Abstract
“Schizophrenia” is used as a unitary diagnostic term for an illness that is extremely heterogeneous in its etiology, pathophysiology, presentation, and trajectory. Furthermore, the presence of psychosis—its hallmark characteristic—can be observed in individuals with other diagnoses, and biologically- and computationally-defined psychosis biotypes differ from those associated with DSM diagnoses and yield different treatment predictions. We argue that schizophrenia is not only stigmatizing as a label, it is not useful as a diagnostic term, a disease concept, or a construct for scientific research. Until we are able to delineate a range of dysfunctions across molecular/cellular and/or macrocircuit levels that map onto psychosis-proneness and indicate optimal treatment pathways, we propose to eliminate schizophrenia and replace it with a new nomenclature as an interim solution. Similar to what is done with other broad descriptive disease concepts in medicine which are defined by hallmark clinical features and then further subtyped (e.g., sickle cell anemia, iron deficiency anemia), we propose that psychosis spectrum illnesses (PSIs) be characterized by their temporal characteristics, relevant modifying/causal and symptom features, and treatment responsiveness.
Original language | English (US) |
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Pages (from-to) | 147-149 |
Number of pages | 3 |
Journal | Schizophrenia Research |
Volume | 242 |
DOIs | |
State | Published - Apr 2022 |
Bibliographical note
Funding Information:This work is supported by the University of Minnesota Psychiatry Residency Program (J.L.Z.) as well as the National Institute of Mental Health (S.V.; 5 P50 MH119569 , 1R01MH120589 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
This work is supported by the University of Minnesota Psychiatry Residency Program (J.L.Z.) as well as the National Institute of Mental Health (S.V.; 5 P50 MH119569, 1R01MH120589). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conceptualization, S.V.; writing, S.V. J.L.Z.; reviewing and editing, S.V. J.L.Z. B.S. The NIMH had no direct involvement in the design, conceptualization, or writing of this report.
Keywords
- Clinical psychiatry
- Diagnosis
- Diagnostic reconceptualization
- Nomenclature
- Psychosis
- Schizophrenia
- Humans
- Psychotic Disorders
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural