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Cohen, D. Santos, L. Esteguy, B. Rodríguez, M. (2010). Chapter of Psychoanalysis and Neuroscience: Argentine Psychoanalytical Association (APA): Schizophrenia's Neuropsychoanalysis: A new Exercise in Consilience. Neuropsychoanalysis, 12(1):107-108.

(2010). Neuropsychoanalysis, 12(1):107-108

Chapter of Psychoanalysis and Neuroscience: Argentine Psychoanalytical Association (APA): Schizophrenia's Neuropsychoanalysis: A new Exercise in Consilience

Diego Cohen, Lorena Santos, Belén Esteguy and Marcelo Rodríguez

What we call schizophrenia, following Kraepelin, Bleuler, Scheneider, and other authors, including the atheoretical concept reflected in the DSM-IV, is encountered by the modern psychiatrist and psychoanalyst with a high degree of complexity and a clear relationship between brain and mind. Perhaps no other mental pathology so clearly demonstrates a state of disintegration of psychic life, even to the layman. Schizophrenia is not a rare disorder: It has a 0.8% life risk, similar to rheumatoid arthritis; suicide rates can be high, and this disorder is devastating to psychic life (Fletcher & Frith, 2009). The complexity of the disorder is mirrored by the complexity of its pharmacological treatment and the contemporary theories that support it. In a recent work, McGlashan (2009) wonders what would happen if Court President Daniel Schreber, whose illness was described by Freud (1911) in one of the first systematic attempts to establish a psychodynamic theory of schizophrenia, had received currently available pharmacology treatments. While obviously a contrafactual exercise, McGlashan proposes that Schreber's hallucinating state would have lasted only days instead of months, that he would not have been fascinated by his psychotic world, and that his experience would have been monotonous, boring, and flattened. In short, by limiting the psychotic symptoms' intensity, he would probably have developed a postpsychotic depressive state (neuroleptic dysphoria).

Notwithstanding the availability of current pharmacological treatments, neurophysiological evidence of dysfunction, and various cognitive theories of the illness, the long-term prognosis of schizophrenia is still very poor, and the effort to improve treatment can be improved by interdisciplinary dialogue.

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