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In Reply.—
Ms Gibbon and Dr Spitzer urge that DSM-III diagnostic criteria be applied in a uniform fashion. We have always considered this to be important and were therefore careful to apply DSM-Ill criteria precisely as written. The 20 patients mentioned by Ms Gibbon and Dr Spitzer had each had an active phase of schizophrenic symptoms for less than six months at admission. In each case, the patient and/or informants reported a sustained change in the patient's usual self that had begun six or more months before admission. These prodromes did not include the characteristics specified by DSM-III, however. Therefore, the appropriate DSM-III diagnosis for these cases is schizophreniform disorder.As Gibbon and Spitzer note, chart reviews have limits, and some of the above 20 patients might have exhibited characteristic prodromal features that were not recorded. To test the possible consequences, we reanalyzed the data by including all 20 patients in the