Skip to main content
SpringerLink
Log in

Psychopathological assessment of schizophrenia: Relevance for classification

  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Considerable effort has been focused on updating the clinical aspects of psychiatric classifications based on recent progress in the field of neurobiology. In this article, recent developments in the primary assessment methods within clinical psychiatry, which are based in phenomenological psychopathology, are reviewed as nosotaxies that are still embedded in clinical description. New directions for research on psychopathology are outlined to elicit better descriptions of subjective experience from patients. Finally, the known limitations of the Kraepelinian dichotomy are summarized, and future problems related to the inclusion of the new dimensional assessment methods in the next psychiatric classifications are described.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Rössler W, Salize HJ, van Os J, Riecher-Rossler A: Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 2005, 15:399–409.

    Article  PubMed  Google Scholar 

  2. Perälä J, Suvisaari J, Saarni SI, et al.: Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry 2007, 64:19–28.

    Article  PubMed  Google Scholar 

  3. Sawa A, Snyder SH: Schizophrenia: diverse approaches to a complex disease. Science 2002, 296:692–695.

    Article  PubMed  CAS  Google Scholar 

  4. Caspi A, Moffitt TE: Gene-environment interactions in psychiatry: joining forces with neuroscience. Nat Rev Neurosci 2006, 7:583–590.

    Article  PubMed  CAS  Google Scholar 

  5. Kendler KS: Toward a philosophical structure for psychiatry. Am J Psychiatry 2005, 162:433–440.

    Article  PubMed  Google Scholar 

  6. Peralta V, Cuesta MJ: The diagnosis of schizophrenia: old wine in new bottles. Int J Psychol Psychol Ther 2003, 3:141–152.

    Google Scholar 

  7. Tandon R, Keshavan MS, Nasrallah HA: Schizophrenia, “just the facts”: what we know in 2008 part 1: overview. Schizophr Res 2008, 100:4–19.

    Article  PubMed  Google Scholar 

  8. Parnas J, Sass LA, Zahavi D: Recent developments in philosophy of psychopathology. Curr Opin Psychiatry 2008, 21:578–584.

    Article  PubMed  Google Scholar 

  9. Fuchs T: The challenge of neuroscience: psychiatry and phenomenology today. Psychopathology 2002, 35:319–326.

    Article  PubMed  Google Scholar 

  10. Andreasen NC: DSM and the death of phenomenology in America: an example of unintended consequences. Schizophr Bull 2007, 33:108–112.

    Article  PubMed  Google Scholar 

  11. Berrios GE: What is phenomenology? A review. J R Soc Med 1989, 82:425–428.

    PubMed  CAS  Google Scholar 

  12. Jaspers K: General Psychopathology. Chicago: University of Chicago Press; 1964.

    Google Scholar 

  13. Rulf S: Phenomenological contributions on schizophrenia: a critical review and commentary on the literature between 1980–2000. J Phenomenol Psychol 2003, 34:1–46.

    Article  Google Scholar 

  14. Parnas J, Bovet P, Zahavi D: Schizophrenic autism: clinical phenomenology and pathogenetic implications. World Psychiatry 2002, 1:131–136.

    PubMed  Google Scholar 

  15. Stanghellini G: Disembodied Spirits and Deanimated Bodies: The Psychopathology of Common Sense (International Perspectives in Philosophy and Psychiatry). New York: Oxford University Press; 2006.

    Google Scholar 

  16. Mullen PE: A modest proposal for another phenomenological approach to psychopathology. Schizophr Bull 2007, 33:113–121.

    Article  PubMed  Google Scholar 

  17. Moscarelli M: Passive and active schizophrenia: toward a new descriptive micropsychopathology. Schizophr Bull 2008 Jun 17 (Epub ahead of print).

  18. Stanghellini G, Ballerini M: Values in persons with schizophrenia. Schizophr Bull 2007, 33:131–141.

    Article  PubMed  Google Scholar 

  19. Ghaemi SN: Feeling and time: the phenomenology of mood disorders, depressive realism, and existential psychotherapy. Schizophr Bull 2007, 33:122–130.

    Article  PubMed  Google Scholar 

  20. Uhlhaas PJ, Mishara AL: Perceptual anomalies in schizophrenia: integrating phenomenology and cognitive neuroscience. Schizophr Bull 2007, 33:142–156.

