The concept of “schizophrenia” may soon disappear

Schizophrenia is one of the most famous syndromes in the field of mental health. Its shocking characteristics and the strangeness of the hallucinations and behavioral alterations it produces have introduced this concept to many people who are not engaged in psychiatry or clinical psychology. Of course, schizophrenia is important in patients and healthcare professionals 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, it is one thing that the symptoms associated with schizophrenia are incredible and very severe, and it is quite another that this clinical entity exists as such, as a natural phenomenon well separated from the rest. In fact, the concept of what we call schizophrenia for years could have its days.

    What if schizophrenia didn’t exist?

    Until a few years ago, Asperger’s syndrome was one of the best-known diagnostic labels, in part due to the striking characteristics of some of these patients: intelligent, difficult to understand, and obsessed with areas of knowledge. very specific.

    However, today this name is no longer used. Since the phenomenon he was referring to Asperger’s syndrome is now part of a spectrum; more specifically, autism spectrum disorders.

    Something very similar could soon happen with the label of schizophrenia, which has been harshly criticized by psychology for decades. Now, doubts about its existence are gaining strength, even within psychiatry. There are basically two reasons for this.

      Several causes of different disorders?

      As with virtually all so-called “mental illnesses”, no specific biological alteration is known to be the cause of schizophrenia.

      This is understandable, given that the nervous system in general and the brain in particular they are extremely complex biological systemsWithout a clear path of entry and exit, and within them millions of microscopic elements participate in real time, from neurons and glial cells to hormones and neurotransmitters.

      However, another possible explanation for why a neurological basis has not been isolated from schizophrenia is that it does not exist. In other words, there are several and very diverse causes that end up generating different chain reactions but at the end of which a set of very similar symptoms appears: hallucinations, delusions, stupor, etc.

      In contrast, attempts to link schizophrenia to a few altered genes, which scoff at a quick and easy way to explain a disease by designating a very specific element as its cause, have failed. Only 1% of the cases in which this syndrome appears have been associated with the removal of a small section of chromosome 22. What happens in the remaining 99% of cases?

      Different treatments for different types of schizophrenia

      Another piece of evidence that reinforces the idea that schizophrenia does not exist as a homogeneous entity is that not only are the parallel pathways intuitive through which symptoms of this syndrome can appear; there also seem to be parallel paths in their treatment.

      The fact that certain types of treatments seem to work specifically in cases where this syndrome appears to be caused by certain triggers, and not others, indicates that there are different foci of nerve activity associated with schizophrenia, and these do not all manifest in all patients at once.

      The reverse can also occur, that in some schizophrenic patients who share significant characteristics in common (which differentiate them from other schizophrenic patients), some drug treatments work particularly poorly, Or does not work. For example, in boys and girls in whom the onset of psychotic symptoms associated with schizophrenia coincides with exposure to traumatic events, antipsychotic drugs are not too effective.


      One of the problems with psychiatry is that it is sometimes inferred that the problems that patients present are deep inside your nervous system, Isolated from the context in which the person has developed and learned to behave.

      Of course, this belief is justified in certain pathologies in which we have seen that certain nerve cells are destroyed, for example.

      However, attributing the focus of syndromes such as schizophrenia to something that is spontaneously “born” in the brain of patients can be misleading. That there is a set of symptoms that suggest a disturbance with reality this does not mean that all these cases have their roots in a concrete disease and separate from all the others. Supporting this idea, to some extent, may become simply giving use to a word that has been in use for a long time. But we must not forget 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 Maaschrist University, have proposed replacing the term “schizophrenia” with that of psychosis spectrum disorders, an idea that corresponds to different causes and mechanisms. break with reality. This less essentialist approach schizophrenia can really help us understand what’s going on in the lives of patients, beyond trying to fit their behaviors into one category of homogenization.

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