An attempt was made to find a combination of MMPI scale relationships which were highly discriminating of schizophrenia. Through the use of a standardized structured interview and a diagnostic system for schizophrenia based on the use of discriminant function analysis with nonpathognomonic symptom combinations, a reliable and valid system was used to establish the criterion diagnosis. Approximately 72% of patients reliably diagnosed as schizophrenics were detected on the MMPI via a set of standard criteria (T score on Sc greater than or equal to 80 less than or equal to 100; total raw score on Sc consisted of no more than 35% K items; T score on F greater than or equal to 75 less than or equal to 95; T score on Pt less than or equal to Sc). Only 5.5% of nonschizophrenics obtained all these standard criteria on the MMPI. The assets and liabilities of these MMPI criteria to diagnose schizophrenia are discussed.
Background: We performed a retrospective analysis of data involving 121 inpatients to examine the rate of weight gain during antipsychoticfree periods and during treatment with various antipsychotic drugs. Method: Data were analyzed to determine differences in weekly weight change during antipsychotic-free (N = 65), typical antipsychotic (N = 51), or atypical antipsychotic (N = 130) treatment periods. Atypical antipsychotic treatment periods were further subdivided into olanzapine (N = 45), clozapine (N = 47), or risperidone (N = 36) treatment periods. A paired comparison was conducted on 65 patients who had an antipsychotic-free treatment period preceding or following a neuroleptic drug treatment period. In addition, patients were classified as either non-obese (with a body mass index [BMI] ≤ 29.9 kg/m 2) or obese (BMI ≥ 30.0 kg/m 2) to test whether the rate of weight gain during treatment periods was related to initial BMI. Results: Across all treatment periods, weekly weight gain was as follows: 0.89 lb/wk (0.40 kg/wk) on atypical antipsychotic medication, 0.61 lb/wk (0.27 kg/wk) on typical antipsychotic medication, and 0.21 lb/wk (0.09 kg/wk) on no antipsychotic medications. The atypical antipsychotic versus antipsychotic-free comparison was significant (F = 3.51; df = 2,231; p = .031), while the typical antipsychotic versus antipsychotic-free comparison was not. Among the individual atypical antipsychotic medications, significantly more weight gain occurred during olanzapine treatment (1.70 lb/wk) (0.76 kg/wk) than with either clozapine (0.50 lb/wk) (0.22 kg/wk) or risperidone (0.34 lb/wk) (0.15 kg/wk) treatments (F = 7.77; df = 2,117; p = .001). In the paired analysis with patients serving as their own controls, the difference between weekly weight gain during atypical antipsychotic treatment and antipsychotic-free treatment was significant (t =-3.91; df = 44; p = .001), while the difference between weight gain during typical antipsychotic treatment and antipsychotic-free treatment was not significant. With the individual drugs, treatment with both olanzapine and clozapine caused significantly higher weekly weight gain than antipsychoticfree treatment (p = .001 and p = .036, respectively), while treatment with risperidone did not. Non-obese patients (BMI < 29.9 kg/m 2) and obese patients (BMI > 30.0 kg/m 2) did not differ significantly in their weight gain during typical or atypical antipsychotic treatment. Conclusion: Treatment with atypical antipsychotics was associated with more weight gain than treatment with typical antipsychotics. Among the atypical drugs, olanzapine was associated with more weight gain than either clozapine or risperidone. The patient's admission BMI was not associated with the amount of weight gained during subsequent antipsychotic treatment.
An attempt was made to assess the discriminative validity of the WIST with a sample of psychiatric inpatients. Through the use of a standardized structured interview and a diagnostic system for schizophrenia based on the use of discriminant function analysis with nonpathognomic symptom combinations, a reliable and valid system was used to establish the criterion diagnosis. Approximately 63% of patients reliably diagnosed as schizophrenic were detected via the WIST while only 14% of nonschizophrenic patients scored in the schizophrenic range on the WIST. The assets and liabilities of using the WIST to diagnose schizophrenia are discussed.
An effort was made to formalize the critical clinical, demographic and historical features of schizophrenia through the development of a reliable assessment questionnaire. The criterion diagnosis was established via traditional hospital procedures and was substantiated by psychometric measures. Raters with comparable diagnostic experience were familiarized with each of the clinical, demographic and historical features before evaluating the presence or absence in a sample of both psychiatric in-patients and out-patients. A structured, standardized interview was used to reduce inconsistency and oversight due to variability in interviewing techniques and coverage of psychopathology. Using the coefficients of the discriminative functions of five major symptoms (loose associations, autism, loss of ego boundaries, emotional blunting, delusions) and two demographic and historical features (family history of mental illness, poor social relations) correctly classified 98 per cent of the total sample of 253 patients. A subsequent investigation demonstrated the utility and generalizability of the proposed system. The assets and liabilities of using such an approach are discussed.
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