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Page Background European Psychiatry 41S (2017) S2

Available online at


25th European Congress of Psychiatry


Debate: Is the concept of schizophrenia useful?



W. Gaebel

Heinrich-Heine-Universität, Düsseldorf, Germany

The concept of schizophrenia has undergone many changes since

its first inception in the early 20


century. Basically, the concept

has stood the tests of time, as it provides useful information about

the clinical picture, the clinical course and the available treat-

ment modalities. Any alternative concept will need to show that

it provides similar information. The concept has also been useful to

establish evidence–based guidelines for diagnosis and treatment,

and to provide valuable information as regards psychosocial out-

comes. In addition, recent genetic and neurophysiological studies

have shown that common grounds of aetiopathogenesis can be

identified, in that schizophrenia is a mental disorder with some

genetic influences and a common pathway in complex disturbances

of brain circuits due to altered neurotranmission. Current research

focuses on identifying biomarkers for early detection, another area

of mental healthcare in which a staging model of schizophrenia

proved useful. This presentation will highlight the most pertinent

arguments for keeping schizophrenia as a useful diagnostic and

therapeutic concept of a mental disorder.

Unterstützung bei Symposien/Symposia Support

Janssen-Cilag GmbH, Neuss;

Aristo Pharma GmbH, Berlin;

Lilly Deutschland GmbH, Bad Homburg;

Servier Deutschland GmbH, München;

Fakultätsmitglied/Faculty Member;

Lundbeck International Neuroscience Foundation (LINF), Däne-


Disclosure of interest

The author declares that he has no

competing interest.



M. Musalek

Anton Proksch Institute, Gräfin Zichy Straße 4-6, 1230, Vienna,


The analysis of the historical development of the currently used

diagnosis schizophrenia in DSM or ICD classification indicates

that sticking to established terms and methodologies more and

more develops to an obstacle in schizophrenia research. The aim

of the currently used operational diagnostic approach was to

reach reliability of diagnoses between different psychiatrists and

researchers as high as possible. This should improve the com-

munication between different research groups and better the

comparison of study results. The aim of a high reliability has surely

been reached, however, the expected striking progress in research

and clinical praxis failed to materialize till today. Reliability,

which means agreement, does not simultaneously means valid-

ity. Modern brain and genetic research requires more homogenous

clinical syndromes or ‘diseases’ to examine them with scientifi-

cally based methodologies and technologies. The prerequisite for

doing this, however, is going back to clinical and empirical real-

ities and to integrate these realities into the development of a

new generation of classification systems that are free of dogmatic


Disclosure of interest

The author declares that he has no

competing interest.