CLINICAL CHARACTERISTICS OF KRAEPELINIAN SCHIZOPHRENIA - REPLICATION AND EXTENSION OF PREVIOUS FINDINGS

Objective: Subtypologies of schizophrenia based on cross-sectional cri teria, such as the nomenclature of the DMSs, have not been successful in identifying valid diagnostic subgroups among patients with schizoph renia. A subtypology that uses criteria to classify individuals on the basis of longitudinal deficits in self-care may identify a more valid subgroup of schizophrenic patients. Methods: This study describes the clinical characteristics of a group of schizophrenic patients identif ied on the basis of a longitudinal criterion: at least 5 years of cont inuous and complete dependence on others for obtaining and maintaining the basic necessities of life, including food, clothing, and shelter. Results: Sixty-one ''Kraepelinian'' schizophrenic inpatients, when co mpared to 80 non-Kraepelinian schizophrenic inpatients who were simila r in years of illness, age, and education, demonstrated more severe ne gative symptoms and more severe formal thought disorder; yet the sever ity of their delusions, hallucinations, and bizarre behavior did not d iffer significantly. None of the Kraepelinian patients and eight non-K raepelinian patients met DSM-III-R criteria for schizoaffective disord er. Conclusions: Data from this replication study suggest that Kraepel inian schizophrenic patients, identified on the basis of a longitudina l course characterized by severe dysfunctions in self-care, may repres ent an alternative, and possibly more valid, method of subtyping schiz ophrenia.