French clinicians unanimously reject the term ‘schizo-affective’ in favor of two specific French diagnostic categories: the ‘bouffees délirantes polymorphes, Magnan-type’ and the ‘dysthymic schizophrenias’. The present article presents the results of two recent nationwide investigations into French clinicians actual opinions and diagnostic practices in this field. It provides operational definitions based upon empirical diagnostic criteria and compares the two concepts with related concepts from other schools.
A factor analysis of a depression rating scale realized on a French sample of solely depressive patients gives evidence of 6 clearly defined factors having a particularly precise psychopathological meaning. The six factors, which correspond closely to those found in the American analysis of the same scale, span the full range of all principal depressive dimensions extracted from several other major depression rating scales.
SummaryThe traditional French nosology of mood disorders is based upon the classical endogenous vs psychogenic dichotomy. The French Classification of Mental Disorders, established by the National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale or INSERM) refers, however, to a different terminology: psychotic is used instead of endogenous and non-psychotic instead of psychogenic.The present report is an attempt to provide operational definitions for the major categories of depression in French nosology. It is based upon an empirical investigation. Fifty French clinicians selected 5 cases among patients who had been diagnosed as presenting either a psychotic depression, a non-psychotic depression or a schizophrenia with mood disorder. For each patient, the participants evaluated the presence or absence of 100 criteria presented in a list, the List of Integrated Criteria for the Evaluation of Taxonomy in Depressive Disorders (LICET-D 100). The list assembles all diagnostic criteria which have been proposed for a diagnosis of depression in 7 recent classification systems.The data were analyzed in 2 steps. The aim of the first step was to define a basic depressive syndrome, termed “unspecific depressive syndrome”, present in all the depressive disorders, independently of their subtypes. The aim of the second step was to elicit a diagnostic index for distinguishing between psychotic and non-psychotic depression. The operational definitions presented in this report are “empirical” in as much as they have been derived from the evaluation of actual patients. They are “French” in as much as they are based upon data obtained from a representative sample of French psychiatrists. They have a high face validity in that they correspond to and in fact simply translate French diagnostic practices in this field. They finally have a satisfactory discriminative validity in that they “correctly” reclassify 82% of the patients, i.e. achieve agreement with clinical diagnosis in more than 8 cases ont of 10.The present report does not provide and in fact was not designed to elicit information on the predictive or construct validities of French diagnostic practices in the field of depressive disorders.
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