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Freeman, T. (1983). Reexamining the Schizophrenias. Psychoanal. Inq., 3(1):71-89.

(1983). Psychoanalytic Inquiry, 3(1):71-89

Reexamining the Schizophrenias Related Papers

Thomas Freeman, M.D.

Diagnostic Concepts

Although 70 years have passed since Eugen Bleuler (1911) introduced the concept of the group of schizophrenias, psychiatrists are still far from unanimous about which patients should be given this diagnosis, particularly at the onset of the illness. Ping-Nie Pao (1979), however, is definite about his position. He underlines the similar mental pathology in all schizophrenic disorders and rejects such supplementary clinical categories as schizophreniform psychosis, reactive (paranoid) psychosis, and schizoaffective psychosis. Nor does he see the diagnosisschizophrenia” as implying the negative prognosis of Kraepelin's “dementia praecox.”

In believing that a complete recovery can take place in schizophrenic psychoses, Pao is in agreement with Manfred Bleuler (1978) and other Swiss psychiatrists (Ciompi, 1980; C. Muller, 1979, personal communication). Using Eugen Bleuler's (1911) diagnostic criteria, they found a favorable outcome in 53% (M. Bleuler) and 49% (Ciompi) of cases followed up for 22 years and 39 years respectively. These results, however, will be challenged by psychiatrists such as Langfeldt (1960) or Ey (1959), who prefer the narrow view of schizophrenia (nuclear or process schizophrenia). They will claim that patients who make a complete recovery have suffered from schizophrenialike illnesses, not from schizophrenia as they understand it.

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