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Robin Murray commentary during the SRF webinar "Is Schizophrenia Dead Yet?"
1. Schizophrenia is not a disease;
rather it is a syndrome
Or rather it is two syndromes: DSM 5 and ICD 10
Only 70% of those who meet ICD 10 criteria also
meet DSM criteria – EU-GEI study
Which one is the real Schizophrenia?
What do you tell the mother of a young man who
meets criteria for ICD10 Sz but not DSMV Sz?
2. What should a diagnosis do?
Convey helpful information - to the
patient/others
Indicate likely causes and mechanisms
Predict outcome
Predict response to treatment
3. Negative aspects of the term
‘schizophrenia’
In practice, different psychiatrists apply the
diagnosis to different people
The diagnosis has no validity – no natural
boundaries or biomarkers
The term falsely implies inevitable progression
and deterioration
Many patients believe that the term degrades
and stigmatizes them
4. Psychosis has more Utility
• Severity/ Persistence
• Dimensions – positive,negative,
disorganisation, mania, depression
• Predominant Aetiology e.g.
• a) Genetic - CNV or high PRS score
• b) Drug-induced
• c) Childhood adversity
• d) Adverse life events/circumstances
