Pope H G, Lipinski J F
Arch Gen Psychiatry. 1978 Jul;35(7):811-28. doi: 10.1001/archpsyc.1978.01770310017001.
Present clinical and research methods of differential diagnosis of schizophrenia and affective psychoses rely very heavily on presenting symptoms and signs, especially in acute psychosis. We have reviewed studies bearing on this issue, including studies of the phenomenology of psychotic illness, outcome, family history, response to treatment with lithium carbonate, and cross-national and historical diagnostic comparisons. We conclude that most so-called schizophrenic symptoms, taken alone and in cross section, have remarkably little, if any, demonstrated validity in determining diagnosis, prognosis, or treatment response in psychosis. In the United States, particularly, overreliance on such symptoms alone results in overdiagnosis of schizophrenia and underdiagnosis of affective illnesses, particularly mania. This compromises both clinical treatment and research.
目前，精神分裂症和情感性精神病的鉴别诊断临床及研究方法在很大程度上依赖于症状和体征，尤其是在急性精神病发作时。我们回顾了与该问题相关的研究，包括精神病性疾病的现象学、转归、家族史、碳酸锂治疗反应以及跨国和历史诊断比较的研究。我们得出结论，大多数所谓的精神分裂症症状，单独来看或从横断面来看，在确定精神病的诊断、预后或治疗反应方面，即便有也几乎没有已证实的有效性。特别是在美国，仅过度依赖这些症状会导致精神分裂症的过度诊断和情感性疾病，尤其是躁狂症的诊断不足。这对临床治疗和研究都造成了损害。
