The Concept Of ‘schizophrenia’ Could Soon Disappear
Schizophrenia is one of the most famous syndromes in the field of mental health. Its striking characteristics and the strangeness of the hallucinations and behavioral alterations it produces have made this concept known to many people who are not dedicated to psychiatry or clinical psychology. Of course, among patients and health professionals, schizophrenia is important not so much because of the above but because of the serious consequences it has for the health of those who have been diagnosed with it.
However, one thing is that the symptoms associated with schizophrenia are incredible and very severe, and another is that this clinical entity exists as such, as a natural phenomenon well separated from the rest. In fact, The concept of what we have been calling schizophrenia for years could have its days numbered
Until a few years ago, Asperger syndrome was one of the best-known diagnostic labels, due among other things to the striking characteristics that some of the patients of this type showed: intelligent, with difficulties empathizing, and obsessed with areas of knowledge. very specific.
However, today this name is no longer used. Since the phenomenon to which I was referring Asperger syndrome has become part of a spectrum ; specifically, Autism Spectrum Disorders.
Something very similar could soon happen with the label of schizophrenia, harshly criticized in psychology for decades. Now, doubts about its existence are gaining strength even within psychiatry. The reasons for this are, fundamentally, two.
As with practically all so-called “mental illnesses”, there is no known specific biological alteration that is the cause of schizophrenia.
This is understandable, considering that the nervous system in general and the brain in particular They are tremendously complex biological systems without a clear entry and exit route, and millions of microscopic elements participate in real time, from neurons and glial cells to hormones and neurotransmitters.
However, another possible explanation for the failure to isolate a neurological basis for schizophrenia is that it does not exist. That is, there are several and very diverse causes that end up generating different chain reactions but at the end a set of symptoms very similar to each other appears: hallucinations, delusions, stupor, etc.
On the other hand, attempts to link schizophrenia to a few altered genes, which would provide a quick and easy way to explain a disease by pointing to a very specific element as its cause, have been unsuccessful. Only 1% of the cases in which this syndrome appears have been associated with the elimination of a small section of chromosome 22. What happens in the remaining 99% of cases?
Different treatments for various types of schizophrenia
Another piece of evidence that reinforces the idea that schizophrenia does not exist as a homogeneous entity is that not only are there parallel pathways through which the symptoms of this syndrome may appear; There also seem to be parallel pathways in their treatment
The fact that certain types of treatments seem to work specifically in cases in which this syndrome appears to be caused by certain triggers, and not in others, points out that there are different foci of nervous activity linked to schizophrenia, and these do not all manifest themselves at the same time. once in all patients.
The opposite may also occur, that in certain schizophrenia patients who have significant characteristics in common (which differentiate them from other schizophrenia patients), some drug treatments work especially poorly, or they don’t work. For example, in boys and girls in whom the onset of psychotic symptoms associated with schizophrenia coincide with exposure to traumatic events, antipsychotic drugs are not very effective.
Conclusion
One of the problems of psychiatry is that it is sometimes inferred that the problems patients show are deep in your nervous system isolated from the context in which the person has developed and learned to behave.
Of course, this belief has reason to exist in certain pathologies in which it has been seen that certain nerve cells are destroyed, for example.
However, attributing the focus of syndromes such as schizophrenia to something that is “born” spontaneously in the brain of patients can be fallacious. That there is a set of symptoms that suggest disruption In reality, it does not mean that all these cases have their roots in a specific disease separate from all the others. Supporting that idea, to a certain extent, can simply be giving use to a word that has been used for a long time. But we must keep in mind that in science language adapts to reality, and not the other way around.
For this reason, researchers such as Jim van Os, professor of Psychiatry at Maaschrist University, have proposed that the term “schizophrenia” be replaced by Psychosis Spectrum Disorders, an idea in which different causes and mechanisms fit into the that this break with reality takes shape. This less essentialist approach of schizophrenia can help us really understand what is happening in patients’ lives, beyond trying to fit their behaviors into a single homogenizing category.
