Lack of reliable diagnoses in some disorders

Though manuals like the Diagnostic and Statistical Manual of Mental Disorders (DSM) have covered a lot of ground when it comes to defining mental illnesses, in some disorders the reliability of diagnosis is still very poor. For example, inter-rater reliability in cases of dementia is very high, with a kappa value of 0.78, while major depressive disorder is often diagnosed differently by independent experts who see the same patient, with a kappa value of just 0.28.

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Source: Unsolved problems in medicine (CC BY-SA 4.0)