Response to Woods and McGlashan Letter

Mark Weiser, M.D.Authors Info & Affiliations

Publication: American Journal of Psychiatry

https://doi.org/10.1176/appi.ajp.2011.11081276r

To the Editor: I thank Drs. Woods and McGlashan for reading and commenting on the editorial. Their letter examines the hypothetical case of a young man with attenuated psychotic symptoms who has “an emotional crisis when his girlfriend leaves him.” Their understanding is that the symptoms “cause the patient no distress” and hence would not meet the proposed DSM-5 criteria for attenuated psychosis syndrome.

In the editorial, our hypothetical patient “might be upset, have difficulty sleeping at night, have difficulties concentrating, have decreased functioning at school or at work, and have more attenuated psychotic symptoms. If this person goes to a psychiatrist presenting with this clinical picture, he might very well meet criteria for the prodromal phase.”

This is clearly a description of a distressed person who seeks the help of a psychiatrist. Since criterion D of the proposed DSM-5 criteria for attenuated psychotic syndrome requires that the attenuated positive symptoms themselves must be “sufficiently distressing and disabling to the patient and/or parent/guardian to lead them to seek help,” our patient would meet the criteria.

I join Drs. Woods and McGlashan in their hope that the DSM-5 field trials will help determine whether these criteria can be applied with reliability in the clinical setting.

Footnote

Accepted for publication in September 2011.

Information & Authors

Information

Published In

American Journal of Psychiatry

Volume 168 • Number 12 • December 2011

Pages: 1338

History

Accepted: September 2011

Published online: 1 December 2011

Published in print: December 2011

Authors

Details

Mark Weiser, M.D.

Ramat-Gan, Israel

View all articles by this author

Funding Information

The author's disclosures accompany the original editorial.

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Response to Woods and McGlashan Letter

Footnote