Diagnostic consistency in catatonic schizophrenia

Abstract

Diagnostic consistency was examined in a group of 572 cases with multiple contacts diagnosed at least once as having catatonic schizophrenia in the Monroe County Psychiatric Register between 1960 and 1966. The diagnosis of catatonic schizophrenia was made in a majority of contacts for less than half the group. Catatonic schizophrenia is used inconsistently and rarely by some facilities; frequently and consistently by other facilities. When a patient has visited multiple facilities and catatonic schizophrenia has been diagnosed at one of them, he has less than a 10 percent chance of having agreement on the diagnosis of catatonic schizophrenia in a majority of contacts with each of the facilities. The transient occurrence of catatonic symptoms in other types of schizophrenia as well as in other types of mental and physical illness is implicated as one of the reasons for the low degree of diagnostic consistency. The diagnostic process, often hurried, imprecise, and without heuristic or therapeutic interest with respect to the particular type of schizophrenia, is also implicated.