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The Road to Nosologic Nirvana-Reply

Robert L. Spitzer, MD
Arch Gen Psychiatry. 1981;38(11):1299-1300. doi:10.1001/archpsyc.1981.01780360115016.
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In Reply.—  With the current availability of DSM-III, is it now inappropriate to report on research studies that diagnosed disorders according to DSM-II? Certainly not. It would be absurd to reject a well-designed study merely because patient selection antedated the availability of DSM-III. Nosologic research did not begin with DSM-III even if (we hope) the innovations of DSM-III facilitate such studies.Is It Accurate to Refer to the DSM-II 'Criteria' for Schizophrenia?—In the article in question, Silverstein and Harrow state that "Diagnoses were determined by the consensus of two senior clinicians using standard diagnostic criteria (DSM-II)....."I submit that it is gilding the lily to refer to the general six-sentence DSM-II description of schizophrenia as "criteria." To do so is to obscure the most important advance in nosologic research that occurred in the 1970s after the publication of DSM-II: the provision of specified inclusion and exclusion criteria for making

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