DSM-V and the diagnostic role of psychotic delusions

López-Silva, Pablo

doi:10.1590/0101-60830000000144

Cited by 3 publications

(5 citation statements)

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“…That is, Schneider argued, delusions should be diagnosed by quality and strength of the belief, rather than the particular content of the beliefs. 39,40 Interestingly, although Schneider's First Rank system has contributed a great deal to the current diagnostic criteriasatisfying just a single criteria was sufficient for schizophrenia diagnosis from DSM III (1980) until the publication of DSM V (2013)it has received marked criticism. 41,42 For instance, a critical analysis of diagnostic studies conducted between 1970-2005 was instrumental in de-emphasizing the First-Rank Scale in DSM V, citing that some components are non-falsifiable, and that the Scale relies too heavily on subjective symptom reports.…”

Section: Schizophreniamentioning

confidence: 99%

“…41,42 For instance, a critical analysis of diagnostic studies conducted between 1970-2005 was instrumental in de-emphasizing the First-Rank Scale in DSM V, citing that some components are non-falsifiable, and that the Scale relies too heavily on subjective symptom reports. 18,39,40,43 University of Western Ontario Medical Journal 9 Although de-emphasized in DSM V, the Schneiderian First-Rank system persists as a vital tool for differential diagnoses. For example, the delusional components of schizophrenia are present in significantly higher rates relative to other symptoms in schizophrenia, and although not exclusive to schizophrenia, delusions accurately predict diagnoses in up to 95% of cases.…”

Section: Schizophreniamentioning

confidence: 99%

“…39,43,44 Delusions are also a profound sign of fundamental breakdown within the mind of the patient that may distinguish schizophrenia from other disorders. 40,41 For example, in resource-constrained healthcare settings or in time-limited circumstances, First-Rank Symptoms can be especially valuable in expediting differential diagnosis. 45 Delusions vary considerably in content and idiosyncratic features.…”

Section: Schizophreniamentioning

confidence: 99%

“…49 Given that each of these differences in content and subjective features are determined by different etiology and prognoses, the First-Rank scale may be a useful nexus in linking schizophrenia in modern clinical practice with early accounts of schizophrenia-related phenomena. 40,41,49…”

Section: Schizophreniamentioning

confidence: 99%

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From madness to mental illness

Hudson

2020

UWOMJ

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Reports of psychotic episodes characterized by irrational, unintelligible behaviours and hallucinations are frequent throughout historical narratives. Appropriately contextualized, some of these descriptions appear to resemble the paranoid, and catatonic characteristics of schizophrenia, respectively, yet holistic accounts of schizophrenia-like syndromes rarely exist prior to the 19th century.1 Despite evolving diagnostic criteria and treatment approaches, and more than 100 years since the demarcation of schizophrenia by Eugen Bleuler in 1908, the etiology, neuropathology and pathophysiology of schizophrenia remain elusive.2-4 No biological markers possess the sensitivity and specificity expected of a diagnostic test, and schizophrenia persists conceptually as a broad clinical syndrome characterized by a range of subjective symptoms with varying patterns of course.5-8 This heterogeneity coupled with a lack of coherence between clinical and preclinical evidence have fueled speculation about the validity of current conceptualizations of the illness.9-12 Nevertheless, patients exhibit typical symptom progression over time, appear to respond favourably to particular treatment approaches, and despite inconsistencies in diagnostic classification, alternative proposals do not offer improvements in any of these categories.13,14 Undoubtedly, further parsing of schizophrenia and related disorders will be necessary to advance future treatment and diagnostic approaches. In this review, we briefly outline the origins of schizophrenia as it is conceptualized contemporarily by linking ancient medical descriptions with modern clinical perspectives, and discuss why historical accounts of schizophrenia may not accurately reflect its prevalence in the past.

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Section: Schizophreniamentioning

confidence: 99%

Section: Schizophreniamentioning

confidence: 99%

Section: Schizophreniamentioning

confidence: 99%

Section: Schizophreniamentioning

confidence: 99%

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From madness to mental illness

Hudson

2020

UWOMJ

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“…Esto hace que el delirio se convierta en una de las principales guías para el diagnóstico de la condición durante gran parte del siglo pasado, especialmente en Alemania, Estados Unidos y el Reino Unido (Peralta & Cuesta, 1999;Murray & Quattrone, 2021). Sin embargo, a la luz de la eliminación del trato preferencial a los delirios en el diagnóstico de la esquizofrenia en la última versión del Manual Diagnóstico y Estadístico de Trastornos Mental (DSM-V, APA, 2013), el rol diagnóstico de los delirios en psiquiatría es una discusión abierta (Tandon, 2013;Soares-Weiser et al, 2015;López-Silva, 2017a).…”

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El delirio en la esquizofrenia como objeto de estudio interdisciplinario en la filosofía de la mente

López-Silva

Cavieres

2022

soph

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El delirio es un fenómeno transdiagnóstico más frecuente en la esquizofrenia. Históricamente, el delirio se ha considerado la marca de la psicosis. Dada las formas en que desafía algunas de las premisas más fundamentales acerca de la naturaleza de la mente humana, durante los últimos 20 años el delirio ha atraído la atención de filósofos, psiquiatras e investigadores en ciencias cognitivas. Sin embargo, a pesar de su relevancia clínica en el diagnóstico de una serie de condiciones, el estudio del delirio aún produce diversas discusiones conceptuales y empíricas. Este artículo intenta clarificar algunos de los problemas más fundamentales que surgen del estudio interdisciplinario del delirio en el contexto de la esquizofrenia. Es importante señalar que la resolución de tales discusiones no constituye un simple ejercicio retórico, sino que permitiría, en el mejor de los casos, sentar las bases para el avance en la investigación clínica y experimental conceptualmente bien informada y, por ende, permitiría importantes avances en su tratamiento. En este sentido, el avance conceptual en el área será importante para definir la carta de navegación de la investigación empírica en el tema. Esto, porque cada teoría que intenta contar una historia explicativa completa y contextualizada del fenómeno de los delirios en la esquizofrenia debería ofrecer respuestas a los problemas que identificamos en este trabajo.

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