SS-08-01

Self and identity in schizophrenia

G. Stanghellini. Florence, ltaly

SS-08-02

Change of schizophrenic syndromes?

C. Mundt. Germany

SS-08-03

Present status of cycloid psychoses

I. Brockington. Lower Brockmgton Farm, Hereforshire, United Kingdom

SS-08-04

Schizophrenia - what for?

M. Musalek. Anton Proksch Institut, Wien, Austria

Since the first description of dementia praecox by Emil Kraepelin and the early works on the group of schizophrenias by Eugen Bleuler many definitions of schizophrenic psychoses have been proposed by different schools leading to a Babel in today's diagnostics. The provisional end of the diagnostic dilemma represents the diagnostic criteria of the ICD-10. for schizophrenia in which divergent symptom clusters as delusions, hallucinations, thought disorders, emotional deviations, and social problems or handicaps are included. As schizophrenia is one of the most stigmatizing diagnosis in psychiatry, we thoroughly have to put the question: do we need this diagnostic category any longer. Main goals of diagnostics are the validity of diagnostic criteria with respect to selection of treatment procedures, prognosis making, improvement of communication, topographical aspects, dangerousness, economical and/or political dimensions. As it could be shown in recent analyses the today's most commonly used diagnostic criteria for schizophrenia do not fulfill these main demands. Therefore the diagnostic label of schizophrenia should be abandoned and replaced by diagnostic procedures or models with higher validity concerning the mentioned main goals of diagnostics. A way-out of the today's frustrating diagnostic situation could be a change of paradigms from categorical to dimensional diagnostics. In contrast to categorical diagnostics, e.g. DSM-IV or ICD-10, dimensional diagnostics are phenomenon-, pathogenesis- and process-oriented. Providing a more valid basis for treatment planning and prognosis making dimensional diagnostics represent suitable alternatives to classical diagnostic procedures.