The authors of the following article published in the journal Schizophrenia Research, are encouraging us to get prepared to drop and replace the term "schizophrenia." I believe we should do this not just on scientific grounds (I have detailed that in many papers) but on ethical and social grounds as well. The myths of non-recoverability and violence seem hard-wired into the diagnosis, there is a lack of appreciation of the heterogeneity involved, and the lack of input from persons with lived experience. Please circulate to colleagues and friends my petition to the WHO and APA to drop the term "schizophrenia", as many medical diagnoses have been renamed throughout history, for the reasons stated in the petition (and other reasons not overtly stated). 

Thank you.

Brian Koehler, PhD, MS

New York University

Schizophrenia Research

Volume 242

, April 2022, Pages 30-34

We are not ready to abandon the current schizophrenia by Silvana Galderisi & Giulia M. Giordano

Abstract

The current schizophrenia construct as delineated in the latest editions of the DSM and the ICD has some strengths, but also many weaknesses.

It improved the reliability of the diagnosis, made communication among clinicians, users and families less ambiguous, is useful for education and training, and for reimbursement and insurance purposes.

However, many serious weaknesses should be considered. The term “Schizophrenia” does not recognize the heterogeneity of the disorder and might nourish the belief that schizophrenia represents a unitary disease. In addition, there is no agreement on the existence and nature of a “core aspect” of the disorder. Stable dimensions, in particular negative symptoms and cognitive impairment, which are key determinants of functioning, are not de facto regarded as core aspects. Finally, the construct is associated to the notion of a poor outcome, to a high level of stigma and has acquired a derogatory connotation.

We are not ready but should be prepared to abandon the current schizophrenia construct. Clinicians and researchers should be encouraged to complement the ICD/DSM diagnosis with an in-depth characterization of the individual clinical picture, along with other variables, such as family history, comorbidities, vulnerability factors and personal trajectory. The “Primary Psychoses” construct, together with improved cross-sectional and longitudinal phenotypes from representative population and patient cohorts, and the availability of artificial intelligence methods, could lead to a new and more precise taxonomy of psychotic disorders, and increase the probability of identifying meaningful biomarkers to improve prevention, diagnosis, prognosis, and treatment for people suffering from psychotic disorders.