Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-27T05:11:46.525Z Has data issue: false hasContentIssue false
  • English
  • Français

Schizophrenia: comparison of 13 diagnostic systems in a cross-sectional study1

Published online by Cambridge University Press:  16 April 2020

S Dollfus ,
M Petit ,
JF Menard  and
P Lesieur
S Dollfus
Affiliation:
University of Rouen, Department of Psychiatry, CHS du Rouvray, 4, rue Paul Etuard, Sotteville-Les-Rouen, 76301
M Petit
Affiliation:
University of Rouen, Department of Psychiatry, CHS du Rouvray, 4, rue Paul Etuard, Sotteville-Les-Rouen, 76301
JF Menard
Affiliation:
University of Rouen, Department of Biophysics, Hôpital Charles Nicolle, Rouen76000
P Lesieur
Affiliation:
Department of Research, CHS du Rouvray, 76301, France
Get access

Summary

The concordance and degree of overlap between 13 diagnostic systems for schizophrenia, including the five European systems of Berner, Bleuler, Langfeldt, Pull and Schneider, were evaluated in a cross-sectional study (N = 51) taking the phase of illness (acute or residual) into account. The diagnostic assessments were processed by computer using a 183-item standardised checklist and a data-processing program in GW-Basic language. The inter-rater reliability, as assessed by Kappa coefficient, was good to excellent for each diagnostic system established by this method (K from 0.5 to 1). When comparing the concordance between pairs of 13 diagnostic systems for schizophrenia in acute and residual phase groups, results showed that only two significant relationships were not influenced by the phase of illness (Carpenter x RDC; Catego x Schneider), while 24 were. These included only two relationships in the acute group (Carpenter Catego; Carpenter Schneider) and 22 links between pairs of systems in the residual group. In the acute group, no diagnosis of schizophrenia, including duration criteria such as those of DSM III-R, Feighner, Langfeldt, Pull and RDC, was linked to other systems. In the residual group, the operational systems such as Catego, DSM III-R, Feighner, Newhaven, Pull and RDC had more than five relationships with the other systems whereas the non-operational systems of Bleuler, ICD9, Langfeldt and Schneider had less than four relationships with the others. Except Pull's criteria, the European diagnostic systems, in particular Berner's and Bleuler's, seemed to differ from the others because of the few relationships displayed. The results underline the importance of taking the phase of illness into account when comparing between studies utilizing different diagnostic systems for schizophrenia. They also show the relationships between European and international diagnostic systems, insufficiently established so far.

