PMID- 7814346
OWN - NLM
STAT- MEDLINE
DCOM- 19950207
LR  - 20061115
IS  - 0160-6689 (Print)
IS  - 0160-6689 (Linking)
VI  - 55
IP  - 12
DP  - 1994 Dec
TI  - Diagnostic reassessment and treatment response in schizophrenia.
PG  - 528-32
AB  - BACKGROUND: The reasons for poor treatment response in some patients with 
      schizophrenia remain unclear. It is possible that misdiagnosis of 
      nonschizophrenic disorders as schizophrenia could result in suboptimal 
      pharmacotherapy in some patients. METHOD: To assess this possibility, 110 
      severely ill, chronic patients with a referral diagnosis of schizophrenia were 
      comprehensively assessed and rediagnosed according to DSM-III-R criteria. Global 
      Assessment of Function (GAF) and Clinical Global Impressions (CGI) ratings were 
      made at admission and at discharge from the ward, after the implementation of 
      individualized treatment plans. RESULTS: The diagnosis of schizophrenia was 
      confirmed in 80 patients (73%) and revised to another type of psychotic illness 
      in 30 patients (27%). The GAF and CGI ratings were similar at admission in 
      patients with confirmed and revised diagnoses. All patients improved by the time 
      of discharge (p = .0001); however, patients with a revised diagnosis improved 
      more than those with confirmed schizophrenia (p = .02). Patients with a revised 
      diagnosis were less likely to require continued hospitalization on chronic care 
      wards (p = .004). At admission, medication regimens were similar in the two 
      groups of patients. At discharge, patients with a revised diagnosis were less 
      likely to have received neuroleptics (p = .007) and more likely to have received 
      antimanic drugs (p = .0002) or electroconvulsive therapy (p = .0004). CONCLUSION: 
      These findings from a clinical sample suggest that diagnostic reassessment is an 
      important first step in the management of apparently refractory schizophrenia.
FAU - Honer, W G
AU  - Honer WG
AD  - Refractory Psychosis Program, Riverview Hospital, Port Coquitlam, British 
      Columbia.
FAU - Smith, G N
AU  - Smith GN
FAU - MacEwan, G W
AU  - MacEwan GW
FAU - Kopala, L
AU  - Kopala L
FAU - Altman, S
AU  - Altman S
FAU - Yorkston, N
AU  - Yorkston N
FAU - Ehmann, T S
AU  - Ehmann TS
FAU - Smith, A
AU  - Smith A
FAU - Lang, M
AU  - Lang M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Psychiatry
JT  - The Journal of clinical psychiatry
JID - 7801243
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antipsychotic Agents/*therapeutic use
MH  - Chronic Disease
MH  - Diagnostic Errors
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Psychiatric Status Rating Scales
MH  - Psychotic Disorders/*diagnosis/drug therapy
MH  - Schizophrenia/*diagnosis/drug therapy
MH  - Schizophrenic Psychology
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 1994/12/01 00:00
MHDA- 1994/12/01 00:01
CRDT- 1994/12/01 00:00
PHST- 1994/12/01 00:00 [pubmed]
PHST- 1994/12/01 00:01 [medline]
PHST- 1994/12/01 00:00 [entrez]
PST - ppublish
SO  - J Clin Psychiatry. 1994 Dec;55(12):528-32.