Schizophrenia is the most widely known and feared mental illness worldwide, yet a rapidly growing literature from a broad spectrum of basic and clinical disciplines, especially epidemiology and molecular genetics, suggests that schizophrenia is the same condition as a psychotic bipolar disorder and does not exist as a separate disease. The goal is to document and interpret these data to justify eliminating the diagnosis of schizophrenia from the nomenclature. The author reviews the changing diagnostic concepts of schizophrenia and bipolar disorder with a historical perspective to clarify how the current conflict over explanations for psychosis has arisen. That two disorders, schizophrenia and bipolar, known as the Kraepelinian dichotomy, account for the functional psychoses has been a cornerstone of Psychiatry for over 100 years, but is questioned because of substantial similarities and overlap between these two disorders. Literature in the field demonstrates that psychotic patients are frequently misdiagnosed as suffering from the disease called schizophrenia when they suffer from a psychotic mood disorder. Such patients, their families, and their caretakers suffer significant disadvantages from the misdiagnosis. Psychotic patients misdiagnosed with schizophrenia receive substandard care regarding their medications, thus allowing their bipolar conditions to worsen. Other adverse effects are substantial and will be included. Liability for medical malpractice is of critical importance for the mental health professionals who make the majority of the diagnoses of schizophrenia. The concept put forward in this work will have a discipline-altering impact.
Schizophrenia is a Misdiagnosis: Implications for the DSM-5 and the ICD-11
C. Raymond Lake
Schizophrenia: the lay public knows a general picture formed from popular culture, familiar legend, and, often, family history. The professional community knows a clinical profile gleaned from decades of scientific theory and findings. But recently a growing body of literature has begun to suggest not only that the diagnosis of schizophrenia is misleading, but that the concept of the disease itself is outmoded. Schizophrenia is a Misdiagnosis makes a persuasive, well-documented argument for the constellation of symptoms commonly known as schizophrenia as a psychotic form of bipolar disorder. The book documents the long history of both disease entities, from the pioneering work of Kraepelin and Bleuler to the rise of drug treatments in the 1950s to today's brain imaging and genetic studies. Long-standing questions regarding key diagnostic symptoms are examined in depth. And the author details the negative sequelae of misdiagnosis-from social stigma to inappropriate and even dangerous treatment-necessitating wide-scale revision. Among the areas covered:
The scientific basis for establishing validity of diseases and their diagnoses.
The overlap of symptoms and course between schizophrenia and mood disorders, from DSM-I to DSM-V.
Medical and other psychiatric conditions often misdiagnosed as schizophrenia.
The impact of misdiagnosis on patients and their caregivers.
Why the concept of schizophrenia continues to survive.
Proposed changes within and outside psychiatry.
A book with the potential to inspire critical change, Schizophrenia is a Misdiagnosis is necessary reading for psychologists, psychiatrists, psychiatric nurses, social workers, primary care physicians, family practitioners, and neurologists.
