Related Experiment Videos
Bizarre delusions and DSM-III-R schizophrenia
D Goldman1, D A Hien, G L Haas
1Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213.
The American Journal of Psychiatry
|April 1, 1992
Summary
Bizarre delusions are not a reliable indicator for diagnosing schizophrenia. Patients with bizarre delusions do not form a distinct clinical subgroup, suggesting diagnostic criteria may need revision.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- The Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R) placed significant emphasis on bizarre delusions for schizophrenia diagnosis.
- This emphasis was historically based rather than empirically supported.
- The clinical utility of prioritizing bizarre delusions in schizophrenia diagnosis requires empirical investigation.
Purpose of the Study:
- To determine the diagnostic contribution of bizarre delusions in schizophrenia.
- To ascertain if patients with bizarre delusions represent a clinically distinct subgroup within schizophrenia.
Main Methods:
- Assessed 214 psychotic inpatients for bizarre delusions using DSM-III-R criteria.
- Examined clinical, demographic, neurobehavioral, and neuroimaging correlates in schizophrenic patients.
- Subgroup analysis included CT scans and neuropsychological testing.
Main Results:
- Bizarre delusions showed a sensitivity of 0.79 and a positive predictive power of 0.82 for schizophrenia diagnosis.
- However, specificity was only 0.56.
- Schizophrenic patients with bizarre delusions did not differ from others, except for more severe positive symptoms.
Conclusions:
- The findings question the diagnostic weight given to bizarre delusions in schizophrenia.
- Suggests revising diagnostic criteria for schizophrenia (e.g., DSM-IV) by reducing emphasis on bizarre delusions.
- Empirical data do not support bizarre delusions as a marker for a distinct clinical subtype.