The Nordic concept of reactive psychosis – a multicenter reliability study

Abstract

Reactive psychosis is a common diagnosis in the Nordic countries (Norway, Sweden, Denmark, Finland and Iceland) and in several other parts of the world. In ICD-9 and DSM-III-R, the concept is defined more narrowly than in the Nordic tradition. In this study we examined the interrater reliability of the Nordic concept by the case-summary method between clinicians from 9 university departments in the Nordic countries. The results show that Nordic psychiatrists have a reasonably reliable concept of reactive psychosis, and that this psychosis can be diagnosed as reliably as schizophrenia and affective psychosis.

Prenatal and perinatal risk factors for schizophrenia, affective psychosis, and reactive psychosis of early onset: case-control study Prenatal and perinatal risk factors for early onset schizophrenia, affective psychosis, and reactive psychosis

“…Scandinavian psychiatrists have a reasonably reliable concept of reactive psychosis,18 but we suspect that some of the cases of reactive psychosis in our study might have been diagnosed as schizophrenia in other countries.…”

Reactive Psychoses Revisited

“…The diagnosis therefore depends less on certain well-circumscribed symptom clusters, than the totality of the clinical picture. Recent multicentre reliability studies [10,11] and persuasively written case reports [12][13][14] attest to the presence, and ease of recognition, of reactive psychoses.…”

Reactive psychosis: A classical category nearing extinction?

“…As with any diag-nostic activity in psychiatry, the psychiatrist's knowledge, clinical skills, experience and empathy certainly play roles in establishing the diagnosis of reactive psychosis. Despite the involvement of these subjective components in the diagnostic process, recent research has concluded that reactivity, which is the core of the diagnosis of reactive psychosis, has an acceptable level of reliability between clinicians from different countries, 13,14 which supports the face validity of reactive psychosis. As mentioned earlier, unlike most diagnostic categories in modern classifications, reactive psychosis cannot be diagnosed only by its symptom profile.…”