Keywords

diagnosiscomputerconcordanceschizophrenia
Type
Original article
Information
European Psychiatry , Volume 8 , Issue 1 , 1993 , pp. 7 - 13
Copyright
Copyright © Elsevier, Paris 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Asnis, LCBaron, MGruen, R (1982) Diagnostic overlap in schizophrenia research: relation to outcome predictors and family history. Psychiatry Res 6, 345–3532CrossRefGoogle ScholarPubMed
Astrachan, BMHarrow, MAdler, DBrauer, LSchwartz, ASchwartz, C (1972) A checklist for the diagnosis of schizophrenia. Br J Psychiatry 121, 529–539CrossRefGoogle Scholar
Berner, P (1965) Das paranoische syndrom. Monographic aus dem gesamtgebiete det neurologie und psychiatrie. Springer Verlag, Berlin, 110Google Scholar
Berner, P (1969) Der lebensabend der paranoiker. Wien Z Nerv Heilk, 27, 115–161Google Scholar
Berner, PKatschnig, HLenz, G (1986) First-Rank symptoms and Bleuler's basic symptoms. Psychopathology 19, 244–252CrossRefGoogle ScholarPubMed
Berner, PGabriel, EKatschnig, HKieffer, WKoehler, KLenz, BSimhandl, Ch (1987) Critères diagnostiques pour les psychoses schizophréniques et affectives. Ed Expansion Scientifique Francaisc. Paris, p 191Google Scholar
Berner, PKatschnig, HLenz, G (1982) Poly-diagnostic approach: a method to clarify incongruence among the classification of the functional psychoses. Psychiatr J Univ Ottawa 7, 244–248Google Scholar
Berner, PKatschnig, HLenz, G (1986) The polydiagnostic approach in research on schizophrenia.In: Science, Practice and Social Policy: Issues in Classifying Mental Disorders (Silverman, IHuston, D eds). Human Sciences Press, New York70–91Google Scholar
Bleuler, E (1969) Dementia praecox or the group of schizophrenia. International Universities Press, New YorkGoogle ScholarPubMed
Brockington, IFKendell, RELeff, JP (1978) Definitions of schizophrenia: concordance and prediction of outcome. Psychol Med 8, 387–398CrossRefGoogle ScholarPubMed
Carpenter, WStephens, JHBarko, JJ (1973) Flexible system for diagnosis of schizophrenia: report from the WHO international pilot study of schizophrenia. Science 192, 1275CrossRefGoogle Scholar
Cohen, JA (1960) A coefficient of agreement for nominal scales. Ed Psychol Measurement 20, 37–46CrossRefGoogle Scholar
Dollfus, SPetit, MMenard, JFBrazo, P-AssoulyBesse, FPreterre, PLLesieur, PL (1993) Approche polydiagnostique de la schizophré nie: validation d'une checklist informatisé e (SIDE Liste d'items à à visée diagnostic à évolutive). Encéphale (in press)Google Scholar
DSM III-R (1987) Diagnostic and statistical manual of mental disorders. Third edn revised. American Psychiatric Association, Washington DCGoogle Scholar
Endicott, JForman, JBWSpitzer, RL (1978) Research approaches to diagnostic classification in schizophrenia.In: Neurochemical and Immunological Components in Schizophrenia. (Bergoma, DGoldstein, al eds). Alan R Liss, New YorkGoogle Scholar
Endicott, JNee, JCohen, JFleiss, JLSimon, R (1986) Diagnosis of schizophrenia. Arch Gen Psychiatry 43, 13–19CrossRefGoogle ScholarPubMed
Endicott, JNee, JFleiss, JCohen, JWilliams, JBWSimon, R (1982) Diagnostic criteria for schizophrenia. Reliabilities and agreement between systems. Arch Gen Psychiatry 39, 884–889CrossRefGoogle ScholarPubMed
Feighner, JRRobins, EGuze, SBWoodruff, RAWinokur, GSimon, R (1972) Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry 26, 57–63CrossRefGoogle ScholarPubMed
Fenton, WSMosher, LRMatthews, SM (1981) Diagnosis of schizophrenia: a critical review of current diagnostic systems. Schizophrenia Bull 7, 3, 452–476CrossRefGoogle ScholarPubMed
Fenton, WSMcGlashan, THHeinssen, RK (1988) A comparison of DSM III and DSM III-R schizophrenia. Am J Psychiatry 145, 1446–1449Google ScholarPubMed
Helzer, JEBrockington, IFKendell, RE (1981) Predictive validity of DSM III and feighner definitions of schizophrenia. Arch Gen Psychiatry 38, 791–797CrossRefGoogle ScholarPubMed
Hwu, HGChen, CCStrauss, ISTan, KLTsuang, MTTseng, WS (1988) A comparative study on schizophrenia diagnosed by ICD-9 and DSM III: course, family, history and stability of diagnosis. Acta Psychiatr Scand 77, 87–97CrossRefGoogle ScholarPubMed
Keks, NACopolov, DLKulkarni, JMackie, BSingh, BSMcGorry, PRubin, RTHassett, AMcLaughlin, MVan Reil, R (1990) Basal and haloperidol-stimulated prolactin in neuroleptic-free men with schizophrenia defined by 11 diagnostic systems. Biol Psychiatry 27, 1203–1215CrossRefGoogle ScholarPubMed
