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Publications [#273389] of Richard S. Keefe

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Journal Articles

  1. Keefe, RSE; Frescka, E; Apter, SH; Davidson, M; Macaluso, JM; Hirschowitz, J; Davis, KL (1996). Clinical characteristics of Kraepelinian schizophrenia: Replication and extension of previous findings. The American Journal of Psychiatry, 153(6), 806-811.
    (last updated on 2019/04/24)

    Objective: Subtypologies of schizophrenia based on cross-sectional criteria, such as the nomenclature of the DSMs, have not been successful in identifying valid diagnostic subgroups among patients with schizophrenia. A subtypology that uses criteria to classify individuals on the basis of longitudinal deficits in self-care may identify a more valid subgroup of schizophrenic patients. Method: This study describes the clinical characteristics of a group of schizophrenic patients identified on the basis of a longitudinal criterion: at least 5 years of continuous and complete dependence on others for obtaining and maintaining the basic necessities of life, including food, clothing, and shelter. Results: Sixty-one 'Kraepelinian' schizophrenic inpatients, when compared to 80 non- Kraepelinian schizophrenic inpatients who were similar in years of illness, age, and education, demonstrated more severe negative symptoms and more severe formal thought disorder; yet the severity of their delusions, hallucinations, and bizarre behavior did not differ significantly. None of the Kraepelinian patients and eight non-Kraepelinian patients met DSM-III-R criteria for schizoaffective disorder. Conclusions: Data from this replication study suggest that Kraepelinian schizophrenic patients, identified on the basis of a longitudinal course characterized by severe dysfunctions in self-care, may represent an alternative, and possibly more valid, method of subtyping schizophrenia.

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