Classification of functional psychoses and its implication for prognosis: comparison between ICD-10 and DSM-IV.
BACKGROUND
The aim was to examine the agreement and differences between ICD-10 and DSM-IV in the classification of functional psychoses.


METHODS
In a sample of 218 first-hospitalised patients, ICD-10 diagnoses were compared with DSM-IV diagnoses. Functional psychoses of both diagnostic systems were classified into the four diagnostic groups schizophrenia, transient/episodic psychoses, delusional disorders and affective disorders. Based on information from a 15-year follow-up, it was examined which course is associated with each diagnostic group.


RESULTS
Although in ICD-10 there was a higher frequency of schizophrenia and a lower one of affective disorders, a high agreement between ICD-10 and DSM-IV (kappa value of 0.82) was found. In both diagnostic systems, transient/episodic psychoses and affective disorders were mainly associated with a non-chronic course and schizophrenia was mainly associated with a chronic one. Nevertheless, several patients with transient/episodic psychoses showed a chronic course (ICD-10: 10%, DSM-IV: 15%) and more than one third of patients with schizophrenia a non-chronic one (ICD-10: 40%, DSM-IV: 33%).


CONCLUSIONS
In the cross-sectional assessment, there is a high diagnostic agreement between ICD-10 and DSM-IV. With respect to the long-term course, the delimitation of transient/episodic psychoses from schizophrenia was neither completely achieved by ICD-10 nor by DSM-IV.
Jäger
Markus
M
Department of Psychiatry, Ludwig-Maximilians University, Munich, Germany. markus.jaeger@psy.med.uni-muenchen.de
Bottlender
Ronald
R
Strauss
Anton
A
Möller
Hans-Jürgen
HJ
D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000145:classification* / Q000175:diagnosis* / Q000523:psychology; D012680:Sensitivity and Specificity