The Concept of Schizophrenia: From the 1850s to the DSM-5

Definition and description of schizophrenia in the DSM-5

“…Three major roots are reflected in all definitions: a) the Kraepelinian emphasis on avolition, chronicity and poor outcome (Kraepelin, 1971); b) incorporation of the Bleulerian view that dissociative pathology is primary and fundamental and accent on negative symptoms (Bleuler, 1950); and c) the Schneiderian stress on reality distortion or positive symptoms (Schneider, 1959). The relative emphasis paid to these three perspectives has, however, varied over time (Andreasen, 1989;Bruijnzeel and Tandon, 2011;Keller et al, 2011), with the Bleulerian accent on negative symptoms and interpersonal pathology leading to a broad definition reflected most strongly in DSM-I and DSM-II. This led to a marked discrepancy between the diagnosis of schizophrenia in the USA versus the UK and perhaps much of Europe (Kendell et al, 1971;Wing and Nixon, 1975).…”

Schizophrenia Is a Misdiagnosis

“…3.1 and 3.2 ). Bruijnzeel and Tandon ( 2011 ) state that, "In fact, almost one third of patients with psychotic symptoms currently [2011] receive a diagnosis of schizoaffective disorder in many mental health care systems." The current author hopes this is an overestimation since the basic DSM diagnostic criteria appear fl awed.…”

“…Bruijnzeel and Tandon ( 2011 ) imply that this change will improve the reliability of the diagnosis of schizoaffective disorder with this change when they said:…”

“…From at least 100 BCE, the literature contained repeated and consistent descriptions of patients who suffered from cycling episodes now recognizable as depression and mania and eventually known as manic-depressive insanity. Despite the above, in the mid-1800s, a new disease was named for the most psychotic and chronic patients having an early age of onset of their disease (Bruijnzeel and Tandon 2011 ) . This new disease, dementia praecox or schizophrenia, was considered different from manic-depressive insanity or bipolar disorder.…”

Early prodromal symptoms can predict future psychosis in familial high-risk youth

“…At the same time, more precise risk stratification holds the potential to reduce risks of intervention in individuals who are not destined to cross the psychosis threshold. Reflecting this promise, the fifth revision of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) is considering inclusion of a risk syndrome for psychosis (Bruijnzeel and Tandon, 2011; Carpenter, 2009) based on the presence of attenuated psychotic symptoms. Although the proposal is controversial (Corcoran et al, 2010; Drake and Lewis, 2010; Woods et al, 2010), its utility rests in part on the availability of reliable and valid clinical measures with high predictive value.…”