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'Errors' v opinions

John E. Helzer, MD; Lee N. Robins, PhD; Roger K. Stoltzman, MD
Arch Gen Psychiatry. 1984;41(1):107-108. doi:10.1001/archpsyc.1984.01790120111020.
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To the Editor.—  In the article "Research Diagnostic Criteria and DSM-III: An Annotated Comparison" (Archives 1982;39:1283-1289), Williams and Spitzer claimed that our earlier comparison of the Feighner criteria, the Research Diagnostic Criteria (RDC), and DSM-III1 contained "many serious factual errors and misleading statements." They also questioned the "unusual method of analyzing the data" that we published in a companion article.2As we learned when we attempted to write questions corresponding to each criterion item in 32 DSM-III diagnoses for the Diagnostic Interview Schedule, and as an exchange of letters between ourselves and Williams and Spitzer in the Journal of Clinical Psychiatry3,4 illustrates, even the relatively well-defined diagnostic criteria of DSM-III offer opportunities for conflicting interpretations. Although Williams and Spitzer cited their own letter to the Journal of Clinical Psychiatry regarding that article, they failed to reference our response to their letter, which showed that the "serious factual errors and misleading statements" they attributed to us can be assigned to (1) legitimate differences in interpreting criteria, (2) a result of contradictory statements within the DSM-III text, or (3) omissions by us of specifications that we thought the context had made obvious.


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