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Article
April 1980

'Undiagnosed' Patients

Author Affiliations

Department of Psychiatry School of Medicine Washington University 4940 Audubon Ave St Louis, MO 63110

Arch Gen Psychiatry. 1980;37(4):485. doi:10.1001/archpsyc.1980.01780170127015

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Abstract

To the Editor.—  The recent exchange of letters between Spitzer, Endicott, and Williams on the one hand and Overall and Hollister on the other (Archives 36:1381-1382, 1979) calls for a comment, particularly since the original Overall-Hollister article and the correspondents refer to the "Washington University criteria." A major point in the Washington University approach to psychiatric classification, not always appreciated by others, has been our emphasis on a category of "undiagnosed" or "undiagnosable" patients. In all of our clinical work, as well as in our research, we find that we are unable to comfortably categorize a substantial minority of patients, the percentage varying with the particular setting or research project. We believe that the present state of our Knowledge concerning psychopathology requires recognizing that we are unable to assign many patients to one of our existing categories. The use of an undiagnosed group permits greater confidence in the validity of the

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