Bizarre delusions and DSM-III-R schizophrenia

Dodi Goldman, Denise A. Hien, Gretchen L. Haas, John A. Sweeney, Allen J. Frances

Research output: Contribution to journalArticle

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Abstract

Objective: Bizarre delusions are assigned greater weight relative to other delusions in the DSM-III-R diagnosis of schizophrenia. The decision to emphasize bizarre delusions was based largely on historical tradition rather than empirical evidence. This study examined 1) the extent to which a history of bizarre delusions contributes to the diagnosis of schizophrenia and 2) whether schizophrenic patients with bizarre delusions constitute a clinically distinguishable subgroup. Method: Two hundred fourteen consecutively admitted psychotic inpatients were assessed for bizarre delusions according to the DSM-III-R criteria. Clinical and demographic correlates of bizarre delusions were examined in subsets of patients diagnosed as schizophrenic according to DSM-III-R who also received CT scans and neuropsychological testing. Results: With the base prevalence rate for schizophrenia of 0.71, bizarre delusions had a sensitivity of 0.79, a specificity of 0.56, and a positive predictive power of 0.82 for the diagnosis of schizophrenia (N=152) relative to other psychotic disorders (N=62). Clinical, neurobehavioral, CT scan, and premorbid adjustment data on the schizophrenic patients indicated that beyond manifesting more severe positive symptoms, patients with bizarre delusions did not otherwise constitute a clinically distinguishable subgroup. Conclusions: The data suggest that criterion A for the diagnosis of schizophrenia in DSM-IV could be improved by removing the special emphasis that was placed on bizarre delusions in DSM-III-R.

Original languageEnglish (US)
Pages (from-to)494-499
Number of pages6
JournalAmerican Journal of Psychiatry
Volume149
Issue number4
StatePublished - 1992

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Delusions
Diagnostic and Statistical Manual of Mental Disorders
Schizophrenia
Psychotic Disorders
Inpatients
Research Design
Demography
Weights and Measures

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Goldman, D., Hien, D. A., Haas, G. L., Sweeney, J. A., & Frances, A. J. (1992). Bizarre delusions and DSM-III-R schizophrenia. American Journal of Psychiatry, 149(4), 494-499.

Bizarre delusions and DSM-III-R schizophrenia. / Goldman, Dodi; Hien, Denise A.; Haas, Gretchen L.; Sweeney, John A.; Frances, Allen J.

In: American Journal of Psychiatry, Vol. 149, No. 4, 1992, p. 494-499.

Research output: Contribution to journalArticle

Goldman, D, Hien, DA, Haas, GL, Sweeney, JA & Frances, AJ 1992, 'Bizarre delusions and DSM-III-R schizophrenia', American Journal of Psychiatry, vol. 149, no. 4, pp. 494-499.
Goldman D, Hien DA, Haas GL, Sweeney JA, Frances AJ. Bizarre delusions and DSM-III-R schizophrenia. American Journal of Psychiatry. 1992;149(4):494-499.
Goldman, Dodi ; Hien, Denise A. ; Haas, Gretchen L. ; Sweeney, John A. ; Frances, Allen J. / Bizarre delusions and DSM-III-R schizophrenia. In: American Journal of Psychiatry. 1992 ; Vol. 149, No. 4. pp. 494-499.
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