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Diagnostic concordance in functional psychosis revisited: a study of inter-relationships between alternative concepts of psychotic disorder

  • Patrick D. McGorry (a1), Bruce S. Singh (a1), Sheryl Connell (a1), Dean McKenzie (a1), Raphael J. Van Riel (a1) and David L. Copolov (a1)...

More than a decade ago, a series of retrospective studies examined the concordance between proliferating definitions of severe psychiatric disorder. The European response has been a polydiagnostic one, which has attempted to maintain interest in a broad range of psychiatric phenomena in the psychoses. In North America a more convergent approach has emerged, resulting in a series of operational definitions evolving from one another, and a correspondingly limited capacity to allow alternative perspectives to co-exist. The present study uses a prospective design as well as recent improvements in the clinical validity of psychopathology assessment to re-evaluate the relationships between competing concepts of psychotic illness in a broad sample (N = 176) of recent-onset psychotic patients. In the schizophrenic group, concordance was predictably highest among recent North American ‘cousins’, and lowest among various historical concepts. There was a moderately high concordance between selected schizoaffective and atypical psychosis definitions, indicating that this component is an important area for further studies of descriptive validity. These interrelationships may be used as a starting point to explore latent classes underlying the phenomena of functional psychosis.

Corresponding author
1Address for correspondence: Dr P. D. McGorry, NH & MRC Schizophrenia Research Unit, Royal Park Hospital, Private Bag 3, parkville, victoria 3052, Australia.
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R. K. Blashfield (1973). Evaluation of the DSM-III classification of schizophrenia as a nomenclature. Journal of Abnormal Psychology 82, 382389.

D. J. Burbach , R. Lewine & H. Y. Meltzer (1984). Diagnostic concordance for schizophrenia as a function of sex. Journal of Consulting and Clinical Psychology 52, 478479.

W. T. Carpenter , J. S. Strauss & J. Bartlo (1973). A flexible system for the diagnosis of schizophrenia: report from the WHO International Pilot Study of Schizophrenia. Science 182, 12751278.

W. T. Carpenter , J. S. Strauss & S. Muleh (1974). Are there pathognomonic symptoms in schizophrenia? Archives of General Psychiatry 28, 847852.

P. J. Clayton (1982). Schizoaffective disorders. Journal of Nervous and Mental Disease 170, 646650.

T. J. Crow (1986). The continuum of psychosis and its implications for the structure of the gene. British Journal of Psychiatry 149, 419429.

J. Ellard (1987). Did schizophrenia exist before the eighteenth century? Australian and New Zealand Journal of Psychiatry 21, 306315.

J. Endicott , J. Nee , J. Fleiss , J. Cohen , J. B. W. Williams & R. Simon (1982). Diagnostic criteria for schizophrenia. Archives of General Psychiatry 39, 884889.

J. P. Feighner , E. Robins , S. B. Guze , R. A. Woodruff , G. Winokur & R. Munoz (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 5763.

W. S. Fenton , L. R. Mosher & S. M. Matthews (1981). Diagnosis of schizophrenia: a critical review of current diagnostic systems. Schizophrenia Bulletin 7, 452476.

M. Harrow & L. S. Grossman (1984). Outcome in schizoaffective disorders: a critical review and reevaluation of the literature. Schizophrenia Bulletin 10, 87108.

J. E. Helzer , I. F. Brockington & R. E. Kendell (1981). Predictive validity of DSM-III and Feighner definitions of schizophrenia. Archives of General Psychiatry 38, 791797.

H. Katschnig & C. Simhandl (1986). New developments in the classification and diagnosis of functional mental disorders. Psychopathology 19, 219235.

N. A. Keks , D. L. Copolov , J. Kulkarni , B. Mackie , B. S. Singh , P. McGorry , R. T. Robin , A. Hassett , M. McLaughlin & R. van Riel (1990). Basal and haloperidol-stimulated prolactin in neuroleptic-free men with schizophrenia defined by 11 diagnostic systems. Biological Psychiatry 27, 12031215.

A. M. P. Kellam (1989). French empirical criteria for the diagnosis of non-affective non-organic psychoses. British Journal of Psychiatry 155, 153159.

R. E. Kendell (1982). The choice of diagnostic criteria for biological research. Archives of General Psychiatry 39, 13341339.

P. D. McGorry , D. L. Copolov & B. S. Singh (1989). The validity of the assessment of psychopathology in the psychoses. Australian and New Zealand Journal of Psychiatry 23, 469482.

P. D. McGorry , D. L. Copolov & B. S. Singh (1990 a). Current concepts in functional psychosis: the case for a loosening of associations. Schizophrenia Research 3, 221234.

P. D. McGorry , B. S. Singh , D. L. Copolov , I. Kaplan , C. R. Dossetor , & R. J. van Riel (1990 c). Royal Park Multidiagnostic Instrument for Psychosis. II. Development, reliability and validity. Schizophrenia Bulletin 16, 517536.

M. Maj (1984). The evolution of some European diagnostic concepts relevant to the category of schizoaffective psychoses. Psychopathology 17, 158167.

M. Menuck , S. Legault , P. Schmidt & G. Remington (1989). The nosologic status of the remitting atypical psychoses. Comprehensive Psychiatry 30, 5373.

M. Philipp & W. Maier (1986). Methodological problems in polydiagnostic research. Psychopathology 19, 236243.

H. G. Pope & J. F. Lipinski (1978). Diagnosis in schizophrenia and manic-depressive illness. Archives of General Psychiatry 35, 811828.

M. A. Schwartz & O. P. Wiggins (1986). Logical empiricism and psychiatric classification. Comprehensive Psychiatry 27, 101114.

J. Stephens , C. Astrup , W. T. Carpenter , J. W. Shaffer & J. Goldberg (1982). A comparison of nine systems to diagnose schizophrenia. Psychiatry Research 6, 127143.

J. S. Strauss & T. E. Gift (1977). Choosing an approach for diagnosing schizophrenia. Archives of General Psychiatry 34, 12481253.

G. Vogl & M. Zaudig (1985). Investigation of operationalized criteria in the diagnosis of schizoaffective and cycloid psychoses. Comprehensive Psychiatry 26, 110.

A. Welner , J. L. Liss , E. Robins & M. Richardson (1972). Undiagnosed psychiatric patients – part I: record study. British Journal of Psychiatry 120, 315319.

M. Young , M. Tanner & H. Meltzer (1982). Operational definitions of schizophrenia. What do they identify? Journal of Nervous and Mental Disease 170, 443447.

M. Zimmerman (1988). Why are we rushing to publish DSM-IV? Archives of General Psychiatry 45, 11351138.

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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
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