    Article  PubMed  Google Scholar 

  21. Kéri S, Kelemen O, Janka Z, Benedek G: Visual-perceptual dysfunctions are possible endophenotypes of schizophrenia: evidence from the psychophysical investigation of magnocellular and parvocellular pathways. Neuropsychology 2005, 19:649–656.

    Article  PubMed  Google Scholar 

  22. Cuesta MJ, Peralta V, Juan JA: Abnormal subjective experiences in schizophrenia: its relationships with neuropsychological disturbances and frontal signs. Eur Arch Psychiatry Clin Neurosci 1996, 246:101–105.

    Article  PubMed  CAS  Google Scholar 

  23. Guy W, Ban TA, eds: The AMDP System: Manual for the Assessment and Documentation of Psychopathology. Berlin: Springer-Verlag; 1982.

    Google Scholar 

  24. Möller HJ: Systematic of psychiatric disorders between categorical and dimensional approaches: Kraepelin’s dichotomy and beyond. Eur Arch Psychiatry Clin Neurosci 2008, 258(Suppl 2):48–73.

    Article  PubMed  Google Scholar 

  25. Cuesta MJ, Peralta V: Integrating psychopathological dimensions in functional psychoses: a hierarchical approach. Schizophr Res 2001, 52:215–229.

    Article  PubMed  CAS  Google Scholar 

  26. Schnell K, Heekeren K, Daumann J, et al.: Correlation of passivity symptoms and dysfunctional visuomotor action monitoring in psychosis. Brain 2008, 131:2783–2797.

    Article  PubMed  Google Scholar 

  27. Cuesta MJ, Peralta V, Zarzuela A, Zandio M: Insight dimensions and cognitive function in psychosis: a longitudinal study. BMC Psychiatry 2006, 6:26.

    Article  PubMed  Google Scholar 

  28. Stanghellini G, Bertelli M, Raballo A: Typus melancholicus: personality structure and the characteristics of major unipolar depressive episode. J Affect Disord 2006, 93:159–167.

    Article  PubMed  Google Scholar 

  29. Hoche A, Dening RG, Dening TR, Berrios GE: The significance of symptom complexes in psychiatry. Hist Psychiatry 1991, 2:329–343.

    Article  PubMed  CAS  Google Scholar 

  30. Healy D, Harris M, Farquhar F, et al.: Historical overview: Kraepelin’s impact on psychiatry. Eur Arch Psychiatry Clin Neurosci 2008, 258(Suppl 2):18–24.

    Article  PubMed  Google Scholar 

  31. Hippius H, Müller N: The work of Emil Kraepelin and his research group in Munchen. Eur Arch Psychiatry Clin Neurosci 2008, 258(Suppl 2):3–11.

    Article  PubMed  Google Scholar 

  32. Jablensky A: Subtyping schizophrenia: implications for genetic research. Mol Psychiatry 2006, 11:815–836.

    Article  PubMed  CAS  Google Scholar 

  33. Greene T: The Kraepelinian dichotomy: the twin pillars crumbling? Hist Psychiatry 2007, 18:361–379.

    Article  PubMed  Google Scholar 

  34. Boyle M: Is schizophrenia what it was? A re-analysis of Kraeplin’s and Bleuler’s population. J Hist Behav Sci 1990, 26:323–333.

    Article  Google Scholar 

  35. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 4. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  36. Cuesta MJ, Peralta V, Zarzuela A: Empirical validation of competing definitions of schizophrenia: a poly-diagnostic study of cognitive impairment in non-affective psychosis. Schizophr Res 2007, 95:39–47.

    Article  PubMed  Google Scholar 

  37. Lieberman DZ, Peele R, Razavi M: Combinations of DSM-IV-TR criteria sets for bipolar disorders. Psychopathology 2008, 41:35–38.

    Article  PubMed  Google Scholar 

  38. Gaebel W, Zielasek J: Psychiatry as a diagnostic discipline. Eur Arch Psychiatry Clin Neurosci 2008, 258(Suppl 5):1.

    Article  PubMed  Google Scholar 

  39. Van Os J, Tamminga C: Deconstructing psychosis. Schizophr Bull 2007, 33:861–862.

    Article  PubMed  Google Scholar 

  40. Craddock N, Owen MJ: Rethinking psychosis: the disadvantages of a dichotomous classification now outweigh the advantages. World Psychiatry 2007, 6:84–91.

