Psychological Medicine

Original Articles

Symptom profiles of psychiatric disorders based on graded disease classes: an illustration using data from the WHO International Pilot Study of Schizophrenia

K. G. Mantona1, A. Kortena1, M. A. Woodburya1, M. Ankera1 c1 and A. Jablenskya1

a1 Duke University Department of Computer Science, Durham, NC, USA; NH&MRC Social Psychiatry Research Unit, the Australian National University, Canberra, ACT, Australia; WHO, Geneva, Switzerland; University Department of Psychiatry, Perth, WA, Australia

Abstract

The Grade of Membership (GoM) model is a classification procedure which allows a person to be a member of more than one diagnostic class. It simultaneously quantifies the degrees of membership in classes while generating the discrete symptom profiles or ‘pure types’ describing classes. The model was applied to the symptomatology, history, and follow-up of 1065 cases in the WHO International Pilot Study of Schizophrenia. The model produced an eight diagnostic class or ‘pure type’ solution, of which five were related to the diagnostic concepts of schizophrenia and paranoid disorder, two types were affective disorders, and one asymptomatic type. A subtype of paranoid schizophreniform disorder found primarily in developing countries was identified. There was a strong association between pure types and the original clinical and computer generated (CATEGO) diagnoses. A GoM based psychiatric classification might more clearly identify core disease processes than conventional classification models by filtering the confounding effects of individual heterogeneity from pure type definitions.

Correspondence:

c1 Address for correspondence: Ms M. Anker, Epidemiological and statistical Methodology, WHO, 1211 Geneva 27, Switzerland.

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