Pfuhlmann B, Franzek E, Stöber G, Cetkovich-Bakmas M, Beckmann H
Department of Psychiatry, University of Würzburg, Germany.
Psychopathology. 1997 Mar-Apr;30(2):100-5. doi: 10.1159/000285036.
Twenty-two patients with a diagnosis of schizophrenia according to DSM-III-R and ICD-10 criteria, for whom the long-term courses of illness were all well documented, were classified by 4 independent investigators using Leonhard's classification of endogenous psychoses. With regard to the large nosological groups of cycloid psychoses (including the subtypes of anxiety-happiness psychosis, confusional psychosis and motility psychosis), of unsystematic schizophrenias (including the subtypes of affect-laden paraphrenia, cataphasia and periodic catatonia), and of systematic schizophrenias (divided into systematic catatonias, systematic paraphrenias, and hebephrenias), is was possible to reach a high level of agreement in the diagnosis, representing a Cohen kappa coefficient of 0.82 and 0.89, respectively. In only 2 out of 22 patients were discrepancies observed in the assignment to the above-mentioned groups. This clearly shows the high reliability of Leonhard's classification, which allows a differentiated diagnostic and prognostic judgement of schizophrenic psychoses according to the DSM-III-R and ICD-10.
根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）和国际疾病分类第十版（ICD-10）标准诊断为精神分裂症的22例患者，其长期病程均有详细记录，由4名独立研究人员采用莱昂哈德的内源性精神病分类法进行分类。关于循环型精神病的大类（包括焦虑-欣快性精神病、错乱性精神病和运动性精神病亚型）、非系统性精神分裂症（包括情感丰富性类偏狂、言语紊乱和周期性紧张症亚型）以及系统性精神分裂症（分为系统性紧张症、系统性类偏狂和青春型精神分裂症），在诊断中能够达成高度一致，科恩kappa系数分别为0.82和0.89。在22例患者中，仅有2例在上述分组归属上存在差异。这清楚地表明了莱昂哈德分类法的高可靠性，它能够根据DSM-III-R和ICD-10对精神分裂症进行有区别的诊断和预后判断。
