A narrative review of nosology and the concept of schizophrenia: criticism and proposal

ABSTRACT Schizophrenia diagnostics have evolved to adapt to clinical needs and scientific advances, and the current denominations emerged at the beginning of the twentieth century. Most problems arise while integrating clinical experiences, based on historical psychopathological descriptions, with e...

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Main Authors: Ricardo Abreu Feijo de Mello, Ary Gadelha, Larissa Leal Freitas, Vitoria Fernandes Sant’Ana, Marcelo Feijó Mello
Format: Article
Language:English
Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2025-02-01
Series:Einstein (São Paulo)
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082025000100400&lng=en&tlng=en
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author Ricardo Abreu Feijo de Mello
Ary Gadelha
Larissa Leal Freitas
Vitoria Fernandes Sant’Ana
Marcelo Feijó Mello
author_facet Ricardo Abreu Feijo de Mello
Ary Gadelha
Larissa Leal Freitas
Vitoria Fernandes Sant’Ana
Marcelo Feijó Mello
author_sort Ricardo Abreu Feijo de Mello
collection DOAJ
description ABSTRACT Schizophrenia diagnostics have evolved to adapt to clinical needs and scientific advances, and the current denominations emerged at the beginning of the twentieth century. Most problems arise while integrating clinical experiences, based on historical psychopathological descriptions, with emerging translational neuroscience research. This study aimed to evaluate the state-of-the-art critics of the current schizophrenia concept and their recommendations for new concepts. We performed a narrative review of the literature and searched for studies published in English in PubMed in the last 2 years which discussed the diagnosis of schizophrenia. Two authors independently selected the studies after analyzing the abstracts. Subsequently, studies were selected for this review by consensus. Twenty-six studies were selected, and all authors, except two, had restrictions on the current categorical model for the diagnosis of schizophrenia owing to the heterogeneity of symptomatology and high frequency of comorbidity. Eight studies proposed changes to the concept of schizophrenia. The central proposition was to adopt psychotic syndrome as a core feature instead of the current concept of schizophrenia. We synthesize these proposals using psychosis as a spectrum that includes schizophrenia as a more severe case at the end of the spectrum.
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publisher Instituto Israelita de Ensino e Pesquisa Albert Einstein
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spelling doaj-art-2bc513efec734c9cb7d8e29fe10b02c82025-08-20T02:02:57ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-63852025-02-012310.31744/einstein_journal/2025rw1131A narrative review of nosology and the concept of schizophrenia: criticism and proposalRicardo Abreu Feijo de Mellohttps://orcid.org/0009-0008-5899-4198Ary Gadelhahttps://orcid.org/0000-0002-0993-8017Larissa Leal Freitashttps://orcid.org/0009-0001-5451-562XVitoria Fernandes Sant’Anahttps://orcid.org/0009-0008-1259-1895Marcelo Feijó Mellohttps://orcid.org/0000-0002-0475-4729ABSTRACT Schizophrenia diagnostics have evolved to adapt to clinical needs and scientific advances, and the current denominations emerged at the beginning of the twentieth century. Most problems arise while integrating clinical experiences, based on historical psychopathological descriptions, with emerging translational neuroscience research. This study aimed to evaluate the state-of-the-art critics of the current schizophrenia concept and their recommendations for new concepts. We performed a narrative review of the literature and searched for studies published in English in PubMed in the last 2 years which discussed the diagnosis of schizophrenia. Two authors independently selected the studies after analyzing the abstracts. Subsequently, studies were selected for this review by consensus. Twenty-six studies were selected, and all authors, except two, had restrictions on the current categorical model for the diagnosis of schizophrenia owing to the heterogeneity of symptomatology and high frequency of comorbidity. Eight studies proposed changes to the concept of schizophrenia. The central proposition was to adopt psychotic syndrome as a core feature instead of the current concept of schizophrenia. We synthesize these proposals using psychosis as a spectrum that includes schizophrenia as a more severe case at the end of the spectrum.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082025000100400&lng=en&tlng=enSchizophreniaPsychiatric disordersPsychopathologyPsychotic disorders
spellingShingle Ricardo Abreu Feijo de Mello
Ary Gadelha
Larissa Leal Freitas
Vitoria Fernandes Sant’Ana
Marcelo Feijó Mello
A narrative review of nosology and the concept of schizophrenia: criticism and proposal
Einstein (São Paulo)
Schizophrenia
Psychiatric disorders
Psychopathology
Psychotic disorders
title A narrative review of nosology and the concept of schizophrenia: criticism and proposal
title_full A narrative review of nosology and the concept of schizophrenia: criticism and proposal
title_fullStr A narrative review of nosology and the concept of schizophrenia: criticism and proposal
title_full_unstemmed A narrative review of nosology and the concept of schizophrenia: criticism and proposal
title_short A narrative review of nosology and the concept of schizophrenia: criticism and proposal
title_sort narrative review of nosology and the concept of schizophrenia criticism and proposal
topic Schizophrenia
Psychiatric disorders
Psychopathology
Psychotic disorders
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082025000100400&lng=en&tlng=en
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