Clinical characteristics of Kraepelinian schizophrenia: replication and extension of previous findings.
OBJECTIVE
Subtypologies of schizophrenia based on cross-sectional criteria, such as the nomenclature of the DSMs, have not been successful in identifying valid diagnostic subgroups among patients with schizophrenia. A subtypology that uses criteria to classify individuals on the basis of longitudinal deficits in self-care may identify a more valid subgroup of schizophrenic patients.


METHODS
This study describes the clinical characteristics of a group of schizophrenic patients identified on the basis of a longitudinal criterion: at least 5 years of continuous and complete dependence on others for obtaining and maintaining the basic necessities of life, including food, clothing, and shelter.


RESULTS
Sixty-one "Kraepelinian" schizophrenic inpatients, when compared to 80 non-Kraepelinian schizophrenic inpatients who were similar in years of illness, age, and education, demonstrated more severe negative symptoms and more severe formal thought disorder; yet the severity of their delusions, hallucinations, and bizarre behavior did not differ significantly. None of the Kraepelinian patients and eight non-Kraepelinian patients met DSM-III-R criteria for schizoaffective disorder.


CONCLUSIONS
Data from this replication study suggest that Kraepelinian schizophrenic patients, identified on the basis of a longitudinal course characterized by severe dysfunctions in self-care, may represent an alternative, and possibly more valid, method of subtyping schizophrenia.
Keefe
R S
RS
Department of Psychiatry, Mount Sinai School of Medicine, New York, USA.
Frescka
E
E
Apter
S H
SH
Davidson
M
M
Macaluso
J M
JM
Hirschowitz
J
J
Davis
K L
KL
D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012648:Self Care; D012720:Severity of Illness Index