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Tijdschrift voor Psychiatrie 47 (2005) 3, 149 - 155


Why retain a diagnosis of schizophrenia?

J.M. Havenaar

It has been argued recently that schizophrenia is a fuzzy ill-defined term that is harmful for patients. This view was also put forward some thirty years ago. It is said that over time the term has acquired markedly negative connotations and that it has no empirical basis. It has been proposed that the term should be abolished completely and be replaced by a dimensional concept, 'psychosis'. On the basis of the distinction drawn by Kendell and Jablensky between the validity and the usefulness of a psychiatric diagnosis, the author reviews the arguments for and against the abolition of the term 'schizophrenia'. The diagnosis 'schizophrenia' is no less valid than the diagnosis of many somatic and psychiatric disorders. The term performs a useful function in the communication between clinicians, patients and policy makers. From a scientific and societal point of view replacing this diagnostic category by a dimensional concept would create just as many problems as it would solve. The best solution is to continue using the two terms, 'schizophrenia' and 'psychosis', whichever seems more appropriate in a particular context.


keywords concept, psychosis, schizophrenia, utility, validity