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The reliability of “bizarre” delusions
Journal article   Peer reviewed

The reliability of “bizarre” delusions

Michael Flaum, Stephan Arndt and Nancy C Andreasen
Comprehensive psychiatry, Vol.32(1), pp.59-65
1991
DOI: 10.1016/0010-440X(91)90070-S
PMID: 2001621

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Abstract

The concept of bizarre delusions figures prominently in the diagnosis of schizophrenia under DSM-III-R criteria. Yet this concept may be difficult to apply in the clinical world. The interrater reliability of distinguishing bizarre versus non-bizarre delusions was estimated by compiling a sample of 40 delusional ideas and asking a group of psychiatrists (ranging from experts in the field to residents) to identify them as bizarre or non-bizarre. The interrater reliability of the 45 respondents was consistently low as measured by kappa statistic (κ < 0.40) within and across groups of raters, and regardless of whether or not a structured definition was applied. Implications for DSM-IV are discussed.

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