Diagnostic stability in subjects with multiple admissions for psychotic illness

Forrester, Andrew; Owens, David C.; Johnstone, Eve C.

doi:10.1017/s0033291799003116

Cited by 34 publications

(31 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This may reflect the crossheritability of these two disorders [6], or alternatively diagnostic misclassification. Although judged to be adequately stable, the stability of an initial clinical diagnosis of affective psychoses has been shown to be lower than that of an initial clinical diagnosis of schizophrenic psychoses, with considerable movement from affective disorders towards schizophrenia [11]. It is also possible that the increased heritability of schizophrenia and affective disorders in younger onset probands relative to other psychotic conditions may reflect the considerable diagnostic heterogeneity within the group of other psychiatric conditions, including both functional and organic psychoses.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies [8,20,38] have justified the use of similar historical clinical diagnoses for severe psychiatric illnesses, on the basis of generally conservative diagnostic practices and findings comparable to those of contemporary studies. Further, the stability of clinical diagnosis of schizophrenia and affective disorder has been shown to be adequate over illness course [11]. The institutional review board of the University of Toronto approved this study.…”

Section: Penrose Archival Datamentioning

confidence: 99%

See 1 more Smart Citation

Heritability of schizophrenia and major affective disorder as a function of age, in the presence of strong cohort effects

Husted

Greenwood

Bassett

2005

Eur Arch Psychiatry Clin Neurosci

View full text Add to dashboard Cite

It remains unclear whether age at onset for major psychiatric disorders is a useful marker of etiologic and genetic heterogeneity. The authors examined how heritability of schizophrenia and major affective disorders varied with age at onset. The sample was drawn from a large archival data set collected by Lionel Penrose, comprising 3,109 families with two or more members first hospitalized in Ontario between 1874 and 1944. The authors studied 1,295 sibships with schizophrenia (n = 487), major affective disorder (n = 378), both (n = 234) or neither (n = 196) of these disorders. Proportional hazards models were used to estimate how the hazard of hospitalization for each disorder (schizophrenia or major affective disorder) varied with proband age at onset, adjusted for changes in age at onset distribution between 1874 and 1944. A sibling's risk of hospitalization for the same illness significantly increased for each 10-year decrease in age at onset of the proband both for schizophrenia (hazard ratio = 1.21, 95 % confidence interval: 1.06, 1.39), and for affective disorder (hazard ratio = 1.29, 95 % CI: 1.14,1.45). Gender of proband was unrelated to sibling risk of the same illness, and tests of interaction effects between proband age at onset and gender on sibling risk were nonsignificant.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Penrose Archival Datamentioning

confidence: 99%

Heritability of schizophrenia and major affective disorder as a function of age, in the presence of strong cohort effects

Husted

Greenwood

Bassett

2005

Eur Arch Psychiatry Clin Neurosci

View full text Add to dashboard Cite

show abstract

“…Register-based studies rely on data from many clinicians, data that are seldom, if ever, tested for reliability. Most studies find schizophrenia to be a very stable diagnosis (from 75 to 92% still schizophrenia) [8] . Schizophreniform disorder proves to be very unstable in long follow-up studies (from 10 to 19% still schizophreniform) [9,10] .…”

Section: Earlier Findingsmentioning

confidence: 99%

First-Episode Psychosis: Diagnostic Stability over One and Two Years

Haahr

Friis²,

Larsen³

et al. 2008

Psychopathology

View full text Add to dashboard Cite

Background: Diagnostic stability is important for daily clinical work and planning of treatment. The aims of this study were to measure diagnostic stability in a clinical epidemiologic sample and to identify markers of change in diagnosis. Sampling and Methods: Diagnostic stability and change were measured in a sample of 301 patients with first-episode psychosis from four national health care sectors in Norway and Denmark at baseline, 1 and 2 years. Results: Diagnostic stabilities were high for schizophrenia and schizoaffective disorder (85–99%), low for schizophreniform disorder (16–19%), and intermediate for other diagnoses. Diagnostic change from schizophreniform to schizophrenia was frequent in year 1 (72%). Characteristics discriminating schizophreniform patients keeping their diagnosis (i.e. having recovered within 6 months with no relapse) from those developing schizophrenia at 1 year were female gender, better childhood premorbid functioning, shorter duration of untreated psychosis and more severe general psychotic symptoms, especially excitation. Conclusions: Findings provide validation for the DSM-IV categories within the schizophrenic spectrum. The limitations of the study were: the raters were not blind to baseline assessments; patients with longer duration of untreated psychosis were more likely to refuse participation; not all patients were assessed at 1- and 2-year follow-up, but the attrition was rather low.

show abstract

“…– Poor diagnostic reliability: particular patients are frequently diagnosed as suffering from different disorders by different observers at a certain given time (interobserver reliability), or by the same observer over a period of time (test-retest reliability) [3,4]. Diagnostic reliability was significantly increased by the establishment of a nosographic consensus based on operational criteria included in the Diagnostic and Statistical Manual by the American Psychiatric Association [5] and the International Classification of Diseases and Related Health Problems by the World Health Organization [6].…”

Section: On the Inconsistency Of Psychiatrymentioning

confidence: 99%

Misunderstanding Psychopathology as Medical Semiology: An Epistemological Enquiry

Gorostiza

Manes²

2011

Psychopathology

View full text Add to dashboard Cite

In our everyday clinical experience we encounter significant problems directly related to the instability of psychopathological concepts. In order to trace the origin of this inconsistency, the nature of these concepts will be explored in their historical development. They will be compared to those pertaining to medical semiology, paying special attention to the specific nature of the ‘object’ each of them refers to. While concepts belonging to medical semiology refer to natural objects and retain their meaning independently of the patient’s context, psychopathological concepts refer to fragments of experience, which lose their significance if detached from their contextual horizon. The instability of psychopathological concepts is a consequence of the misunderstanding of psychopathology as medical semiology. As an alternative to this view, it will be argued that psychopathology represents an active and never-ending process aimed at the creation of intelligibility.

show abstract

Diagnostic stability in subjects with multiple admissions for psychotic illness

Abstract: The stability levels for schizophrenia and affective disorders are adequate, but the low levels for a range of other psychotic conditions raise questions regarding their predictive validity.

Cited by 34 publications

References 30 publications

Heritability of schizophrenia and major affective disorder as a function of age, in the presence of strong cohort effects

Heritability of schizophrenia and major affective disorder as a function of age, in the presence of strong cohort effects

First-Episode Psychosis: Diagnostic Stability over One and Two Years

Misunderstanding Psychopathology as Medical Semiology: An Epistemological Enquiry

Contact Info

Product

Resources

About