Diagnosis in schizophrenia and manic-depressive illness: a reassessment of the specificity of 'schizophrenic' symptoms in the light of current research.

Full Abstract

Present clinical and research methods of differential diagnosis of schizophrenia and affective psychoses rely very heavily on presenting symptoms and signs, especially in acute psychosis. We have reviewed studies bearing on this issue, including studies of the phenomenology of psychotic illness, outcome, family history, response to treatment with lithium carbonate, and cross-national and historical diagnostic comparisons. We conclude that most so-called schizophrenic symptoms, taken alone and in cross section, have remarkably little, if any, demonstrated validity in determining diagnosis, prognosis, or treatment response in psychosis. In the United States, particularly, overreliance on such symptoms alone results in overdiagnosis of schizophrenia and underdiagnosis of affective illnesses, particularly mania. This compromises both clinical treatment and research.

Author information

Author/s: Pope, H G (HG); Lipinski, J F (JF);

Journal and publication information

Publication Type: Clinical Trial; Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.

Journal: Archives of general psychiatry (Arch Gen Psychiatry), published in UNITED STATES. (Language: eng)

Reference: 1978-Jul; vol 35 (issue 7) : pp 811-28

Dates: Created 1978/09/25; Completed 1978/09/25; Revised 2007/11/15;

PMID: 354552, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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