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J E Mezzich

Publications and source records attributed to J E Mezzich.

At least 55 records · Page 3Linked to original sources
PubMed1986

Descriptive validity of DSM-III depressions.

There are five categories of psychiatric disorders in DSM-III that embrace depressive moods: adjustment disorder with depressed mood (group 1), bipolar depression (group 2), major depression (group 3), dysthymic disorder (group 4), and atypical depression (group 5). A large sample of patients seen in a metropolitan university psychiatric referral center, with these categories as primary diagnoses in axis I, constitute the subjects studied (N = 2988). The study includes a comparison of the cross-sectional clinical properties of these patients, including an inventory of psychopathological symptoms, entries in axes II to V (i.e., as described in DSM-III, plus a sixth axis measuring current adjustment) and immediate dispositions rendered by clinicians. This study addresses the descriptive validity of DSM-III diagnostic categories of depression. A clustering of depressions based on a continuum of severity is uncovered as well as unique features of certain subtypes that point to categorical aspects of DSM-III mood disorders. The nature and implication of these findings are discussed.

Adjustment Disorders↗
PubMed1985

International experience with DSM-III.

The authors investigated various aspects of the international use of and experience with DSM-III through a consultation by mail sponsored by the World Psychiatric Association. The respondents were 175 expert diagnosticians nominated as such by the national psychiatric associations of 52 countries spanning all continents. The United States diagnostic system was used by 72% of the participants, only slightly less than the internationally official International Classification of Diseases, Injuries, and Causes of Death, ninth revision (ICD-9) (77%). Furthermore, DSM-III was perceived to be considerably more useful than the current international classification manual. The leading difficulties encountered with DSM-III involved problematic boundaries or definitions of diagnostic categories and the lack of suitable categories in some cases. The most frequent recommendations offered for the advancement of diagnostic systems included the improvement of patient evaluation procedures, the greater use and refinement of multiaxial diagnosis, and the empirical validation of diagnostic systems.

Cross-Cultural Comparison↗
PubMed1985

Severity of illness and diagnostic formulation: classifying patients for prospective payment systems.

The authors review several methods for enhancing the clinical utility of psychiatric diagnostic formulations and their value in predicting resource consumption. They suggest incorporating the concept of severity of illness in a comprehensive diagnostic formulation, using an extended coding schema that includes a rating of severity. Other modifications of DSM-III axes are proposed.

Costs and Cost Analysis↗
PubMed1984

Admission decisions and multiaxial diagnosis.

We comparatively examined the relevance of the various components of an expanded DSM-III diagnostic formulation to admission decisions by studying all 745 new patients who came to a 24-hour walk-in clinic during a six-month period and who were admitted to either inpatient or outpatient care at a comprehensive psychiatric institute. A diagnosis of psychotic disorders was found to be significantly associated with hospitalization, while anxiety disorders, adjustment disorders, personality disorders, and nonmental disorder conditions were associated with outpatient referral. The strongest correlations with hospitalization, however, were obtained for current adaptive functioning and, to a lesser extent, for highest level of adaptive functioning in the past year.

Adolescent↗
PubMed1984

Symptoms and hospitalization decisions.

On the basis of semistructured evaluations of all new patients presenting for care during a 1-year period at a comprehensive psychiatric facility, the authors systematically assessed the relationship between various aspects of the patients' symptoms and hospitalization decisions. The individual symptoms correlating the highest with hospitalization were self-neglect, disorganized thought process, and impulsivity. Even greater correlations, in increasing order, were obtained for the total number of symptoms present, for delusional psychosis (one of the broad factors underlying the patient's symptoms), and for a linear combination composed of self-neglect, impulsivity, suspiciousness, and suicidal indicators.

Adult↗
PubMed1982

A format for DSM-III diagnostic formulation: experience with 1,111 consecutive patients.

The authors present a format that organizes DMS-III diagnoses according to its five axes. For each axis, it provides an ordered listing of several diagnostic categories, their qualification as principal or provisional diagnoses, and alternative categories to be ruled out. For each dimensional axis, the terms and codes of the scale are specified and arranged linearly. This format was used with 1,111 new patients who consecutively applied for care at a comprehensive psychiatric facility during a 6-month period. The authors report on the frequency of use of specific diagnostic categories and dimensional levels along provisional, and rule-out diagnoses were noted.

Adolescent↗
PubMed1980

Depressive symptomatology across the Americas.

We compared depressive symptomatology and its sociocultural context across a Peruvian sample of 93 and a US sample of 64 adult depressive patients. The design involved the interview and evaluation of both groups by a bilingual investigator using Spanish- and English-language versions of the same assessment instruments. A basic commonality of core depressive symptoms and signs was found across samples, which also had similar levels of overall depressive severity. However, more complaints and higher scores on somatic symptoms and daily fluctuation of depression were seen in the Peruvian group, while the US group had higher scores on suicidal manifestations.

Adjustment Disorders↗
PubMed1979

Patterns and issues in multiaxial psychiatric diagnosis.

The multiaxial diagnostic model, consisting in the systematic formulation of a patient's condition according to separate clinical variables of aspects, is receiving increasing attention in several parts of the world. This innovative model promises to improve diagnostic reliability and validity and involves many methodological challenges. This paper reviews patterns and issues in the conceptualization of axial content, number and organization of axes, dimensional versus categorical scaling, and evaluation and further development of multiaxial systems.

Humans↗
PubMed1979

A data-based typology of depressed adolescents.

To develop a data-based classification of depressive adolescents, a face valid depression scale for adolescents was applied to MMPI protocols of 212 adolescent psychiatric patients of ages 12 to 18, to identify a depressive subsample which turned out to have 36 females and 10 males. Complete linkage cluster analysis was applied to this subsample and three hierachically organized depressive groups were obtained: "Restless" and "Socially Frustrated", which joined into a higher order group, and "Endogenous". Discriminant function analysis was applied for differentiating and cross-validating the obtained groups.

Adolescent↗
PubMed1979

Symptomatology of depression in adolescence.

The symptomatology and dimensions of depression in adolescence were studied using the MMPI protocols of 212 adolescent psychiatric patients. A Face Valid Depression Scale for Adolescents was judgmentally developed by five child psychiatrists and psychologists. It included symptoms common to depressive adults and adolescents as well as symptoms peculiar to adolescents, which was confirmed by comparison with adult depression scales. Factor analysis of the scale yielded the following six factors: lack of self-confidence, social abandonment, loss of interests, sadness, somatic symptoms, and acting-out. The second and sixth factors appeared to be particularly characteristic of adolescents.

Adolescent↗
PubMed1978

Evaluating clustering methods for psychiatric diagnosis.

This report represents an empirical evaluation of the major clustering approaches on psychiatric diagnostic data. Experienced psychiatrists, using 17 psychopathological variables, developed 88 archetypal psychiatric patients to represent four diagnostic categories (manic-depressive depressed, manic-depressive manic, simple schizophrenic, and paranoid schizophrenic). Ten computerized methods representative of the major clustering approaches and using various measures of similarity between patients were applied to this data set to develop de novo patient groupings. Evaluative criteria included the concordance of clustering output to the structure of the original data, and clustering replicability. Considerable differences were obtained among clustering methods. The best-ranked procedures were nearest centroid sorting methods and complete and centroid linkage hierarchical methods. The overall poorest ranking were obtained for multivariate normal mixture analysis and facial representation of multidimensional points. Further evaluation of cluster analytic methods on real biological and psychosocial data sets yielded similar rankings.

Bipolar Disorder↗