The Diagnostic Efficiency of the Rorschach Depression Index and the Schizophrenia Index: A Review

Abstract

This review focuses on the diagnostic efficiency of the new versions of the Rorschach Comprehensive System Depression Index (DEPI) and the Schizophrenia Index (SCZI). Clinical diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders was chosen as the external validation criteria. The sensitivity, specificity, and overall classification rates for the indices were presented from the studies or computed from the data when possible. The positive and negative predictive validity was estimated at three different base rates. As regards the DEPI the results showed a large variation in diagnostic performance as the index seemed to have relatively more success in identifying nonpsychotic and unipolar depression than psychotic and bipolar depression. The DEPI did not successfully identify depression among adolescent patients. As regards the SCZI the results more consistently indicated that the index effectively discriminates between psychotic and nonpsychotic patients and the predictive validity of both a positive and negative SCZI was found to be high.

Association of Rorschach and MMPI Psychosis Indicators and Schizophrenia Spectrum Diagnoses in a Russian Clinical Sample

“…The base rate of schizophrenia spectrum disorders in the sample was roughly comparable to base rates in clinical samples reviewed by Jørgensen et al (2000). Using ICD-10 primary chart diagnoses, 51% of participants had a schizophrenia spectrum disorder (as compared to 28% to 50% in the studies reviewed by Jørgensen et al, 2000), 23% had depression, 2% had a manic or mixed episode, 14% had schizoaffective disorder, and 10% had other disorders such as alcoholism or epilepsy.…”

“…Using ICD-10 primary chart diagnoses, 51% of participants had a schizophrenia spectrum disorder (as compared to 28% to 50% in the studies reviewed by Jørgensen et al, 2000), 23% had depression, 2% had a manic or mixed episode, 14% had schizoaffective disorder, and 10% had other disorders such as alcoholism or epilepsy.…”

“…Meta-analyses by Jørgensen et al (2000) found a sensitivity of about .70 and a specificity of about .80, with the precise figures varying depending on the criteria used for selecting studies into the meta-analysis. Recent studies Stokes, Pogge, Grosso, & Zaccario, 2001) of child samples have also found support for the validity of the SCZI.…”

“…Recent studies have supported the validity of the SCZI in differentiating between psychotic and nonpsychotic patients in clinical samples (reviewed by Jørgensen, Andersen, & Dam, 2000; also see Lindgren, 1995). Meta-analyses by Jørgensen et al (2000) found a sensitivity of about .70 and a specificity of about .80, with the precise figures varying depending on the criteria used for selecting studies into the meta-analysis.…”

“…In their review of the contemporary international literature on the diagnostic efficiency of the SCZI, Jørgensen et al (2000) reported some data collected outside of North America. For example, in a Finnish sample, the SCZI performed well in differentiating patients with schizophrenia from a control group of patients with depression (Ilonen et al, 1999).…”