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Reliability and validity of the DSM-IV diagnostic category of schizoaffective disorder: preliminary data.

Abstract：

BACKGROUND:Concerns have been expressed about the reliability and validity of the DSM-IV criteria for schizoaffective disorder, but no systematic study has been published up to now. METHODS:The Cohen's kappa for the individual items of the DSM-IV definition of schizoaffective disorder, manic episode and major depressive episode was evaluated in 150 patients independently interviewed by two psychiatrists using the Composite International Diagnostic Interview. The two-year outcome of patients with a consensus DSM-IV diagnosis of schizoaffective disorder was compared to that of patients with DSM-IV schizophrenia and schizophreniform disorder, using the Strauss-Carpenter Outcome Scale. RESULTS:The Cohen's kappa was 0.22 for the diagnosis of schizoaffective disorder, 0.71 for that of manic episode, and 0.82 for that of major depressive episode. Schizoaffective patients had a significantly better outcome than those with schizophrenia but a worse outcome than those with schizophreniform disorder. CONCLUSIONS:The inter-rater reliability of the DSM-IV criteria for schizoaffective disorder is not satisfactory. The better outcome of DSM-IV schizoaffective disorder compared with schizophrenia seems to depend more on the inclusion, in the definition of schizophrenia but not in that of schizoaffective disorder, of the six-month duration and functional impairment criteria than on the different symptomatological patterns of the two conditions. LIMITATION:The size of the sample of patients fulfilling DSM-IV criteria for schizoaffective disorder was small. CLINICAL RELEVANCE:The study suggests that the clinical implications of the currently problematic diagnosis of schizoaffective disorder may be modest.

journal_name

J Affect Disord

journal_title

Journal of affective disorders

authors

Maj M,Pirozzi R,Formicola AM,Bartoli L,Bucci P

doi

10.1016/s0165-0327(99)00059-2

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

95-8

issue

1-3

eissn

0165-0327

issn

1573-2517

pii

S0165032799000592

journal_volume

57

pub_type

杂志文章

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