A comparison of DSM-III and DSM-III-R schizophrenia.

The authors compared DSM-lll and DSM-llI-R definitions ofschizophrenia among 532 inpatients treated in a long-term residential setting and reevaluated an average of 15 years later. Largely by excluding those with nonhizarre delusions (somatic, grandiose, or religious) witl,out hallucinations, DSM-III-R reduced the number of patients diagnosed with schizophrenia by 10%. With the exception of the sign and symptom variables used to define them, the DSM-lII schizophrenic patients included (N 164) and excluded (N 18) by DSM-Ill-R did not differ with respect to demographic, premorbid, or long-terni outcome characteristics. The authors argue that frequent changes in diag;iostic schemes in the absence of evidence of improved validity are likely to impede progress in research. (AmJ Psychiatryi988; 145:1446-1449)