Reactive Psychosis II: Does DSM-III-R Define a Third Psychosis?

The DSM-III and DSM-III-R criteria for “brief reactive psychosis” change the original concept of this disorder in a manner so restrictive as to virtually eliminate the diagnosis. In a companion paper to this one, we have reviewed the original concept and data supporting further study of this classification. We now argue that the operational criteria of the DSM-IIIs do not enhance the study of this putative disease entity, but rather thwart this goal by restricting the diagnosis so severely that too few cases will be found to test the third psychosis hypothesis. We suggest revised criteria that will retain the essential features of the traditional concept while defining explicit criteria in the style of the DSM-IIIs.