OBJECTIVE: The authors evaluated the interrater reliability of ratings
of bizarre delusions, addressing limitations of previous studies. METHOD:
Fifty randomly selected psychiatrists rated bizarre delusions in 30 case
vignettes adapted from a previous study by Spitzer and associates.
Estimates of reliability were obtained for definitions of bizarre delusions
in the DSM-III, DSM-III-R, and draft DSM-IV criteria for schizophrenia and
for the clinicians grouped according to their current and previous
experience with psychotic patients. RESULTS: The kappas for ratings of
bizarre delusions according to the different definitions and among
clinicians with different levels of experience were in the moderate to fair
range. CONCLUSIONS: The reliability of ratings of bizarre delusions appears
to be less than satisfactory for clinical practice, and the increased
weight given to this symptom in modern diagnostic systems does not seem
justifiable.Abstract Teaser