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A Journal on Psychiatry, Psychology and Psychopharmacology
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index
Minerva Psichiatrica 1999 December;40(4):311-6
Schizophrenia between psychopathology and nosography
Saya A., Celli A. M., Fedeli B.
A historical survey of psychopathology and nosography concerning schizophrenia is made. The attempt is to trace the sources of the current theories' concept in classical psychiatry, beginning by highlighting the difference between the present classifications of a syndromic-descriptive kind and the scientific-naturalistic model proposed by Kraepelin, Bleuler and Leonhard. Special attention is given to the fortune of negative symptoms, and especially to autism: Bleuler's primitive and fundamental symptom had been, for a long time, left out of the classifications with schneiderian matrix; it regains significance in negative schizophrenia and most of all in the theory of basic symptoms, which contemplates insight and the use of strategies of defence and compensation by schizophrenic patients. A comparison with other conceptions of compensation is then proposed. The study goes on pointing out the signs of the crisis of schizophrenic symptom's specificity, i.e.: diagnostic systems including several non-symptoms criteria (DSM 4û and ICD 10), an increasing interest for quite aspecific symptoms (basic symptoms and other described in non-regressive schizophrenia by Nymann), plus the hypotesis of the co-existence of hierarchically lower disorders (Pyramid of Foulds). The rising attention for symptoms of intercritical phases, could be attributed to the advent of psychopharmocology and to a new approach to mental desease, no longer of a custodialistic kind but focused on the psychopathological complexity of the disorders.