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Tijdschrift voor Psychiatrie 58 (2016) 7, 513 - 519


Schizophrenia exists: yes / no / don’t know

P.F. Bouvy

background The suggestion that schizophrenia does not exist has let to a discussion in Dutch national newspapers. According to several contributors, the diagnosis schizophrenia can wrongly lead to stigmatisation and defeatism with regard to treatment and should therefore be replaced by the broader concept, psychosis. This view strengthens the argument that ‘schizophrenia does not exist’. In reaction to this view it has been suggested that in some articles that schizophrenia is now believed to have a definite biological basis.
aim To clarify the various arguments and concepts that are used.
method The arguments for and against are reviewed from an ontological perspective. Ethical/political arguments and scientific arguments are handled separately and are set against each other.
results The ontological status of psychiatric disorders, including schizophrenia, are problematic, as has been shown in a recent study by Kendler. From the perspective of the medical scientific programme – namely, try to go from syndromes to anatomically defined diseases - it would appear that one party wants to abandon this programme, whereas the other party wants to continue it.
conclusion Research over the last few decades has been unable to clarify the ontological status of schizophrenia.

keywords ontology, psychosis, schizophrenia