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Diagnostic concordance in functional psychosis revisited: a study of inter-relationships between alternative concepts of psychotic disorder

Published online by Cambridge University Press:  09 July 2009

Patrick D. McGorry ,
Bruce S. Singh ,
Sheryl Connell ,
Dean McKenzie ,
Raphael J. Van Riel  and
David L. Copolov
Patrick D. McGorry*
Affiliation:
National Health and Medical Research Council Schizophrenia Research Unit, Royal Park Hospital, Melbourne, Australia
Bruce S. Singh
Affiliation:
National Health and Medical Research Council Schizophrenia Research Unit, Royal Park Hospital, Melbourne, Australia
Sheryl Connell
Affiliation:
National Health and Medical Research Council Schizophrenia Research Unit, Royal Park Hospital, Melbourne, Australia
Dean McKenzie
Affiliation:
National Health and Medical Research Council Schizophrenia Research Unit, Royal Park Hospital, Melbourne, Australia
Raphael J. Van Riel
Affiliation:
National Health and Medical Research Council Schizophrenia Research Unit, Royal Park Hospital, Melbourne, Australia
David L. Copolov
Affiliation:
National Health and Medical Research Council Schizophrenia Research Unit, Royal Park Hospital, Melbourne, Australia
*
1Address for correspondence: Dr P. D. McGorry, NH & MRC Schizophrenia Research Unit, Royal Park Hospital, Private Bag 3, parkville, victoria 3052, Australia.
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Synopsis

More than a decade ago, a series of retrospective studies examined the concordance between proliferating definitions of severe psychiatric disorder. The European response has been a polydiagnostic one, which has attempted to maintain interest in a broad range of psychiatric phenomena in the psychoses. In North America a more convergent approach has emerged, resulting in a series of operational definitions evolving from one another, and a correspondingly limited capacity to allow alternative perspectives to co-exist. The present study uses a prospective design as well as recent improvements in the clinical validity of psychopathology assessment to re-evaluate the relationships between competing concepts of psychotic illness in a broad sample (N = 176) of recent-onset psychotic patients. In the schizophrenic group, concordance was predictably highest among recent North American ‘cousins’, and lowest among various historical concepts. There was a moderately high concordance between selected schizoaffective and atypical psychosis definitions, indicating that this component is an important area for further studies of descriptive validity. These interrelationships may be used as a starting point to explore latent classes underlying the phenomena of functional psychosis.

Type
Original Articles
Information
Psychological Medicine , Volume 22 , Issue 2 , May 1992 , pp. 367 - 378
Copyright
Copyright © Cambridge University Press 1992

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