    PubMed  Google Scholar 

  41. Regier DA: Dimensional approaches to psychiatric classification: refining the research agenda for DSM-V: an introduction. Int J Methods Psychiatr Res 2007, 16(Suppl 1):S1–S5.

    Article  PubMed  Google Scholar 

  42. Dutta R, Greene T, Addington J, et al.: Biological, life course, and cross-cultural studies all point toward the value of dimensional and developmental ratings in the classification of psychosis. Schizophr Bull 2007, 33:868–876.

    Article  PubMed  Google Scholar 

  43. Peralta V, Cuesta MJ: A dimensional and categorical architecture for the classification of psychotic disorders. World Psychiatry 2007, 6:100–101.

    PubMed  Google Scholar 

  44. Alarcon RD: When the paradigms languish. World Psychiatry 2007, 6:97–98.

    PubMed  Google Scholar 

  45. First MB: Beyond clinical utility: broadening the DSMV research appendix to include alternative diagnostic constructs. Am J Psychiatry 2006, 163:1679–1681.

    Article  PubMed  Google Scholar 

  46. Cuesta MJ, Peralta V: Current psychopathological issues in psychosis: towards a phenome-wide scanning approach. Schizophr Bull 2008, 34:587–590.

    Article  PubMed  Google Scholar 

  47. Kraemer HC: DSM categories and dimensions in clinical and research contexts. Int J Methods Psychiatr Res 2007, 16(Suppl 1):S8–S15.

    Article  PubMed  Google Scholar 

  48. Pincus HA, Tew JD, First MB: Psychiatric comorbidity: is more less? World Psychiatry 2004, 3:18–23.

    PubMed  Google Scholar 

  49. Jablensky A: The syndrome—an antidote to spurious comorbidity? World Psychiatry 2004, 3:24–25.

    PubMed  Google Scholar 

  50. Beals J, Novins DK, Spicer P, et al.: Challenges in operationalizing the DSM-IV clinical significance criterion. Arch Gen Psychiatry 2004, 61:1197–1207.

    Article  PubMed  Google Scholar 

  51. Faust D, Miner RA: The empiricist and his new clothes: DSM-III in perspective. Am J Psychiatry 1986, 143:962–967.

    PubMed  CAS  Google Scholar 

  52. Kendell RE: Schizophrenia: the remedy for diagnostic confusion. Br J Psychiatry 1975, Spec No 9:11–17.

    Google Scholar 

  53. Allardyce J, Gaebel W, Zielasek J, van Os J: Deconstructing Psychosis conference February 2006: the validity of schizophrenia and alternative approaches to the classification of psychosis. Schizophr Bull 2007, 33:863–867.

    Article  PubMed  Google Scholar 

  54. Peralta V, Cuesta MJ: Characterization of affective domains within the nonaffective psychotic disorders. Schizophr Res 2009, 111:61–69.

    Article  PubMed  Google Scholar 

  55. Baca-Garcia E, Perez-Rodriguez MM, Basurte-Villamor I, et al.: Diagnostic stability of psychiatric disorders in clinical practice. Br J Psychiatry 2007, 190:210–216.

    Article  PubMed  Google Scholar 

  56. Dikeos DG, Wickham H, McDonald C, et al.: Distribution of symptom dimensions across Kraepelinian divisions. Br J Psychiatry 2006, 189:346–353.

    Article  PubMed  Google Scholar 

  57. Lichtenstein P, Yip BH, Bjork C, et al.: Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based study. Lancet 2009, 373:234–239.

    Article  PubMed  CAS  Google Scholar 

  58. Peralta V, Cuesta MJ: Familial liability and schizophrenia phenotypes: a polydiagnostic approach. Schizophr Res 2007, 96:125–134.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychiatric Unit, Virgen del Camino Hospital, Irunlarrea 4, 31008, Pamplona, Spain

    Manuel J. Cuesta

Authors
  1. Manuel J. Cuesta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Victor Peralta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manuel J. Cuesta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cuesta, M.J., Peralta, V. Psychopathological assessment of schizophrenia: Relevance for classification. Curr Psychiatry Rep 11, 324–331 (2009). https://doi.org/10.1007/s11920-009-0047-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-009-0047-4

Keywords

Search

Navigation