Lauren & Shetty, Hitesh, 2020. "Documenting diagnosis in child and adolescent mental healthcare: A content analysis of diagnostic statements in a psychiatric case register," Children and Youth Services Review, Elsevier, vol. 113(C).
    • Handle: RePEc:eee:cysrev:v:113:y:2020:i:c:s0190740919312782
    DOI: 10.1016/j.childyouth.2020.104948
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    References listed on IDEAS

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    1. O'Connor, Cliodhna & Kadianaki, Irini & Maunder, Kristen & McNicholas, Fiona, 2018. "How does psychiatric diagnosis affect young people's self-concept and social identity? A systematic review and synthesis of the qualitative literature," Social Science & Medicine, Elsevier, vol. 212(C), pages 94-119.
    2. Jutel, Annemarie & Nettleton, Sarah, 2011. "Towards a sociology of diagnosis: Reflections and opportunities," Social Science & Medicine, Elsevier, vol. 73(6), pages 793-800, September.
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    Cited by:

    1. Ni, Shiguang & Lu, Shuang & Lu, Ke & Tan, Haoyue, 2021. "The effects of parental involvement in parent–child reading for migrant and urban families: A comparative mixed-methods study," Children and Youth Services Review, Elsevier, vol. 123(C).

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