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Samuel B. Guze, MD; C. Robert Cloninger, MD; Ronald L. Martin, MD; Paula J. Clayton, MD

Arch Gen Psychiatry. 1983;40(12):1273-1276.

Abstract
• The Washington University Psychiatry Clinic, St Louis, study began with the systematic clinical evaluation of a cross section of 500 of the clinic's patients. This was followed by a "blind" follow-up of the index subjects and a blind study of first-degree relatives. This report deals with the diagnosis of schizophrenia at index, at follow-up, and among the firstdegree relatives. The results indicate that the criteria used for the diagnosis of schizophrenia select patients who show a high degree of diagnostic consistency over many years, although not all patients who meet these criteria after follow-up receive the diagnosis of schizophrenia initially. Most important, the diagnostic criteria select cases associated with a strong familial increase in the risk of schizophrenia (nearly fivefold). The follow-up results indicate also that Feighnerpositive schizophrenics often experience intercurrent depressions, but that the presence of such depressions does not affect the familial incidence of either schizophrenia or primary affective disorders.

Author Affiliations
From the Department of Psychiatry, Washington University School of Medicine (Drs Guze and Cloninger), St Louis, and the Jewish Hospital of St Louis (Dr Cloninger). Dr Martin is now with the University of Kansas Medical Center, Kansas City, and Dr Clayton is now with the University of Minnesota, Minneapolis.

Footnotes
Accepted for publication Aug 16, 1983.

Reprint requests to Department of Psychiatry, Washington University School of Medicine, 4940 Audubon Ave, St Louis, MO 63110 (Dr Guze).

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