Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-23T09:20:18.073Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  09 July 2009

K. G. Manton ,
A. Korten ,
M. A. Woodbury ,
M. Anker  and
A. Jablensky
K. G. Manton
Affiliation:
Duke UniversityDepartment 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
A. Korten
Affiliation:
Duke UniversityDepartment 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
M. A. Woodbury
Affiliation:
Duke UniversityDepartment 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
M. Anker*
Affiliation:
Duke UniversityDepartment 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
A. Jablensky
Affiliation:
Duke UniversityDepartment 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
*
1Address for correspondence: Ms M. Anker, Epidemiological and statistical Methodology, WHO, 1211 Geneva 27, Switzerland.
Get access Rights & Permissions [Opens in a new window]

Synopsis

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.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 1 , February 1994 , pp. 133 - 144
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, Task Force on DSM-IV. (1990). DSM-IV. Work in Progress. American Psychiatric Association: Washington, DC.Google Scholar
Blazer, D., Schwartz, M., Woodbury, M. A., Manton, K. G., Hughes, D. & George, L. K. (1988). Depressive symptoms and depressive diagnoses in a community population: use of a new procedure for analysis of psychiatric classification. Archives of General Psychiatry 45, 1078–1084.CrossRefGoogle Scholar
Clive, J., Woodbury, M. A. & Siegler, I. C. (1983). Fuzzy and crisp set-theoretical-based classification of health and disease. Journal of Medical Systems 7, 317–322.CrossRefGoogle ScholarPubMed
Davidson, J. R. T., Woodbury, M. A., Pelton, S. & Krishnan, K. R. R. (1988). A study of depressive typologies using Grade of Membership analysis. Psychological Medicine 18, 179–189.CrossRefGoogle ScholarPubMed
Davidson, J. R. T., Woodbury, M. A., Zisook, S. & Giller, E. L. (1989). Classification of depression by Grade of Membership: a confirmation study. Psychological Medicine 19, 987–998.CrossRefGoogle ScholarPubMed
Everitt, B. S. (1990). Cluster Analysis (2nd edn). Gower Press: London.Google Scholar
Griesinger, W. (1861). Die Pathologie und Therapie der Psychischen Krankheiten. Krabbe: Stuttgart.Google Scholar
Hand, D. J. (1981). Discrimination and Classification. Wiley: New York.Google Scholar
Hempel, C. G. (1959). Introduction to problems of taxonomy. In Field Studies in the Mental Disorders (ed. Zubin, J.), pp. 3–22. Grune and Stratton: New York.Google Scholar
Left, J., Sartorius, N., Jablensky, A., Korten, A. & Ernberg, G. (1992). The International Pilot Study of Schizophrenia: five-year follow-up findings. Psychological Medicine 22, 131–145.Google Scholar
Lorr, M., Klett, C. J. & McNair, D. M. (1963). Syndromes of Psychosis. Pergamon Press: New York.Google Scholar
McCutcheon, A. (1987). Latent Class Analysis. Sage: Beverly Hills, CA.CrossRefGoogle Scholar
Manton, K. G. & Solds, B. J. (1985). Dynamics of health changes in the oldest old; new perspectives and evidence. Milbank Memorial Fund Quarterly. 63, 206–285.CrossRefGoogle ScholarPubMed
Meehl, P. E. (1962). Schizotaxia, schizotypy, schizophrenia. American Psychologist 17, 827–838.CrossRefGoogle Scholar
Moore, T. V. (1930). The Essential Psychoses and Their Functional Syndromes. Williams and Wilkins: Baltimore.Google Scholar
Schneider, K. (1959). Clinical Psychopathology. Grune and Stratton: New York.Google Scholar
Swartz, M., Blazer, D., Woodbury, M. A., George, L. & Landerman, R. (1986). Somatization disorder in the U.S. southern community: use of a new procedure for analysis of medical classification. Psychological Medicine 16, 595–609.Google ScholarPubMed
Weber, A. C. & Scharfetter, C. (1984). The syndrome concept: history and statistical operationalizations. Psychological Medicine 14, 315–325.CrossRefGoogle ScholarPubMed
Wing, J. K. (1980). Methodological issues in psychiatric case identification. Psychological Medicine 10, 5–10.CrossRefGoogle ScholarPubMed
Wing, J. K. & Brown, G. W. (1970). Institutionalism and Schizophrenia. Cambridge University Press: London.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wittenborn, J. R. (1951). Symptom pattern in a group of mental hospital patients. Journal of Consulting Psychology 16 (4). Reprinted in Research in Psychopathology (ed. H. C. Quay), van Nostrand: Princeton, N. J. (1963).Google Scholar
Woodbury, M. A. & Clive, J. (1974). Clinical pure types as a fuzzy partition. Journal of Cybernetics 4, 111–121.CrossRefGoogle Scholar
Woodbury, M. A., Clive, J. & Garson, A. (1978). Mathematical typology: a Grade of Membership technique for obtaining disease definition. Computers and Biomedical Research 11, 277–298.CrossRefGoogle ScholarPubMed
Woodbury, M. A. & Manton, K. G. (1982). A new procedure for the analysis of medical classifications. Methods of Information in Medicine 21, 210–220.Google Scholar
Woodbury, M. A. & Manton, K. G. (1989). Grade of Membership analysis of depression-related psychiatric disorders. Sociological Methods and Research 18, 126–163.CrossRefGoogle Scholar
World Health Organization (1973). Report of the International Pilot Study of Schizophrenia, Vol. I. Results of the Initial Evaluation Phase. WHO: Geneva.Google Scholar
World Health Organization (1979). Schizophrenia: An International Follow-up Study. Wiley and Sons: Chichester.Google Scholar
World Health Organization (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.Google Scholar