Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-28T04:13:42.942Z Has data issue: false hasContentIssue false

Methodological Issues in Using a Polydiagnostic Approach to Define Psychotic Illness

Published online by Cambridge University Press:  02 January 2018

Anne E. Farmer*
Affiliation:
Department of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN
Simon Wessely
Affiliation:
Institute of Psychiatry and King's College Hospital Medical School, London
David Castle
Affiliation:
Institute of Psychiatry and King's College Hospital Medical School, London
Peter McGuffin
Affiliation:
Department of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN
*
Correspondence

Abstract

Although a polydiagnostic approach to the definition of psychotic disorder provides many advantages to the researcher, there are also disadvantages. A comparison between several different sets of operational criteria using the opcrit computer program on a consecutive series of 397 psychotic subjects is described. The results show that although current diagnostic procedures are generally reliable, such approaches can still only supplement skilled clinical judgement, and there remain many pitfalls for the unwary.

Type
Papers
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

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

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Carpenter, W. T., Strauss, J. S. & Bartko, J. J. (1973) Flexible system for the diagnosis of schizophrenia: a report from the WHO Pilot Study of Schizophrenia. Science, 182, 1275.Google Scholar
Castle, D., Wessely, S., Der, G., et al (1991) The incidence of operationally defined schizophrenia in Camberwell, 1965–84. British Journal of Psychiatry, 159, 790794.Google Scholar
Crow, T. J. (1980) The molecular pathology of schizophrenia: more than one disease process? British Medical Journal, 280, 6668.Google Scholar
Farmer, A. E., McGuffin, P. & Spitznagel, E. L. (1983) Heterogeneity in schizophrenia: a cluster analytic approach. Psychiatry Research, 8, 112.Google Scholar
Farmer, A. E., McGuffin, P. & Gottesman, I. I. (1984) Searching for the split in schizophrenia: a twin study perspective. Psychiatry Research, 13, 109118.Google Scholar
Farmer, A. E., McGuffin, P. & Gottesman, I. I. (1987) Twin concordance for DSMIII schizophrenia: scrutinizing the validity of the definition. Archives of General Psychiatry, 44, 634644.Google Scholar
Farmer, A. E. & McGuffin, P. (1989) The classification of the depressions: contemporary confusion revisited. British Journal of Psychiatry, 155, 437443.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 5767.Google Scholar
Kendell, R. E. (1983) Diagnosis and classification. In Companion to Psychiatric Studies (eds R. E. Kendell & A. K. Zealley), pp. 205222. Edinburgh: Churchill Livingstone.Google Scholar
McGuffin, P., Farmer, A. E., Gottesman, I. K., et al (1984) Twin concordances for operational definitions of schizophrenia. Archives of General Psychiatry, 41, 541545.Google Scholar
McGuffin, P., Farmer, A. E. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the opcrit system. Archives of General Psychiatry, 48, 764770.CrossRefGoogle ScholarPubMed
Pull, M. C., Pull, C. B. & Pichot, P. (1987) Des criteres empiriques français pour les psychoses. II. Consensus des psychiatres français et definitions provisoires. L'Encephale, 13, 5357.Google Scholar
Robins, L. N., Wing, J., Wittchen, H. U., et al (1988) The Composite International Diagnostic Interview. Archives of General Psychiatry, 45, 10691078.Google Scholar
Schneider, K. (1959) Clinical Psychopathology (trans. Hamilton, M.). New York: Grune and Stratton Inc.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1975) Research Diagnostic Criteria. Instrument No. 58. New York: New York State Psychiatric Institute.Google Scholar
Taylor, M. A. & Abrams, R. (1978) The prevalence of schizophrenia: a reassessment using modern diagnostic criteria. American Journal of Psychiatry, 135, 945948.Google Scholar
Tsuang, M. T. & Winokur, G. (1974) Criteria for subtyping schizophrenia. Archives of General Psychiatry, 31, 43.Google ScholarPubMed
Wessely, S., Castle, D., Der, G., et al (1991) Schizophrenia and Afro-Caribbeans. A case-control study. British Journal of Psychiatry, 159, 795801.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Wing, J. K. & Sturt, E. (1978) The PSE–ID–CATEGO System Supplementary Manual. London: Mimeograph MRC Social Psychiatry Unit, Institute of Psychiatry.Google Scholar
World Health Organization (1967) Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, 1965 revision (8th edn) (ICD–8). Geneva: WHO.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.