Janusz Rybakowski: 120 years of the Kraepelinian dichotomy of "endogenous psychoses" in historical perspective

Hector Warnes’ reply to Nassir Ghaemi’s comment on his (Warnes) comment and Janusz Rybakowski’s reply to his (Warnes) comment

       I quoted the Tandon, Keshavan and Nasrallah study on schizophrenia because it is an excellent overview of the current status of schizophrenia research. I read it again and did not find a 45% overlap of symptoms nor did I find an attempt to use primarily a symptomatic or phenomenological approach either categorical or dimensional. Their paper underlines the heterogeneity of the disorder with different courses resulting from a variety of genetic, epigenetic and environmental causes. In fact, after a brilliant synthesis of the illness the authors made a statement of one of ways to proceed, "formulating or reformulating hypotheses that can be refuted, tested, perhaps in the mouse or other experimental model."

       In Medicine the concept of overlap syndromes is defined as multiple disease states occurring together to produce a unique clinical phenotype and disease behavior (Iaccarino, Gatto, Bettio, et al. 2013), referring to the connective tissue disease syndromes mostly related to autoimmunity. Not unlike the field of Medicine where the metabolic syndrome has been recognized as a semiological cluster that predicts certain outcomes the current blurring of some "sacred" boundaries in our field every so often calls for more predictability and validity.

References:

Iaccarino L, Gatto M, Bettio S, Caso F, Rampudda M, Zen M, Ghirardello A, Punzi L, Doria A. Overlap connective tissue disease syndromes. Autoimmun Rev. 2013; 12(3):363-73. 

Tandon R, Keshavan MS, Nasrallah HA. Schizophrenia, "just the facts" what we know in 2008. 2. Epidemiology and etiology. Schizophr Res. 2008; 102(1-3):1-18.

December 31, 2020