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Use of Antidepressants in Schizophrenia: Diagnostic Problems-Reply

Mark S. Kramer, MD, PhD; Wolfgang H. Vogel, PhD; Celeste DiJohnson; Donna Ann Dewey; Patricia Sheves, RN, BSN; Steven Cavicchia, PsychD; Patrick Litle, PhD; Robert Schmidt, RPh; Iva Kimes, RPh
Arch Gen Psychiatry. 1990;47(10):979-980. doi:10.1001/archpsyc.1990.01810220095018.
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In Reply.—  Dr Osser laments that in the ever-changing world of diagnostic criteria, it is sometimes difficult for clinicians to translate the results of clinical psychopharmacology studies into clinical practice. He comments that our recent work on the effect of antidepressants in depressed schizophrenic patients may not be comprehensible to clinicians who use DSM-III-R criteria. Dr Osser elegantly dissects the differences between the RDE, DSM-III, and DSMIII-R classifications of schizoaffective disorder. Nevertheless, our results apply only to those patients who are classified as having DSM-III-R schizophrenia with a depressive disorder not otherwise specified. As we stated, the patients we studied were persuasively schizophrenic and actively psychotic by any criteria. Their depressive syndromes at the time they were studied, as well as in the context of their ample longitudinal histories, were not at all predominant, relative to their schizophrenic disorder. Hence, our study indicates that these patients with schizophrenia, not those patients classified


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