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Outcome of Schizophrenic Subtypes Defined by Four Diagnostic Systems
Kenneth S. Kendler, MD;
Alan M. Gruenberg, MD;
Ming T. Tsuang, MD, PhD, DSc
Arch Gen Psychiatry. 1984;41(2):149-154.
Abstract
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• This report examines the short- and long-term outcome of the subtypes of schizophrenia as defined by four diagnostic systems: DSM-III, Research Diagnostic Criteria, Ninth Revision of the International Classification of Diseases, and the Tsuang-Winokur (T-W) criteria. Patients were from the Iowa 500 study and met Washington University criteria for schizophrenia. Subtype diagnosis was based on extensive chart material reviewed by investigators blind to outcome. Short-term outcome, based on chart information, and long-term outcome, based on individual field follow-up, were both better for paranoid than for nonparanoid schizophrenia, the difference being greatest using the T-W criteria. The difference in outcome between paranoid and nonparanoid schizophrenia was greater at long-term than at short-term follow-up, and greater using residential and occupational than psychiatric outcome criteria. Outcome did not differ for the two common forms of nonparanoid schizophrenia: hebephrenic and undifferentiated. The subtyping of schizophrenia has important predictive validity, which was greatest using the T-W criteria.
Author Affiliations
From the Departments of Psychiatry and Human Genetics, Medical College of Virginia, Richmond (Dr Kendler); the Yale Psychiatric Institute, Department of Psychiatry, Yale University School of Medicine, New Haven, Conn (Dr Gruenberg); and the Department of Psychiatry and Human Behavior, Brown University, and the Psychiatric Epidemiology Research Unit, Butler Hospital, Providence, RI (Dr Tsuang).
Footnotes
Accepted for publication July 18, 1983.
Reprint requests to Psychiatric Epidemiology Research Unit, Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906 (Dr Tsuang).
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