Hierarchical arrangement of psychiatric symptoms in the context of schizophrenia

Foulds' model proposing a four-class hierarchical structure of mental illne ss represents an interesting dimension of psychiatric research and discussi on and probably has a significant potential on diagnosis, taxonomy, therape utics and theory. Psychiatric symptoms were Investigated In a group of 244 schizophrenic patients with the purpose of analyzing Foulds and Bedford's n otion that psychiatric symptoms are arranged hierarchically. To achieve thi s the R (recent) version of the Delusions, Symptoms, States, Inventory (DSS I) was administered in the form of a constructed interview to these patient s. The hierarchical arrangement of psychiatric symptoms was verified since a great majority of the cases (80.8%) produced symptom patterns conforming to the hierarchy model. However, patients with duration of illness longer t han 10 years reported conforming patterns in a lower percentage (77%), wher eas 84.6% of those with a duration of illness less than 2 years reported co nforming patterns. The non-conforming patterns were those in which integrat ed delusions were absent in the presence of delusions of disintegration, ne urotic symptoms were absent in the presence of integrated delusions, and dy sthymic states were absent in the presence of neurotic symptoms. (C) 2001 E ditions scientifiques et medicales Elsevier SAS.