title: Bizarre delusions and DSM-III-R schizophrenia.
abstract: OBJECTIVE
  Bizarre delusions are assigned greater weight relative to other delusions in the DSM-III-R diagnosis of schizophrenia. The decision to emphasize bizarre delusions was based largely on historical tradition rather than empirical evidence. This study examined 1) the extent to which a history of bizarre delusions contributes to the diagnosis of schizophrenia and 2) whether schizophrenic patients with bizarre delusions constitute a clinically distinguishable subgroup.
  
  
  METHODS
  Two hundred fourteen consecutively admitted psychotic inpatients were assessed for bizarre delusions according to the DSM-III-R criteria. Clinical and demographic correlates of bizarre delusions were examined in subsets of patients diagnosed as schizophrenic according to DSM-III-R who also received CT scans and neuropsychological testing.
  
  
  RESULTS
  With the base prevalence rate for schizophrenia of 0.71, bizarre delusions had a sensitivity of 0.79, a specificity of 0.56, and a positive predictive power of 0.82 for the diagnosis of schizophrenia (N = 152) relative to other psychotic disorders (N = 62). Clinical, neurobehavioral, CT scan, and premorbid adjustment data on the schizophrenic patients indicated that beyond manifesting more severe positive symptoms, patients with bizarre delusions did not otherwise constitute a clinically distinguishable subgroup.
  
  
  CONCLUSIONS
  The data suggest that criterion A for the diagnosis of schizophrenia in DSM-IV could be improved by removing the special emphasis that was placed on bizarre delusions in DSM-III-R.
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213.
authors.forename: D
authors.initials: D
authors.lastname: Goldman
authors.forename: D A
authors.initials: DA
authors.lastname: Hien
authors.forename: G L
authors.initials: GL
authors.lastname: Haas
authors.forename: J A
authors.initials: JA
authors.lastname: Sweeney
authors.forename: A J
authors.initials: AJ
authors.lastname: Frances
mesh_terms: D000293:Adolescent; D000328:Adult; D003702:Delusions / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis*; D012565:Schizophrenic Psychology