Psychiatrists Only Agree 55 Percent of the Time on Diagnoses

WEDNESDAY, Sept. 16, 2026 (HealthDay News) — Psychiatric diagnostic interrater reliability remains limited globally, according to a study published online July 28 in Frontiers in Psychiatry.

Mateo Boberg, from the University Hospital of Copenhagen in Denmark, and colleagues conducted a large-scale international study to assess the reliability of psychiatric diagnoses. The analysis included 1,902 diagnostic assessments (using nine clinical case vignettes) from 1,038 medical doctors working in adult psychiatry in 19 countries. 

The researchers found that interrater reliability among medical doctors was modest (Krippendorff’s α = 0.48), yielding diagnostic agreement between two doctors in roughly 55 percent of cases. Overall diagnostic accuracy was 66 percent, with the lowest accuracy seen for vignettes depicting schizophrenia spectrum disorders. There were similar patterns involving diagnostic disagreements, with schizophrenia cases frequently misclassified as obsessive compulsive disorder, personality disorder, or bipolar disorder.

“These are not random errors,” Boberg said in a statement. “There is a clear pattern to the disagreements. This likely reflects the fact that diagnostic categories are not as clearly defined as we have assumed, when experienced psychiatrists can interpret the same symptom presentations so differently.”

Two authors disclosed financial ties to the biopharmaceutical industry.

Abstract/Full Text