Schizophrenia: Then and Now

The term schizophrenia was introduced over 100 years ago and it is a psychological disorder characterized by a loss of contact with reality as well as a disruption of thought, perception, mood, and movement. Throughout the years, a lot of information has been uncovered but there is still a lot of progress to be made in terms of understanding its etiology and in creating effective treatment options

Linguistic and (micro-)cultural differences in the global debate about re-naming 'schizophrenia': A mixed-methods survey from Switzerland

Background and hypothesis: This survey explores Swiss mental health professionals', users', and relatives' opinions on re-naming schizophrenia exploiting Switzerland's specific multilingualism to examine possible effects of linguistic and microcultural differences on the issue. Study design: Opinions on 'schizophrenia' were collected using a self-rated online questionnaire incl. Freetext answers available in the three main Swiss languages, German, French and Italian. It was distributed to the main professional and self-help organizations in Switzerland between June and October 2021. Study results: Overall, 449 persons completed the questionnaire, 263 in German, 172 in French and 14 in Italian. Of the total sample, 339 identified as mental health professionals, 81 as relatives and 29 as users. Considering the whole sample, almost half favored a name-change with a significant difference between stakeholder- and between language groups. Also, the name 'schizophrenia' was evaluated more critically than the diagnostic concept. Qualitative analysis of freetext answers showed a highly heterogenous argumentation, but no difference between language groups. Conclusions: Our results suggest the attitude towards re-naming might itself be subject to (micro)cultural difference, and they highlight the nature of 'schizophrenia' as not only a scientific, but also a linguistic and cultural object. Such local factors ought to be taken into consideration in the global debate

Carl Jung’s relationship with Sabina Spielrein: A reassessment

The aim of this article is to give an accurate account of the relationship between Sabina Spielrein and Carl Gustav Jung, based on a close reading of the available documentary evidence. I challenge many of the commonly held assumptions about their relationship. These include the belief that Spielrein was Jung’s first analytic patient, that they had a long and mutually passionate affair, and that Spielrein was the inspiration behind Jung’s conception of the ‘anima’. I argue that there is little evidence for these and a number of other beliefs that have been passed down through successive cultural iterations without careful documentary analysis

The evolution of cognitive–behavioral therapy for psychosis

Cognitive therapy for psychosis has developed over the past 30 years from initial case studies, treatment manuals, pilot randomized controlled studies to fully powered and methodologically rigorous efficacy and, subsequently, effectiveness trials. Reviews and meta-analyses have confirmed the benefits of the interventions. Considered appraisal by government and professional organizations has now led to its inclusion in international treatment guidelines for schizophrenia. Patients consistently ask for access to psychotherapeutic interventions, and it is slowly becoming available in many European countries and other parts of the world, eg, US and the People’s Republic of China. However, it remains unacceptably difficult to access for the vast majority of people with psychosis who could benefit from it. Psychosis affects people in the prime of their lives and leads to major effects on their levels of distress, well-being, and functioning, and also results in major costs to society. Providing effective interventions at an early stage has the potential to reduce the high relapse rates that occur after recovery from first episode and the ensuing morbidity and premature mortality associated with psychosi

Schizophrenia - From Devilry to Disease

Symptoms of psychotic diseases historically instilled fear and distrust in onlookers, who associated them with witchcraft, demonic spirits, and the devil. From Egyptian medicine to medieval witch hunts, psychotic diseases have been associated with the supernatural throughout history. Yet even with advancements in neuroscience and improvements in our understanding of mental illness, stigma surrounding mental health remains prevalent today. Schizophrenia is a psychiatric illness which has evaded a clinical definition until relatively recently; even now, the precise features that constitute a schizophrenic patient are open to dispute. This article explores the ancient history of mental health with a particular emphasis on psychosis, and also considers the changing attitudes and understanding of schizophrenia throughout the last century, leading to its clinical definition as a treatable condition

