Diagnostic efficiency of DSM-III schizophrenia.
Using methods and statistics from actuarial decision theory, the authors evaluate the efficiency of constituent criteria and symptoms of DSM-III schizophrenia among 532 diagnostically heterogeneous patients participating in the Chestnut Lodge follow-up study. The conditional probability of meeting the full diagnostic set given each individual and combination of two, three, and four criteria is calculated. The best two-way (characteristic symptoms + absence of affective syndrome) and three way (characteristic symptoms + absence of affective syndrome + 6-month duration) combinations of criteria were associated with 93% and 100% probability of meeting the complete definition. Other criteria were relatively nonspecific. The data suggest that the efficiency and descriptive validity of future definitions of schizophrenia might be improved by including those features unique to the diagnosis and eliminating those that are relatively uninformative.
Fenton
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Chestnut Lodge Research Institute, Rockville, Maryland 20850.
McGlashan
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D000206:Actuarial Analysis; D003662:Decision Theory; D006801:Humans; D011237:Predictive Value of Tests; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis*