The Nosology of the Psychoses

In 1972-1975 I had the good fortune to work with the late R E Kendell on schizo-affective psychoses.  We followed up the British patients in the US/UK Diagnostic Project (interviewing 96% of those still living), collected schizo-affective patients from the Maudsley, Bethlem Royal and St Francis Hospitals, and studied a complete series of Camberwell 1st admissions.  This project resulted in the following 17 publications:

  • Brockington I F, Kendell R E, Kellett J M, Curry S H, Wainwright S (1978) Trials of Lithium, Chlorpromazine and Amitriptyline in schizoaffective psychosis. British Journal of Psychiatry 133: 162-168 (over 100 citations).
  • Brockington I F, Kendell R E, Leff J P (1978) Definitions of schizophrenia: concordance and prediction of outcome. Psychological Medicine 8: 387-398 (over 300 citations). 
  • Brockington I F, Leff J P (1979) Schizoaffective psychosis: definitions and incidence. Psychological Medicine 9: 91-99 (over 150 citations).
  • Brockington I F, Kendell, R E, Wainwright S, Hillier V F, Walker J (1979) The distinction between the affective psychoses and schizophrenia. British Journal of Psychiatry 135: 243-248 (over 100 citations).
  • Kendell R E, Brockington I F, Leff J P (1979) Prognostic implications of six alternative definitions of schizophrenia. Archives of General Psychiatry 36: 25-31 (over 150 citations).
  • Brockington I F, Wainwright S, Kendell R E (1980) Manic patients with schizophrenic or paranoid symptoms. Psychological Medicine 10: 73-83 (over 100 citations).
  • Kendell R E, Brockington I F (1980) The identification of disease entities and the relationship between schizophrenia and the affective psychosis. British Journal of Psychiatry 137: 324-331 (300 citations).
  • Brockington I F, Kendell R E, Wainwright S (1980) Depressed patients with schizophrenic or paranoid symptoms. Psychological Medicine 10: 665-675 (over 150 citations).
  • Helzer J E, Brockington I F, Kendell R E (1981) Predictive validity of DSM III and Feighner definitions of schizophrenia: a comparison with Research Diagnostic Criteria and Catego. Archives of General Psychiatry 38: 791-797 (over 100 citations).
  • Brockington I F, Perris C, Kendell R E, Hillier V F, Wainwright S (1982) The course and outcome of cycloid psychosis. Psychological Medicine 12: 97-105 (over 100 citations).
  • Brockington I F, Helzer J E, Hillier V F, Francis A T (1982) Definitions of depression: concordance and prediction of outcome. American Journal of Psychiatry 139: 1022-1027.
  • Brockington I F, Hillier V F, Francis A T, Helzer J E (1983) Wainwright S. Definitions of mania: concordance and prediction of outcome. American Journal of Psychiatry 140: 435-438.
  • Brockington I F, Meltzer H Y (1983) The nosology of schizoaffective psychosis. Psychiatric Developments 1: 317-338.
  • Helzer J E, Kendell R E, Brockington I F (1983) The contribution of the six month criterion to the predictive value of the DSM III definition of schizophrenia. Archives of General Psychiatry 40: 1277-1280.
  • Brockington I F (1985) The diagnosis of schizophrenia and schizoaffective psychoses.  Chapter in P Bradley P, S R Hirsch (editors) Psychopharmacology and treatment of schizophrenia. .
  • Brockington I F, Roper A, Copas J, Buckley M, Andrade C E, Wigg P, Farmer A, Kaufman C, Hawley R (1991) Schizophrenia, bipolar disorder and depression: a discriminant analysis, using `lifetime’ psychopathology ratings. British Journal of Psychiatry 159: 485-494.
  • Brockington I F, Roper A, Buckley M, Copas J, Andrade C, Wigg P, Farmer A, Kaufman C, Hawley R, Meltzer H Y (1991) Bipolar disorder, cycloid psychosis and schizophrenia: a study using “lifetime” psychopathology ratings, factor analysis and canonical variate analysis. European Psychiatry 6: 223-226.

The last two papers supported the distinction between bipolar disorder and a continuum of schizophrenia and depression, and persuaded me that the concept of ‘schizophrenia’ was an obstacle to progress in research on the nosology of the psychoses, as set out in my inaugural lecture at the University of Birmingham, and this next paper:

  • Brockington I F (1992) Schizophrenia.  Yesterday’s concept.  European Psychiatry 2: 203-207.

After moving to the University of Manchester in 1975, and during a Visiting Professorship at the University of Chicago, I pursued my interest in the clinical methodology of research into the psychoses, resulting in these 5 papers:

  • Downing A R, Brockington I F (1978) Nurse rating of psychotic behaviour. Journal of Advanced Nursing 3: 551-561.
  • Downing A R, Francis A T, Brockington I F(1980) A comparison of information sources in the study of psychotic illness. British Journal of Psychiatry 137: 38-44.
  • Brockington I F, Meltzer H Y (1982) Documenting an episode of psychotic illness: the need for multiple information sources, multiple raters and narrative. Schizophrenia Bulletin 8: 485-492.
  • Brockington I F, Roper A, Meltzer H Y, Altman E, Perry R (1992) Multiple Raters. International Journal of Methods in Psychiatric Research. Vol 2: 187-190.
  • Brockington I F, Roper A, Edmunds E, Kaufman C, Meltzer H Y (1992) A longitudinal psychopathological schedule. Psychological Medicine 22: 1035-1043.