The diagnosis and understanding of schizophrenia. Summary and conclusions.
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Biomedical subjects
Publications and source records attributed to W T Carpenter.
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Behavioral data on a large patient group were collected by investigators from nine countries in the International Pilot Study of Schizophrenia, sponsored by the World Health Organization. The data on half the group were analyzed to derive a system of 12 signs and symptoms for the identification of schizophrenia, as this disorder is diagnosed in many centers throughout the world. The findings were replicated with the other half of the patient group. The criteria constitute an operational method for identifying patients who would be commonly considered schizophrenic in many centers.
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Schizophrenia is a heterogeneous clinical syndrome and this variability may reflect differences in etiology and pathophysiology. Such heterogeneity could be responsible for the difficulties in research when all patients with schizophrenia are included in the same group. Subgroups of more clinical homogeneity are more likely to be homogeneous for the presumed pathophysiology of interest. Primary, enduring negative symptoms have been proposed to designate the deficit syndrome. The data obtained in the recent years and summarized in this review show that negative symptoms broadly defined are less effective for subgrouping schizophrenia and that the deficit syndrome is a different domain within schizophrenia.