The convergence between different definitions of functional psychoses

Abstract

The purpose of this study was to investigate the mutual concordance between different definitions of functional psychoses, including ICD-10. The operational criteria checklist (OPCRIT) was applied to 168 patients with clinical diagnoses of psychotic and affective disorders. The main sources of OPCRIT ratings were the ninth and tenth versions of present-state examination (68%), and formal psychiatric interview with chart reviews constituted the remaining source (32%). Mutual concordance between different definitions of schizophrenia, mania, depressive disorders (atypical psychosis, schizophreniform, schizo-affective, and other functional psychotic disorders) was calculated. On the average, a modest concordance level was found for schizophrenia and depressive disorders (0.52, 0.50, respectively) and a good concordance level for mania (0.67). Mutual concordance levels between ICD-10, DSM-III, DSM-III-R. and RD definitions for schizophrenia, mania, and depression ranged from good to excellent. Old diagnostic systems tend to have lower concordance levels. Poor concordance levels between different definitions of nonschizophrenic and non-affective psychoses were found. Although the findings of this study indicate that recent definitions of diagnostic systems are comparable, a multidiagnostic approach to assess patients with mental disorders is recommended.

Key Words:

• Functional psychoses
• ICD-10
• Mania
• Schizophrenia