SYMPTOM ASSESSMENT IN CASENOTES AND THE CLINICAL-DIAGNOSIS OF SCHIZOPHRENIA

It is well known from several international studies that the incidence rates for schizophrenia, based on first-admission samples, are low in Denmark, especially in females, compared with other countries. This m ight be due to special diagnostic traditions in Denmark. To analyze ho w Danish psychiatrists reach a diagnosis of schizophrenia, a stratifie d subsample of 122 cases out of all 1,259 patients, aged between 12 an d 64 years, with a first hospital admission in 1976 under the diagnosi s of schizophrenia, paranoid psychosis, acute reactive paranoid psycho sis, or casus limitaris was selected. For this subsample, psychopathol ogical symptoms, as documented in the clinical case-notes, were rated by PSE-9 symptom lists for subsequent CATEGO analysis. The core syndro me of schizophrenia, as defined by the CATEGO class S+, showed no asso ciation with the clinical schizophrenia diagnosis compared with the ot her diagnoses mentioned. Also, positive symptoms of schizophrenia did not determine the diagnosis, but for typical negative symptoms such as sociations were indicated. Some negative symptoms also seemed to be li nked to a depressive state. Furthermore, the present work indicates th at using first-admission data leads to a higher age at schizophrenia o nset and a lower first-admission rate in Denmark compared with Germany .