Am J Psychiatry 1988; 145:1446-1449
Copyright © 1988 by American Psychiatric Association
A comparison of DSM-III and DSM-III-R schizophrenia
WS Fenton, TH McGlashan and RK Heinssen
Chestnut Lodge Research Institute, Rockville, MD 20850.
The authors compared DSM-III and DSM-III-R definitions of schizophrenia
among 532 inpatients treated in a long-term residential setting and
reevaluated an average of 15 years later. Largely by excluding those with
nonbizarre delusions (somatic, grandiose, or religious) without
hallucinations, DSM-III-R reduced the number of patients diagnosed with
schizophrenia by 10%. With the exception of the sign and symptom variables
used to define them, the DSM-III schizophrenic patients included (N = 164)
and excluded (N = 18) by DSM-III-R did not differ with respect to
demographic, premorbid, or long-term outcome characteristics. The authors
argue that frequent changes in diagnostic schemes in the absence of
evidence of improved validity are likely to impede progress in research.
