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Diagnostic Discrepancies: A Reply to North and Cadoret-Reply

Remi J. Cadoret, MD; Carol S. North
Arch Gen Psychiatry. 1982;39(1):112-113. doi:10.1001/archpsyc.1982.04290010084016.
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In Reply.  — Richard Gordon has written a thought-provoking commentary on our article, criticizing two of our "rediagnoses" on the basis of the facts reported in the patients' personal accounts. In Vonnegut's account of his first psychotic episode, Dr Gordon claims that there is no evidence of "elevated or irritable mood." We disagree and point to several instances where an elevated mood is described.On page 94,' Vonnegut describes an "incredible sense of well-being and saying by-by to all the shit in my life"; again on page 104, "... it's fantastically wonderful, I'm really over-whelmed. I've really got nothing to hide. Ask me anything"; and on page 108, "The highs weren't that different from the lows. Neither was grounded. Both had at best a marginal relationship to anyone's reality. My hapiness and sadness was all out of proportion to anything that was happening."

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