Carlos R. Hojaij: Schizophrenia and Consciousness
The major dilemma for research in schizophrenia is its psychopathological characterization and the lack of neuro-physio-pathological correlations of this psychopathology. Current international classifications neither give a proper guide for identifying (diagnosing) schizophrenia, nor provide a comprehensive picture of the disease. Further, the data offered by neuroscience make correlations only with symptoms found in schizophrenia (some also found in other conditions) and not with the whole clinical picture.
The author raises the following questions:
- Is there any psychopathological phenomenon that is an essential prerequisite for diagnosing schizophrenia?
- In which way is the genetic-somatic foundation of schizophrenia processed that it leads to the clinical picture seen?
- What kind of alterations correspond to the psychopathological symptoms that comprise the disturbed personality in schizophrenia?
The author suggests that only an integrated psychopathological-neurophysiological approach in research could give meaningful answers to these questions.
Classical phenomenological psychopathology permits considerations to perceive schizophrenia as a disease related to the entire personality. In order to evolve a comprehensive understanding of schizophrenia, consciousness is conceptualized as a phenomenon that comprises all the different manifestation of the personality. This conceptualization has opened a perspective to recognize that schizophrenia is a disease in which a dissociative psychic process produces a split that affects the whole person
. There is a vast amount of information from the last two decades on consciousness, perceived as a result of special brain development, and its intricate complex functioning. Connectivity, variability, plasticity, ability to categorize, dependence on value, contribute to the existence and integrity of consciousness.
A hypothesis was advanced for the diagnostic concept of schizophrenia that is based on some neurophysiologically disturbed properties of consciousness. The advantage of such an approach is that it overcomes the biased tendency to look for one particular symptom and/or mechanism to explain schizophrenia. Neuro-psychopathologically consciousness is a unitary integrative phenomenon.
Carlos R. Hojaij
May 4, 2017