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Biomedical subjects

R L Spitzer

Publications and source records attributed to R L Spitzer.

At least 91 records · Page 5Linked to original sources
PubMed1983

A revised decision tree for the DSM-III differential diagnosis of psychotic patients.

Clinician-researchers involved in developing DSM-III found that the decision tree for the differential diagnosis of psychotic features that appears in the manual does not accurately or clearly represent the logic of the classification. They present a revised decision tree that is more accurate, simpler, and clearer and that they believe will greatly facilitate the tree's use in teaching and clinical practice. A revised criterion for major depressive episode and manic episode (criterion C), which was published in the third and subsequent printings of DSM-III, is also discussed.

Bipolar Disorder↗
PubMed1982

Reliability in the DSM-III field trials: interview v case summary.

A study compared the reliability of psychiatric diagnoses obtained from the live interviews and from case summaries, on the same patients, by the same clinicians, using the same DSM-III diagnostic criteria. The results showed that the reliability of the major diagnostic classes of DSM-III was higher when diagnoses were made from live interviews than when they were made from case summaries. We conclude that diagnoses based on information contained in traditionally prepared case summaries may lead to an underestimation of the reliability of diagnoses made based on information collected during a "live" interview.

Adolescent↗
PubMed1982

Research diagnostic criteria and DSM-III: an annotated comparison.

For several years the Research Diagnostic Criteria (RDC) have been used widely by investigators to select and describe research subjects. These criteria were used as the initial basis for the specified diagnostic criteria for the major diagnostic categories of DSM-III. With the availability of DSM-III in early 1980, research investigators involved in ongoing studies using the RDC and those planning future studies need to understand the relationship between these two systems so that they can make an informed decision about the use of these systems in their work. We compared each of the RDC categories with the corresponding DSM-III categories and determined major differences in the way the systems define many of the categories and the reasons form these differences. We delineated some of the issues that need to be considered when making decisions about which sets of criteria to use in research studies.

Humans↗
PubMed1982

Supervising intake diagnosis. A psychiatric 'Rashomon'.

Psychiatric diagnoses based on data collected during routine clinical intake evaluations done by trainees are often later used in research studies and in program evaluation. It is commonly assumed that the supervisory process can effectively overcome errors that trainees make in diagnosis. We designed a study to assess the adequacy of patient-in-absentia supervision for ensuring accurate psychiatric diagnoses. In 30% of the cases there were major diagnostic disagreements between the supervised diagnoses and consensus diagnoses based on information provided by both the trainee and an experienced clinician who sat in on the trainee's initial interview. These findings have implications for clinical care, training, and research.

Adult↗
PubMed1982

Edited correspondence on the status of homosexuality in DSM-III.

In 1973, after a prolonged period of social agitation and professional conflict, the American Psychiatric Association deleted homosexuality from its official listing of psychiatric disorders (DSM-II). In its place a new classification for homosexuals distressed over their orientation was to be included in DSM-II. Four years later an acrimonious dispute surfaced over the status of homosexuality in the revised APA nomenclature of disorders (DSM-III). The edited correspondence of the participants in this dispute is presented here as a way of revealing the lingering conflict over homosexuality within American psychiatry.

History, 20th Century↗
PubMed1982

DSM-III: rationale, basic concepts, and some differences from ICD-9.

This paper reviews the major innovations in approach to psychiatric diagnosis incorporated into DSM-III. These include the classification of mental disorders according to shared descriptive clinical features, the use of specified diagnostic criteria for making psychiatric diagnoses, and the multiaxial system of patient evaluation. It describes the principal revisions of diagnostic concepts in DSM-III from several areas of classification, such as Schizophrenia and Affective Disorders, that account for some of the differences between DSM-III and ICD-9. The rationale for the changes in approach and in basic diagnostic concepts at the time of DSM-III's publication is presented. More recent evidence concerning the validity of newly-conceptualized categories is also included.

Adjustment Disorders↗
PubMed1982

Hysteroid dysphoria: an unsuccessful attempt to demonstrate its syndromal validity.

Hysteroid dysphoria has been described as a chronic illness characterized by recurrent periods of depression precipitated by a specific type of stress and associated with a histrionic personality. In addition, there are specific atypical symptoms. The authors tested the syndromal validity of this proposed category in a sample of 1,324 patients with mild depression reported on by psychiatrists in a questionnaire survey. They found 41 (3.1%) who fit a pattern consisting of the basic features of the condition. However, patients who fit this pattern were not more likely to have substantially more atypical symptoms than patients without this pattern. The authors conclude that the syndromal validity of hysteroid dysphoria is not supported.

Adult↗
PubMed1981

Teaching and learning DSM-III.

This article presents recommendations for training programs in DSM-III to help counter feelings of apprehension expressed by many mental health professionals over the transition to the new nomenclature and its multiaxial evaluation system. The authors suggest educational objectives, didactic curricula, and methods for training in the clinical application of DSM-III and discuss supervising the use of DSM-III in patient intake and evaluation. Thorough mastery of DSM-III should not be expected after a limited program; learning its strengths and limitations will be a continuing process.

Adult↗