Lipkowitz M H, Idupuganti S
Am J Psychiatry. 1983 Jan;140(1):52-5. doi: 10.1176/ajp.140.1.52.
The authors mailed 1,227 questionnaires to U.S. psychiatrists at the time of the introduction of DSM-III to ascertain their diagnostic approach to schizophrenia; 25% (N = 301) of the questionnaires were returned. Only 4 symptom categories reached a 50% accordance level, and there was little agreement on combinations of signs or symptoms, including that recommended by DSM-III. A cluster analysis showed some overall patterns: younger respondents and those from the Pacific coast tended to diagnose more closely to DSM-III; older respondents gave more individualistic responses. The authors express concern that research separating schizophrenia from other disorders that are far more effectively treated has not had a substantial effect on the diagnostic practices of U.S. psychiatrists.
在《精神疾病诊断与统计手册》第三版(DSM - III)发布之际,作者们向美国精神科医生邮寄了1227份问卷,以确定他们对精神分裂症的诊断方法;25%(N = 301)的问卷被退回。只有4个症状类别达到了50%的一致水平,对于体征或症状的组合,包括DSM - III推荐的组合,几乎没有达成共识。聚类分析显示了一些总体模式:年轻的受访者以及来自太平洋沿岸的受访者倾向于更接近DSM - III进行诊断;年长的受访者给出的回答更具个性化。作者们表示担心,将精神分裂症与其他治疗效果更好的疾病区分开来的研究,对美国精神科医生的诊断实践并没有产生实质性影响。