Editorials

Renaming schizophrenia

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39057.662373.80 (Published 18 January 2007) Cite this as: BMJ 2007;334:108
  1. Jeffrey A Lieberman, chairman and director (jlieberman@columbia.edu),
  2. Michael B First, professor of clinical psychiatry
  1. 1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY 10032, USA

    Diagnosis and treatment are more important than semantics

    Recent reports in the media have called for schizophrenia to be “abolished as a concept” because it is scientifically meaningless.1 This is not the first time that the validity of this diagnostic entity has been challenged, and it will not be the last until the cause of the disorder and its precise pathophysiology are known.

    The current system of psychiatric diagnosis cannot describe definitive disease entities because of our inability to demonstrate “natural” boundaries between disorders. However, as Kendell and Jablensky point out, “thoughtful clinicians have long been aware that diagnostic categories are simply concepts, justified only by whether they provide a useful framework for organising and explaining the complexity of clinical experience in order to derive inferences about outcome and to guide decisions about treatment.”2 In this context, the charge that schizophrenia does not …

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