Progress of Psychiatric Diagnosis

To the Editor.—  Endicott and Spitzer's presentation in the Archives (35:837-848, 1978) of the latest version of the Schedule for Affective Disorders and Schizophrenia is but one indication of how far psychiatric diagnosis has progressed in the past decade. One disturbing feature of their report was the lack of reliability of the formal thought disorder scale that the authors attributed to either infrequent occurrence of those behaviors or the lack of unidimensionality of the concept. I believe the latter is the more likely since five of the six items in the scale have not been thought of as formal thinking disorder by most Phenomenologists.^1-2 In addition to neologisms (used by the authors) phenomenologists include under formal thought disorder the following: paraphasias, drivelling (jargon agrammatism), nonsequitive speech in the absence of flight of ideas, verbigeration (palilalia), and tangential speech. In our criteria for schizophrenia,³ we have utilized this concept