Kendell, REBrogkington, IFLeff, JP (1979) Prognostic implications of six alternative definitions of schizophrenia. Arch Gen Psychiatry 36, 25–31CrossRefGoogle ScholarPubMed
Kieffer, W (1988) International perspectives on schizophrenia and affective disorder.In: Schizoaffective Psychoses (Maneros, ATsuang, MT eds). Springer, BerlinGoogle Scholar
Landmark, JCernovsky, ZZMerskey, HLeslie, B (1986) Interrelationships of systems for diagnosing schizophrenia. Comp Psychiatry 4, 343–350CrossRefGoogle Scholar
Landmark, JMerskey, HCernovsky, ZHelmes, E (1990) The positive triad of schizophrenic symptoms. Its statistical properties and its relationship to 13 traditional diagnostic systems. Br J Psychiatry 156, 388–394CrossRefGoogle ScholarPubMed
Langfeldt, G (1960) Diagnosis and prognosis of schizophrenia. Proc Roy Soc Med 53, 1047–1052CrossRefGoogle ScholarPubMed
Langfeldt, G (1969) Schizophrenia: diagnosis and prognosis. Behav Sci 14, 173-182CrossRefGoogle ScholarPubMed
Leboyer, MJay, MD'Amato, TCampion, DGuilloud- Bataille, MHillaire, DDrouet, ALepine, JPBois, EFeingold, J (1990) Subtyping familial schizophrenia: reliability, concordance and stability. Psychiatry Res 34, 77–88CrossRefGoogle ScholarPubMed
Lenz, G (1986) International perspectives on schizophrenic and related psychotic disorders.In: International Classification in Psychiatry (Mezzich, JEVon Cranach, M eds). Cambridge University PressGoogle Scholar
McGlashan, TH (1984) Testing four diagnostic systems for schizophrenia. Arch Gen Psychiatry 41, 141–144CrossRefGoogle Scholar
Mellor, CS (1970) First rank symptoms of schizophrenia: 1. The frequency in schizophrenia on admission to hospital; 2. Differences between individual first rank symptoms. Br J Psychiatry 117, 15–23CrossRefGoogle Scholar
Organisation mondiale de la santé (1979) Troubles mentaux: glossaire et guide de la classification en concordance avec la neuvième révision de la classification des maladies. OMS, GenèveGoogle Scholar
Overall, JEHollister, LE (1979) Comparative evaluation of research diagnostic criteria for schizophrenia. Arch Gen Psychiatry 36, 1198–1205CrossRefGoogle Scholar
Pull, CBPull, MCPichot, P (1981) LICET-S: une liste intégrée de critères d’ éévaluation taxinomiques pour les psychoses non-affectives. J Psy Biol Ther 1, 33–37Google Scholar
Pull, MCPull, CBPichot, P (1987a) Des critères empiriques francais pour les psychoses. II. Consensus des psychiatres francais et définitions provisoires. Encéphale 13, 53–57Google Scholar
Pull, MCPull, CBPichot, P (1987b) Des critères empiriques francais pour les psychoses. III. Algorithmes et arbre de décision. Encéphale 59–66Google Scholar
Schneider, K (1959) Clinical psychopathology. Grune and Stratton, New YorkGoogle Scholar
Silverstein, MLHarrow, M (1978) First rank symptoms in the post-acute schizophrenic: a follow-up study. Am J Psychiatry 135, 1481–1486Google Scholar
Spitzer, RLFleiss, JL (1974) A re-analysis of the reliability of psychiatric diagnosis. Br J Psychiatry 125, 341–347CrossRefGoogle ScholarPubMed
Spitzer, RLEndicott, JRobins, E (1978) Research diagnostic criteria. Arch Gen Psychiatry 35, 773–782CrossRefGoogle ScholarPubMed
Stephens, JHOta, KYCarpenter, WTShaffer, JW (1980) Diagnosis criteria for schizophrenia: prognostic implications and diagnostic overlap. Psychiatry Res 2, 1–12CrossRefGoogle ScholarPubMed
Stephens, JHAstrup C, Carpenter, WTShaffer, JWGoldberg, J (1982) A comparison of nine systems to diagnose schizophrenia. Psychiatry Res 6, 127–143CrossRefGoogle Scholar
Strauss, JSCarpenter, WT (1972) The prediction of outcome in schizophrenia. Arch Gen Psychiatry 27, 739–746CrossRefGoogle Scholar
Strauss, JSGift, TE (1977) Choosing an approach for diagnosing schizophrenia. Arch Gen Psychiatry 34, 1248–1253CrossRefGoogle Scholar
Taylor, MAAbrams, R (1978) The prevalence of schizophrenia: a reassessment using modern diagnostic criteria. Am J Psychiatry 135, 8, 945–948Google ScholarPubMed
Van den Brink, WKoeter, MWJOrmel, JDijkstra, WGiel, RSloof, CWohlfarth, TD (1989) Psychiatric diagnosis in an outpatient population. A comparative study of PSE-Catego and DSM III. Arch Gen Psychiatry 46, 369–372CrossRefGoogle Scholar
Wing, JKCooper, JESartorius, N (1974) The measurement and classification of psychiatric symptoms. Cambridge University Press, LondonGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.