Abstract Videotapes of diagnostic interviews with eight patients, three American and five English, were shown to large audiences of trained psychiatrists in the eastern United States and in different parts of the British Isles. The diagnoses made by these audiences were compared and for some patients there were major disagreements between them. The overall pattern of diagnostic differences between the American and British raters indicates that the American concept of schizophrenia is much broader than the British concept, embracing not only part of what in Britain would be regarded as depressive illness, but also substantial parts of several other diagnostic categories—manic illness, neurotic illness, and personality disorder. These serious differences in the usage of diagnostic terms have important implications for transatlantic communication, and indeed for international communication in general. References 1. Kramer M: Some problems for international research suggested by observations on differences in first admission rates to the mental hospitals of England and Wales and of the United States, in Proceedings of the Third World Congress of Psychiatry. Montreal, McGill University Press, 1961, vol 3, pp 153-160. 2. Cooper JE, Kendell RE, Gurland BJ, et al: Cross-national study of diagnosis of the mental disorders: Some results of the first comparative investigation . Amer J Psychiat 125( (suppl) ):21-29, 1969. 3. Cooper JE: The use of a procedure for standardizing psychiatric diagnosis , in Hare EH, Wing JK (eds): Psychiatric Epidemiology . London, Oxford University Press, 1970, pp 109-131. 4. Sandifer MG, Hordern A, Timbury GC, et al: Psychiatric diagnosis: A comparative study in North Carolina, London and Glasgow . Brit J Psychiat 114:1-9, 1968.Crossref 5. Katz M, Cole JO, Lowery HA: Studies of the diagnostic process: The influence of symptom perception, past experience and ethnic background on diagnostic decisions . Amer J Psychiat 125:937-947, 1969. 6. Lorr M, Klett CJ: Inpatient Multidimensional Psychiatric Scale . Palo Alto, Calif, Consulting Psychologists Press, 1967. 7. Copeland JRM, Cooper JE, Kendell RE, et al: Differences in usage of diagnostic labels amongst psychiatrists in the British Isles. Brit J Psychiat (in press). 8. Gurland BJ, Fleiss JL, Cooper JE, et al: Cross-national study of diagnosis of mental disorders: Hospital diagnoses and hospital patients in New York and London . Compr Psychiat 11:18-25, 1970.Crossref 9. Scadding JG: Meaning of diagnostic terms in broncho-pulmonary disease . Brit Med J 2:1425-1430, 1963.Crossref 10. Shepherd M, Brooke EM, Cooper JE, et al: An experimental approach to psychiatric diagnosis . Acta Psychiat Scand , (suppl 201) , 1968. 11. Rawnsley K: An international diagnostic exercise, in Proceedings of the Fourth World Congress of Psychiatry. Amsterdam. Excerpta Medica Foundation, 1967, vol 4, pp 2683-2686. 12. Lipkin KM, Dyrud J, Meyer GG: The many faces of mania . Arch Gen Psychiat 22:262-267, 1970.Crossref 13. Gattozzi AA: Lithium in the Treatment of Mood Disorders. National Clearinghouse for Mental Health Information, Publication No. 5033, US Government Printing Office, 1970, pp 23-24. 14. Hoch P, Polatin P: Pseudoneurotic forms of schizophrenia . Psychiat Quart 23:248-276, 1949.Crossref 15. Lewis NDC, Piotrowski ZA: Clinical diagnosis of manic depressive psychosis , in Hoch PH, Zubin J (eds): Depression . New York, Grune & Stratton Inc, 1954, pp 25-38.
Archives of General Psychiatry – American Medical Association
Published: Aug 1, 1971