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The concept of 'schizophrenia' could disappear soon

The concept of 'schizophrenia' could disappear soon

April 28, 2024

Schizophrenia is one of the most famous syndromes of the field of mental health. Its striking features and the strange hallucinations and behavioral alterations it produces have made this concept known to many people who are not dedicated to psychiatry or clinical psychology. Of course, among patients and health professionals, schizophrenia is important not so much because of the above, but because of the serious consequences it has for the health of those who have been diagnosed with it.

However, one thing is that the symptoms associated with schizophrenia are incredible and very severe, and another is that this clinical entity exists as such, as a natural phenomenon well separated from the rest. In fact, the concept of what we have been calling schizophrenia for years could have been numbered .


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What if schizophrenia does not exist?

Until a few years ago, Asperger's syndrome was one of the best-known diagnostic labels, due to, among other things, the striking characteristics of some of the patients of this type: intelligent, with difficulties to empathize, and obsessed with areas of knowledge very specific

However, today this denomination is no longer used. Since the phenomenon referred to Asperger's syndrome has become part of a spectrum ; Specifically, Autism Spectrum Disorders.

Something very similar could happen soon with the label of schizophrenia, harshly criticized from psychology for decades. Now, doubts about its existence are gaining strength even within psychiatry. The reasons for this are, fundamentally, two.


  • Related article: "The 5 differences between psychosis and schizophrenia"

Several causes for different disorders?

As with virtually all so-called "mental illnesses", there is no known specific biological alteration that is the cause of schizophrenia.

This is understandable, considering that the nervous system in general and the brain in particular they are tremendously complex biological systems , without a clear entry and exit route, and millions of microscopic elements participate in real time, from neurons and glial cells to hormones and neurotransmitters.

However, another possible explanation for the fact that it has not been possible to isolate a neurological basis of schizophrenia is that it does not exist. That is, there are several and very diverse causes that end up generating different chain reactions but in whose end appears a set of symptoms very similar to each other: hallucinations, delusions, stupor, etc.


On the other hand, attempts to link schizophrenia to a few altered genes, which would provide a quick and easy way to explain a disease by pointing to its cause as a very specific element, have been unsuccessful. It has only been possible to associate 1% of the cases in which this syndrome appears to the elimination of a small section of chromosome 22. What happens in 99% of the remaining cases?

Different treatments for various types of schizophrenia

Another of the evidences that reinforce the idea that schizophrenia does not exist as a homogeneous entity is that not only are parallel pathways intuited by which the symptoms of this syndrome may appear; there also seem to be parallel pathways in their treatment .

The fact that certain types of treatments seem to work specifically in cases in which this syndrome seems caused by certain triggers, and not in others, indicates that there are different foci of nervous activity linked to schizophrenia, and these do not all manifest themselves to the time in all patients.

The opposite can also happen, that in certain patients of schizophrenia that have significant characteristics in common (which differentiate them from other patients of schizophrenia), some pharmacological treatments work especially badly , or they do not work. For example, boys and girls in whom the onset of psychotic symptoms associated with schizophrenia coincide with exposure to traumatic events, antipsychotic drugs are not very effective.

conclusion

One of the problems of psychiatry is that, sometimes, it is inferred that the problems shown by patients are found in the depths of your nervous system , isolated from the context in which the person has developed and has learned to behave.

Of course, this belief is right to be in certain pathologies in which it has been seen that certain nerve cells are being destroyed, for example.

However, attributing the focus of syndromes such as schizophrenia to something that is "born" spontaneously in patients' brains can be fallacious. That there is a set of symptoms that suggest disruption With reality does not mean that all these cases have their roots in a specific disease and separated from all others. To sustain that idea, up to a certain point, can be, simply, to use a word that has been used for a long time. But we must bear in mind that in science language adapts to reality, and not the other way around.

For this reason, researchers like Jim van Os, Professor of Psychiatry at the University of Maaschrist, have proposed that the term "schizophrenia" be replaced by that of Disorders of the Spectrum of Psychosis, an idea in which different causes and mechanisms can fit. that this rupture with reality takes shape. This less essentialist approach of schizophrenia can make us really understand what happens in the lives of patients, beyond trying to fit their behavior into a single homogenizing category.


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