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

Psychol Med. 1992 May;22(2):367-78. doi: 10.1017/s0033291700030312.


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 poly-diagnostic 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Delusions / classification
  • Delusions / diagnosis
  • Delusions / psychology
  • Female
  • Hallucinations / classification
  • Hallucinations / diagnosis
  • Hallucinations / psychology
  • Humans
  • Male
  • Psychiatric Status Rating Scales / statistics & numerical data*
  • Psychometrics
  • Psychotic Disorders / classification
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / psychology
  • Schizophrenia / classification
  • Schizophrenia / diagnosis
  • Schizophrenic Psychology
  • Thinking