Helen E. Klein

Sex Differences in Schizophrenia

Demographic and clinical characteristics of 275 schizophrenics consecutively admitted to seven hospitals were examined. Males were younger than females when first hospitalized, diagnosed and treated. Psychiatrists rated on two rating scales by using a structured interview to compare the symptomatology. Female schizophrenics were more agitated, inappropriate, silly, irrelevant, over-talkative, and exhibiting more flight of ideas, while male schizophrenics were more slowed, hypoactive, grandiose, withdrawn, and showing more blocking, auditory hallucinations and poor communications. Katz Adjustment Scales were rated by the patients and their relatives. Female schizophrenics were perceived by relatives to be more helpless and withdrawn-depressed than male schizophrenics.

Differences in psychopathology between black and white schizophrenics.

The psychopathology of black and white schizophrenics was compared in 275 consecutive admissions of schizophrenics, who were rated on two rating scales by psychiatrists, using a structured interview. There were significant differences between black and white schizophrenics; blacks exhibited more frequent symptoms of angry outbursts, poor communication, disorientation, asocial behaviour and auditory and visual hallucinations, while whites showed more frequent symptoms of unsystematized delusions. When controlled for sex, additional symptom differences were found for female schizophrenics; blacks were more often excited, ambivalent, rigid and dysphoric. For male schizophrenics, all symptom differences disappeared except one; blacks were more frequently asocial.

Transcultural Interrater Reliability

Five psychiatrists from Missouri and five psychiatrists from Istanbul, Turkey, participated in an interrater reliability study that utilized videotapes to rate symptomatology of 30 schizophrenic patients. Three rating scales were completed for each patient: the Brief Psychiatric Rating Scale, the Itil-Keskiner Psychopathological Rating Scale, and the Seven Point Global Rating Scale. Fifteen of the patients were hospitalized in two Missouri state hospitals and 15 in a Turkish state hospital. This study was conducted to determine if psychiatrists from both cultures would comparably rate patients. Each patient was videotaped while being interviewed by a structured interview prerecorded on cassette tape and operated by a research nurse. The recorded structured interview ensured uniformity of interviewing and permitted rating of patients when convenient for the raters. The study was able to control many of the variables that often can, and do, contaminate interrater reliability studies (Tinsley & Weiss, 1975)....

Symptomatology differentials between urban and rural schizophrenics.

The frequency of symptoms between urban and rural schizophrenic patients was compared in 275 consecutive admissions of schizophrenics, who were rated on two rating scales by psychiatrists, using a structured interview. There were significant differences between urban and rural schizophrenics; rural patients were more frequently apathetic, blunted, labile, angry, aggressive, negativistic and uncooperative, while urban schizophrenics were more often anxious, rigid, ambivalent, disoriented, conceptually disorganised and asocial. Significant symptom differences were also found for only older or younger schizophrenics.

Symptom Differences Between Urban and Rural Schizophrenics in Turkey

The symptomatology of Turkish urban and rural schizophrenic patients was compared in 94 consecutive hospital admissions. These were rated on two rating scales by psychiatrists, using a structured interview. Urban patients were more frequently anxious, tense, stiff, rigid, perseverating and depersonalized than rural patients; urban patients also exhibited more frequent symptoms of outbursts, blocking, thought pressure, depressed mood and somatic concern than their rural counterparts. Rural patients were more often withdrawn, disoriented, confused/delirious and lacking contact in communication than urban patients; rural patients also showed more frequent symptoms of flight of ideas and consciousness lapses than their urban counterparts.