THE CONVERGENCE BETWEEN DIFFERENT DEFINITIONS OF FUNCTIONAL PSYCHOSES

The purpose of this study was to investigate the mutual concordance be tween different definitions of functional psychoses, including ICD-10. The operational criteria checklist (OPCRIT) was applied to 168 patien ts with clinical diagnoses of psychotic and affective disorders. The m ain sources of OPCRIT ratings were the ninth and tenth versions of pre sent-state examination (68%), and formal psychiatric interview with ch art reviews constituted the remaining source (32%). Mutual concordance between different definitions of schizophrenia, mania, depressive dis orders (atypical psychosis, schizophreniform, schizoaffective, and oth er functional psychotic disorders) was calculated. On the average, a m odest concordance level was found for schizophrenia and depressive dis orders (0.52, 0.50, respectively) and a good concordance level for man ia (0.67). Mutual concordance levels between ICD-10, DSM-III, DSM-III- R, and RDC definitions for schizophrenia, mania, and depression ranged from good to excellent. Old diagnostic systems tend to have lower con cordance levels. Poor concordance levels between different definitions of nonschizophrenic and nonaffective psychoses were found. Although t he findings of this study indicate that recent definitions of diagnost ic systems are comparable, a multidiagnostic approach to assess patien ts with mental disorders is recommended.