Revisiting the Diagnosis of Schizophrenia: Where have we been and Where are We Going?
Open accessAbstract
Appropriate and reliable classification of mental illness is crucial for advancing the field of psychiatry as agreement on diagnosis has broad implications for treatment of mental disorders and research into the etiopathophysiology of mental disorders. Since schizophrenia was first recognized by Kraepelin (as dementia praecox), there has been much discussion about what does and does not diagnostically constitute the disorder. The importance placed upon different symptoms and course types associated with schizophrenia has been as heterogeneous as the disorder itself. This article focuses upon the classification of schizophrenia over the last 100 years, the current diagnosis of schizophrenia, changes for schizophrenia planned in the upcoming DSM 5, future directions for improving the diagnosis of schizophrenia, and the implications of a new diagnostic paradigm for the illness.
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In ICD-11, the nine ICD-10 schizophrenia subtypes are omitted because of their longitudinal instability and lack of prognostic validity, and replaced by coded symptom and course qualifiers.
“Similar to the DSM-5, in the ICD-11, the nine ICD-10 schizophrenia subtypes (paranoid, hebephrenic, catatonic, etc.) are now omitted because of their longitudinal instability and lack of prognostic validity [21], and have been replaced by a system of coded symptom and course qualifiers (see below).”
From Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies (2020) · cites this paper as [21]
In “The Emphasis on Reality Distortion in Current Diagnosis” (page unavailable), the paper explicitly describes schizophrenia subtypes as unstable across episodes. It says reality-distortion symptoms do not predict course or outcome, but does not directly establish the prognostic validity of the subtypes or discuss ICD-11’s omission of them and replacement with coded qualifiers. (LLM, conf=0.84)
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Status of Psychotic Disorders in ICD-11
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- Authors
- Keller, W. R., Fischer, B. A., & Carpenter Jr., W. T.
- Affiliations
- University of Maryland, Baltimore (US)
- ORCID
- Keller, William R.
- Venue
- CNS Neuroscience & Therapeutics
- Publisher
- Wiley
- Published
- 2010-12-27
- Volume
- 17
- Issue
- 2
- Pages
- 83-88
- ISSN
- 1755-5930 (ISSN-L)
- PMC
- PMC6493851
- OpenAlex
- W1499358446
- Cited by
- 46
- References
- 76
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2022: 2 · 2021: 1 · 2020: 6 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 5 · 2013: 5 · 2012: 5
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- CNS Neuroscience & Therapeutics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- schizophrenia, diagnosis, classification of mental illness, DSM-5, dementia praecox, Kraepelin, diagnostic criteria, symptom heterogeneity, clinical course, history of psychiatry
- MeSH terms
- Humans, Psychiatry, Schizophrenia, Diagnostic and Statistical Manual of Mental Disorders
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