BIOLOGICAL BASES OF PSICHIATRY 

Minerva Psichiatrica 2011 December;52(4):171-85

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Advances in psychopathology, classification and diagnosis of psychosis and its clinical implications

Franzek E. J. ¹, Musalek M. ²

¹ Novadic Kentron, Network of Addiction, Vught, the Netherlands 2 Anton Proksch Institute, Vienna, Austria

One of the main reasons for the dragging progress in psychoses research is the differing standpoint of leading psychiatrists when classifying psychoses which exhibit ”First Rank” Symptoms according to Kurt Schneider. Right from the very beginning to the present day the paradigm of a common disease or disease continuum and the paradigm of a variety of different disease entities stand directly opposed to each other. The analysis of the historical development of the currently used classification systems indicates that sticking to already established terms and methodologies becomes more and more an obstacle in research. Modern research requires homogenous clinical syndromes or homogenous disease spectra to examine them with scientifically based methodologies and technologies. Before the introduction of DSM-V and ICD-11 an urgent question has to be answered first: is the concept of a psychotic continuum really incompatible with the concept of several different disease spectra or is there a not yet known link between them? The prerequisite for answering this question is going back to clinical and empirical realities. Then we need to develop a new generation of classification systems that are free of any dogmatic ideation and irreversible paradigms. The research in psychoses is the neurology of highest brain functions. There is little doubt that the dichotomy of endogenous psychoses in an affective bipolar spectrum and a schizophrenia spectrum was a milestone in psychiatric research. However, recent research points to a third etiological independent spectrum of stress-induced cycloid psychoses that can be diagnosed and differentiated from both affective and schizophrenic psychoses with reliable operational methodology.