A comparative study on schizophrenia diagnosed by ICD‐9 and DSM‐III: Course, family history and stability of diagnosis

Abstract

Data from the Taipei Center of the International Pilot Study of Schizophrenia were reanalyzed using the ICD-9 and DSM-III diagnoses at 7-year follow-up. Patients diagnosed as schizophrenic according to DSM-III were shown to be a more homogeneous group in terms of their clinical manifestations, social functions and family psychiatric history than those defined as schizophrenic by ICD-9. The discordant cases of ICD-9 schizophrenia and DSM-III affective disorders were found to be different from the concordant schizophrenic group, but similar to the concordant group of affective disorders diagnosed by ICD-9 and DSM-III. Thirty-five per cent of mood-incongruent psychotic major depressive disorders defined by DSM-III at initial evaluation were diagnosed as schizophrenia at 7-year follow-up.

Symptomatic and diagnostic stability in schizophrenia: a one-year follow-up study

“…The stability of the schizophrenic diagnosis under DSM III-R has not as yet been studied. In our study, this stability was as good as the stability of the schizophrenic diagnosis under DSM III (Helzer et al, 1981;Hwu et al, 1988). We also agree with Lenz et al (1991) who showed a good stability coefficient for schizophrenia under DSM III (86.4%), above ICD9(80«/o)and RDC (77%).…”

“…The issue of diagnostic systems stability is of crucial interest for research. As Hwu et al (1988) expressed, it is only under similar conditions of diagnostic stability that it is reasonable to compare the clinical outcome and familial psychiatric history of schizophrenic patients defined by different diagnostic systems in numerous follow-up studies. Only then could discrepancies and similarities between studies become relevant.…”

“…Many authors have compared the stability of affective and schizophrenic disorders (Winokur, 1974;Kazanetz, 1979;Trainor, 1979;Tsuang et al, 1981), others have studied subtype stability in schizophrenia (Kendlcr et al, 1985) or the stability of schizophrenia under several diagnostic systems, but often with a retrospective methodology (Helzer et al 1977;Brockingtont'M/, 1978;Fenlon etal, 1981;Helzer et al, 1981;McGlashan, 1984;Hwu et al, 1988) except the study of Lcnz et al (1991). Some results are worth considering: the F 7 eighner or DSM III systems seem more stable over time than the Catego, Schneider and New-Haven systems.…”

Diagnostic shifts of functional psychoses in the transition from ICD-9 to ICD-10

“…Die diagnostische Hauptgruppe Schizophrenie wurde in der ICD-10 eingeengt, womit die ICD-10 dem DSM-III und DSM-IV folgt [11,12,19]. Diese Tendenz kann aber auch als Rückwendung in Richtung des Kraepelin-Konzeptes der "Dementia praecox" gesehen werden, das, wie von Jablenski et al [13] gezeigt wurde, wesentlich enger gefasst war als die Schizophrenie im Sinne der ICD-9.…”

“…Es kam weder zu einem Gewinn noch zu einem Verlust an Homogenität bezüglich der psychopathologischen Symptomatik zum Aufnahmezeitpunkt. Die prädiktive Va- lidität dieser diagnostischen Hauptgruppe hat sich, ähnlich wie es für DSM-III und DSM-IV [12,19,23] gezeigt wurde, in der ICD-10 hingegen erhöht: Die Schizophrenie wurde der Tendenz nach noch mehr auf Fälle mit ungünstigem Verlauf eingeengt, wenngleich beispielsweise Klosterkötter [17] betonte, Kraepelins Anschauungen in Hinblick auf den chronischen Krankheitsverlauf seien "nur ganz rudimentär" in die Konzeption der ICD-10-Schizophrenie eingegangen.…”