OBJECTIVE: The purpose of this study was to determine 1) the reliability
of diagnoses of schizophrenia at coronal autopsy and 2) the degree to which
the use of different diagnostic instruments for schizophrenia would affect
postmortem brain research. METHOD: Eighty- three subjects, recorded at
coronal autopsy as having had schizophrenia, were referred for
neurochemistry studies. The diagnoses reported to the state coroner's
office were reevaluated by a review of psychiatric case histories by
clinicians using semistructured assessment and diagnostic criteria.
RESULTS: The application of DSM-III- R, Research Diagnostic Criteria (RDC),
ICD-10, Schneiderian, and Feighner criteria to the diagnosis of the 83
subjects revealed that 63.9%, 48.2%, 48,2%, 43.4%, and 42.2%, respectively,
met the criteria for schizophrenia. Highest concordance was between the RDC
and ICD-10 systems, while lowest concordance was between the RDC and
Schneider systems. CONCLUSIONS: These data suggest that unless carefully
reviewed, diagnosis may be a major confounding factor in postmortem studies
of brain tissue from subjects with schizophrenia.