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What Can They Tell Us About the Clinical Course and Pathophysiologic Processes of Schizophrenia?

Jeffrey A. Lieberman, MD
Department of Psychiatry Hillside Hospital 75-59 263rd St Glen Oaks, NY 11004

Arch Gen Psychiatry. 1995;52(5):361-363.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

HISTORICALLY, psychiatry has emphasized phenomenologic description in its conceptualization and characterization of schizophrenia. Although Kraepelin¹ and Langfeldt² included longitudinal course as a diagnostic criterion, most students of schizophrenia focused on qualitative descriptions of the psychopathologic processes. Initial efforts to define the disorder by its neurobiologic characteristics were frustrated by the inability of classical neuropathologists to identify histopathologically distinct and replicable lesions.^3,4 Given the variable nature of the disorder, clinicians attempted to reduce its heterogeneity by delineating meaningful subtypes. The traditional subtypes of paranoid, undifferentiated, hebephrenic (disorganized), and catatonic schizophrenia were defined by qualitative differences in psychopathologic features and have endured despite the absence of validating evidence from investigations of treatment response, long-term outcome, pathophysiologic processes, or genetics. However, reductio ad absurdum, some skeptics suggest that phenomenological distinctions in schizophrenia may be meaningless in our efforts to understand the underlying nature and cause of the disease.

The efforts . . . [Full Text PDF of this Article]

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