On the Descriptive Validity of ICD-10 Schizophrenia: Empirical Analyses in the Spectrum of Non-Affective Functional Psychoses

Abstract

In order to examine the descriptive validity of ICD-10 schizophrenia, 1,476 consecutively admitted in-patients were included in the present study. ICD-10 schizophrenia (n = 951) was compared with other non-affective psychotic disorders [persistent delusional disorders (n = 51), acute and transient psychotic disorders (n = 116) and schizoaffective disorders (n = 354)] with respect to sociodemographic, symptomatological and other clinical parameters. Analyses revealed that it is possible to distinguish schizophrenia from other non-affective psychotic disorders according to ICD-10 criteria: schizophrenic patients were characterised by more pronounced negative symptoms and a lower global functioning. They were younger than patients with persistent delusional disorders and schizoaffective disorders but older than patients with acute and transient psychotic disorders. The results are in line with a high descriptive validity of ICD-10 schizophrenia and highlight the importance of negative symptoms for this diagnosis.

Classification of Functional Psychoses and Its Implication for Prognosis: Comparison between ICD-10 and DSM-IV

“…For more than 100 years, psychiatrists have known the problem of transient/episodic psychoses. There have been several attempts to comprise cases with prominent psychotic symptoms typical for Bleuler's 'group of schizophrenia' on the one hand and a favourable course typical for Kraepelin's 'manic-depressive insanity' on the other hand to an own diagnostic entity [1,9,10].…”

“…However, based on the experience that some cases with prominent psychotic symptoms typical for 'dementia praecox' are associated with a favourable course typical for 'manic-depressive insanity', Kraepelin's classification was expanded by concepts such as 'schizoaffective psychosis' [3], 'schizophreniform psychosis' [4], 'cycloid psychosis' [5,6] or 'reactive psychosis' [7,8]. In spite of several differences, all these diverse concepts aimed at the delimitation of benign psychotic disturbances with a remitting course from chronic schizophrenic disorders [9,10]. Robins and Guze [1] also pleaded for a differentiation between 'good prognosis schizophrenia' according to the concepts mentioned above and 'poor prognosis schizophrenia', as these were considered to be two separate diagnostic entities.…”

The Mutability of Schizophrenia: From Hafners Epidemiology to Hafners Psychopathology

“…Those who assert that it is rely primarily on factors such as age and gender [53]. Negative symptoms appear to be at least as important as positive symptoms, if not more so.…”

Akute vorübergehende psychotische Störungen (ICD-10: F23)

“…Die Ergebnisse zeigen, dass sich die AVPS gegenüber der Schizophrenie durch eine geringer ausgeprägte Negativsymptomatik auszeichnen, während sich hinsichtlich der Intensität der paranoid-halluzinatorischen Symptomatik in der akuten Episode keine Unterschiede zwischen den beiden Diagnosegruppen finden [6].…”