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Cited by 73Schizophrenia research and treatmentMental Health and PsychiatryBipolar Disorder and Treatment

Competing Definitions of Schizophrenia: What Can Be Learned From Polydiagnostic Studies?

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Jansson, L. B., Parnas, J.·2007·Schizophrenia Bulletin
DOI 10.1093/schbul/sbl065PMC PMC3304082
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Abstract

The contemporary diagnoses of schizophrenia (sz)-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-IV) and International Classification of Diseases, 10th Revision(ICD-10)-are widely considered as important scientific achievements. However, these algorithms were not a product of explicit conceptual analyses and empirical studies but defined through consensus with the purpose of improving reliability. The validity status of current definitions and of their predecessors remains unclear. The so-called "polydiagnostic approach" applies different definitions of a disorder to the same patient sample in order to compare these definitions on potential validity indicators. We reviewed 92 polydiagnostic sz studies published since the early 1970s. Different sz definitions show a considerable variation concerning frequency, concordance, reliability, outcome, and other validity measures. The DSM-IV and the ICD-10 show moderate reliability but both definitions appear weak in terms of concurrent validity, eg, with respect to an aggregation of a priori important features. The first-rank symptoms of Schneider are not associated with family history of sz or with prediction of poor outcome. The introduction of long duration criteria and exclusion of affective syndromes tend to restrict the diagnosis to chronic stable patients. Patients fulfilling the majority of definitions (core sz patients) do not seem to constitute a strongly valid subgroup but rather a severely ill subgroup. Paradoxically, it seems that a century after the introduction of the sz concept, research is still badly needed, concerning conceptual and construct validity of sz, its essential psychopathological features, and phenotypic boundaries.

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  • DSM-5 diagnostic requirements for Schizophrenia are more likely to identify patients with a higher tendency to chronicity than ICD-11.

    “Although both diagnostic systems require a full month of the defining psychotic symptoms, the DSM-5 diagnostic requirements are more likely to identify patients with a higher tendency to chronicity 37 .”

    From An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in <scp>ICD</scp> ‐11 and <scp>DSM</scp> ‐5 (2021) · cites this paper as [37]

    The Reliability section lists a six-month illness-duration requirement for DSM-IV and a one-month requirement for ICD-10. The Abstract says long duration criteria tend to restrict diagnosis to chronic, stable patients. But this 2007 paper does not assess DSM-5 against ICD-11, so it cannot establish the claim about those editions specifically. (LLM, conf=0.86)

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Research works printed but not linked: 9

  1. Cernovsky Z, Landmark J, Leslie B. Social and anamnestic correlates of consensus in diagnosing schizophrenia. J Clin Psychol. 1985;41:614-619.
  2. Modestin J, Spichtig L, Ryffel D. Subjektive Basissymptome und Schizophrenie-Definition. Schweiz Arch Neurol Psychiatr. 1987;138:35-41.
  3. Goodman LA. The analysis of systems of qualitative varia- bles when some of the variables are unobservable. Am J Sociol. 1974;79:1179-1259.
  4. Kendler KS, Karkowski LM, Walsh D. The structure of psy- chosis: latent class analysis of probands from the Roscom- mon Family Study. Arch Gen Psychiatry. 1998;55:492-499.
  5. Gottesman II, Shields J. Schizophrenia and Genetics: A Twin Study Vantage Point. New York, NY: Academic Press; 1972.
  6. Berner P, Katschnig H. Approche polydiagnostique en recherche psychiatrique. Ann med psychol. 1984;142: 825-831.
  7. Ciompi L, Mu ¨ller C. Lebensweg und Alter der Schizophre- nien. Eine katamnestische Langzeitstudie bis ins Senium. Heidelberg, Germany: Springer; 1976.
  8. Huber G, Gross G, Schu ¨ttler R. Schizophrenie. Verlaufs-und socialpsychiatrische Langzeitundersuchungen an den 1945 bis 1959 in Bonn hospitalisierten schizophrenen Kranken. Berlin, Germany: Springer; 1979.
  9. Cooper JE, Kendell RE, Gurland BJ, Sharpe L, Copeland JRM, Simon R. Psychiatric diagnosis in New York and Lon- don. Oxford, UK: Oxford University Press; 1972.

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Authors
Jansson, L. B., & Parnas, J.
Affiliations
University of Copenhagen (DK)
ORCID
Venue
Schizophrenia Bulletin
Publisher
Oxford University Press (OUP)
Published
2007-07-17
Volume
33
Issue
5
Pages
1178-1200
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
DOI
10.1093/schbul/sbl065
PMC
PMC3304082
OpenAlex
W2160232387
Cited by
73
References
184
Citations by year
2025: 2 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 8 · 2015: 3 · 2014: 5 · 2013: 9 · 2012: 4
FWCI
2.98
Type
journal article
Language
en
Open access
Locations
  • Schizophrenia Bulletin (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords
schizophrenia, diagnostic validity
MeSH terms
Adult, Female, Humans, Male, Terminology as Topic, Psychiatric Status Rating Scales, Psychometrics, Schizophrenia, Schizophrenic Psychology, Reproducibility of Results, Age of Onset, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders

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