Journal
NEUROPSYCHOPHARMACOLOGY
Volume 34, Issue 9, Pages 2081-2087Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/npp.2009.32
Keywords
diagnosis; psychosis; kraepelin; schizophrenia; bipolar disorder; DSM-V
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Funding
- NIH [1P50 MH082999, 5T32 MH67533]
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Kraepelin proposed dementia praecox and manic-depressive illness as the two major psychotic disorders. This paradigm is still prevalent, but observations of overlapping boundaries between bipolar disorder and schizophrenia challenge this dichotomy. However, the concept of schizophrenia has been radically altered from the original Kraepelinian proposal. We defend the two psychoses positions, but suggest two flaws in the heuristic application: (1) overlapping features, such as psychotic symptoms, are not decisive in differential diagnosis; and (2) each disorder is a syndrome, not a disease entity. An alternative paradigm based on domains of pathology is more powerful for studies of etiology, pathophysiology, and therapeutic discovery. Neuropsychopharmacology (2009) 34, 2081-2087; doi:10.1038/npp.2009.32; published online 18 March 2009
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