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The Role of Complex Emotions in Inconsistent Diagnoses of Schizophrenia

Gara, Michael A. PhD*; Vega, William A. PhD; Lesser, Ira MD; Escamilla, Michael MD§; Lawson, William B. MD, PhD; Wilson, Daniel R. MD, PhD; Fleck, David E. PhD**; Strakowski, Stephen M. MD**

The Journal of Nervous and Mental Disease: September 2010 - Volume 198 - Issue 9 - p 609-613
doi: 10.1097/NMD.0b013e3181e9dca9
Original Articles

In the case of large-scale epidemiological studies, there is evidence of substantial disagreement when lay diagnoses of schizophrenia based on structured interviews are compared with expert diagnoses of the same patients. Reasons for this level of disagreement are investigated in the current study, which made use of advances in text-mining techniques and associated structural representations of language expressions. Specifically, the current study examined whether content analyses of transcribed diagnostic interviews obtained from 150 persons with serious psychiatric disorders yielded any discernable patterns that correlated with diagnostic inconsistencies of schizophrenia. In summary, it was found that the patterning or structure of spontaneous self-reports of emotion states in the diagnostic interview was associated with diagnostic inconsistencies of schizophrenia, irrespective of confounders; i.e., age of patient, gender, or ethnicity. In particular, complex emotion patterns were associated with greater disagreement between experts and trained lay interviewers than were simpler patterns.

*Department of Psychiatry, UMDNJ-University Behavioral HealthCare and Robert Wood Johnson Medical School, Piscataway, NJ; †Department of Psychiatry and School of Social Work, University of Southern California, Los Angeles, CA; ‡Department of Psychiatry, Harbor-UCLA Medical Center and the Los Angeles Biomedical Research Institute, Torrance, CA; §Department of Psychiatry, Texas Tech University Health Sciences Center, El Paso, TX; ¶Department of Psychiatry and Behavioral Sciences, Howard University Medical Center, Washington, DC; ∥Department of Psychiatry, Creighton University, Omaha, NE; and **Department of Psychiatry, University of Cincinnati, Cincinnati, OH.

Send reprint requests to Michael A. Gara, PhD, UMDNJ-Robert Wood Johnson Medical School, 671 Hoes Lane, Piscataway, N.J 08855–1392. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.