ISSN:0254-4962    

DOI:10.1159/000284462

出版商:S. Karger AG    

年代:1986

数据来源: Karger

ISSN:0254-4962    

DOI:10.1159/000284463

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Six new developments in the classification and diagnosis of functional mental disorders are described. These are: the standardization of data collection, the formulation of operational diagnostic criteria, the multiaxial approach to psychiatric diagnosis, the development of compromise classification systems, the polydiagnostic approach, and, finally, the idea of validating diagnostic concepts instead of taking them for granted. The merits and pitfalls of each of these new developments are discussed. It is concluded that both the traditional categorical diagnostic approach and the introduction of diagnostic compromise systems are an obstacle to progress in psychiatric research. On the other hand, a blind belief in operational diagnostic criteria also has its drawback. Only efforts at standardized data collection, at using a multiaxial and polydiagnostic approach, and regarding psychiatric diagnoses as hypothesis, will contribute to progress in psychiatric research.

ISSN:0254-4962    

DOI:10.1159/000284464

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The growing application of the polydiagnostic approach makes it necessary to examine the methodological problems associated with the simultaneous assessment of multiple competing diagnoses. This paper contrasts the method of nonstandardized consecutive judgement of nonintegrated criteria lists with the method of a structured polydiagnostic interview with integrated criteria lists. The comparison of two polydiagnostic studies using both methods of assessment confirms that the unstructured use of nonintegrated and consecutively judged criteria lists is biased by a halo effect. This halo effect leads to a reduction of differences between the classifications of competing operational diagnoses and influences the type of patient distribution along the diagnostic dimension. This finding is interpreted as an argument to switch over to integrated criteria lists applied on the basis of an unstructured clinical examination or a structured interview.

ISSN:0254-4962    

DOI:10.1159/000284465

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

By comparing six different operational diagnostic systems (International Classification of Diseases, Diagnostic and Statistical Manual; 3rd ed., Research Diagnostic Criteria, St. Louis criteria, Taylor criteria and Vienna Research Criteria), the data presented in this paper illustrate how attribution to various categories of functional psychoses varies according to the applied algorithms. Bleuler’s basic symptoms are obviously considered by all of the compared systems to be more significant for attribution to schizophrenia than first-rank symptoms.

ISSN:0254-4962    

DOI:10.1159/000284467

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The relationship between diagnostic assignment and specific symptomatology on admission and the duration of the first hospital stay was investigated in 200 patients with a functional psychosis. There were considerable differences in the mean duration of stay in hospital for patients fulfilling different diagnostic criteria for schizophrenia: the broader the concept of schizophrenia, the shorter the duration of stay. In looking at symptomatology, it could be demonstrated that patients with formal thought disorder had the highest mean duration of first inpatient episode.

ISSN:0254-4962    

DOI:10.1159/000284468

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

77 patients with delusional psychoses, regardless of their nosological attribution (except severe organicity), and their first-degree relatives were diagnosed with the Research Diagnostic Criteria (RDC) and the Vienna Research Criteria (VRC). The diagnostic procedure was performed blindly in the relatives. Both criteria were sufficiently capable of identifying a schizophrenic and affective subgroup of patients characterized by the appearance of homotypical secondary cases. Apart from a small RDC schizoaffective group differing in genetic pattern, there exists another large group of nonschizophrenic, nonaffective delusional disorders lacking a genetic link to the above-mentioned diagnoses. In respect to the development of the diagnostic criteria, the results of this study call for the formulation of (1) a narrow definition of schizophrenia (as in the VRC) which is based on thought disorder and affective blunting with the exception of so-called productive symptomatology (delusions, hallucinations); (2) separate criteria for schizoaffective disorders (as in RDC), and (3) a broad and nonrestrictive definition for nonschizophrenic delusional disorders.

ISSN:0254-4962    

DOI:10.1159/000284469

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A dimensional classification according to the decisiveness of the diagnosis of endogenous depression is proposed, based on a polydiagnostic approach using latent-trait models (Rasch model). The instrument is derived from a sample of 130 depressed patients, and a cross-validation of this instrument is reported in a sample of 87 patients with major depressive episode. The utility of this scale in biological research is discussed.

ISSN:0254-4962    

DOI:10.1159/000284470

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

200 patients with an ICD diagnosis of 295, 296, 297 or 298 at their first admission were rated positive or negative for a series of different diagnostic criteria for functional psychoses. Criteria with a very wide concept of affective disorder like the VRC or the DSM-III or Taylor or St. Louis are in contrast to more narrowly defined concepts in RDC or ICD. Because of these differences there is a great need for more effective validation studies based on the simultaneous application of different diagnostic criteria. This has been called the ‘polydiagnostic approach’.

ISSN:0254-4962    

DOI:10.1159/000284471

出版商:S. Karger AG    

年代:1986

数据来源: Karger