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Reliabilities and Agreement Between Systems

Jean Endicott, PhD; John Nee, PhD; Joseph Fleiss, PhD; Jacob Cohen, PhD; Janet B. W. Williams, DSW; Robert Simon, MA

Arch Gen Psychiatry. 1982;39(8):884-889.

Abstract
• We compared the joint frequencies and reliabilities of the following sets of criteria for the diagnosis of schizophrenia: the New Haven Schizophrenia Index; the Carpenter, Strauss, Bartko (4-, 5-, 6-, and 7-item) system; DSM-III; Research Diagnostic Criteria (RDC; full and chronic); the Feighner system; and the 1975 criteria of Taylor and Abrams. The systems, of essentially equal reliability, varied sevenfold in their rates of diagnosing schizophrenia. Patients in whom schizophrenia was diagnosed by the lower-rate systems were likely to receive the same diagnosis by the higher-rate systems. This tends not to be the case when an affective syndrome is present.

Author Affiliations
From the Research Assessment and Training Unit (Drs Endicott and Nee and Mr Simon) and Biometrics Research Department (Dr Williams), New York State Psychiatric Institute; the Department of Psychiatry, College of Physicians and Surgeons (Drs Endicott, Nee, and Williams), and the Division of Biostatistics, School of Public Health (Dr Fleiss), Columbia University; and the Department of Psychology, New York University (Dr Cohen).

Footnotes
Accepted for publication Oct 27, 1981.

Reprint requests to Research Assessment and Training Unit, New York Psychiatric Institute, 722 W 168th St, New York, NY 10032 (Dr Endicott).

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