PROBLEM OF DIAGNOSIS IN POSTMORTEM BRAIN STUDIES OF SCHIZOPHRENIA

Objective: The purpose of this study was to determine 1) the reliabili ty of diagnoses of schizophrenia at coronal autopsy and 2) the degree to which the use of different diagnostic instruments for schizophrenia would affect postmortem brain research. Method: Eighty-three subjects , recorded at coronal autopsy as having had schizophrenia, were referr ed for neurochemistry studies. The diagnoses reported to the state cor oner's office were reevaluated by a review of psychiatric case histori es by clinicians using semistructured assessment and diagnostic criter ia. Results: The application of DSM-III-R, Research Diagnostic Criteri a (RDC), ICD-10, Schneiderian, and Feighner criteria to the diagnosis of the 83 subjects revealed that 63.9%, 48.2%, 48.2%, 43.4%, and 42.2% , respectively, met the criteria for schizophrenia. Highest concordanc e was between the RDC and ICD-10 systems, while lowest concordance was between the RDC and Schneider systems. Conclusions: These data sugges t that unless carefully reviewed, diagnosis may be a major confounding factor in postmortem studies of brain tissue from subjects with schiz ophrenia.