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Diagnostic Discrepancies: A Reply to North and Cadoret

Remi J. Cadoret, MD; Carol S. North
Arch Gen Psychiatry. 1982;39(1):113. doi:10.1001/archpsyc.1982.04290010084018.
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In Reply.  — The appetite disturbance noted by the Weissmans was not included in our table because, as stated in our "Methods" section (p 133), To be included in a particular diagnostic syndrome, a symptom had to be a temporally related part of the symptom cluster. For example, the weight loss experienced by Mark Vonnegut during his manic episode was not included in the diagnosis of a possible depression, which occurred temporally before the manic episode.For similar reasons, the suicidal behavior was not included in the depression table. It is possible that the admixture of suicidal ideation with the manic episode (if not literary license) represented a mixed affective condition, since the author does report marked mood swings (eg, "My happiness and sadness was all out of proportion to anything that was happending."1(p108)).


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