The authors mailed 1,227 questionnaires to U.S. psychiatrists at the time of the introduction of DSM-III to ascertain their diagnostic approach to schizophrenia; 25% (N = 301) of the questionnaires were returned. Only 4 symptom categories reached a 50% accordance level, and there was little agreement on combinations of signs or symptoms, including that recommended by DSM-III. A cluster analysis showed some overall patterns: younger respondents and those from the Pacific coast tended to diagnose more closely to DSM-III; older respondents gave more individualistic responses. The authors express concern that research separating schizophrenia from other disorders that are far more effectively treated has not had a substantial effect on the diagnostic practices of U.S. psychiatrists.