The grammar of psychosis

This thesis is concerned with the philosophical grammar of certain psychiatric concepts, which play a central role in delineating the field of psychiatric work. The concepts studied are ‘psychosis’, ‘delusion’, ‘person’, ‘understanding’ and ‘incomprehensibility’. The purpose of this conceptual analysis is to provide a more perspicuous view of the logic of these concepts, how psychiatric work is constituted in relation to them, and what this tells us about the relationships between the conceptual and the empirical in psychiatric concepts. The method used in the thesis is indebted primarily to Ludwig Wittgenstein’s conception of philosophy, where we are urged to look at language uses in relation to practices in order to obtain a clearer overview of practices of interest; this will enable us to resolve the conceptual problems related to these practices. This questioning takes as its starting point the concept of psychosis, a central psychiatric concept during the twentieth century. The conceptual analysis of ‘psychosis’ shows that the concept is logically dependent on the concepts of ‘understanding’ and ‘person’. Following the lead found in this analysis, the logic of person-concepts in psychiatric discourse is analysed by a detailed textual analysis of a psychiatric journal article. The main finding is the ambiguous uses of ‘person’, enabling a specifically psychiatric form of concern in human affairs. The grammar of ‘understanding’ is then tackled from the opposite end, by exploring the logic of the concept of ‘incomprehensibility’. First, by studying the DSM-IV definition of delusion it is shown that its ambiguities boil down to the question of whether psychiatric practice is better accounted for in terms of the grammar of ‘incorrectness’ or ‘incomprehensibility’. Second, the grammar of ‘incomprehensibility’ is further focused on by introducing the distinction between positive and negative conceptions of ‘incomprehensibility’. The main finding is that this distinction has wide-ranging implications for our understanding of psychiatric concepts. Finally, some of the findings gained in these studies are ‘put into practice’ in studying the more practical question of the conceptual and ethical problems associated with the concept of ‘prodromal symptom of schizophrenia’ and the agenda of early detection and intervention in schizophrenia more generally.Siirretty Doriast

Zelda y Scott Fitzgerald y el psicoanálisis: la construcción de «Suave es la noche» (1934)

This article analyzes the biographical and contextual elements which enabled Fitzgerald to incorporate the psychiatry of the time into Tender Is the Night (1934). The content of the novel is linked to Zelda Fitzgerald’s mental illness and her admission to a Swiss psychiatric clinic in 1930. It also identifies the parallels between the doctors who treated the couple and those that appear in the novel, examining the elements used to construct fictional characters inspired by major figures in psychiatry during this period, including Oscar Forel, Eugen Bleuler and Carl Gustav Jung. Lastly, it evaluates the weight and significance of the discourse and the psychiatric and psychoanalytic concepts utilized by Fitzgerald in the novel.Este artículo analiza los elementos biográficos y contextuales que permitieron a Scott Fitzgerald realizar en Tender is the Night (1934) una aproximación a la psiquiatría de la época. Se relacionan los contenidos de la novela con la enfermedad mental de Zelda Fitzgerald y su ingreso en una clínica psiquiátrica suiza en 1930. Asimismo, se identifican los paralelismos existentes entre los médicos que trataron al matrimonio y los que aparecen en la novela, examinando los elementos que sirvieron para construir unos personajes de ficción inspirados en relevantes figuras de la psiquiatría del momento, como Oscar Forel, Eugen Bleuler o Carl Gustav Jung. Finalmente, se estima el peso y trascendencia del discurso y los conceptos psiquiátricos y psicoanalíticos manejados por Scott Fitzgerald en la novela

»Schizophrenie« in der Alltagssprache: Eine linguistische Begriffsgeschichte 1908–2009

Der Terminus "Schizophrenie" hat seit seiner Prägung durch Eugen Bleuler im Jahr 1908 eine erstaunliche Verbreitung und Veränderung erfahren. Verhältnismässig rasch im Fach aufgenommen, gehört er bis heute zu den zentralen Diagnosetermini der Psychiatrie. Zugleich ist "Schizophrenie" zusammen mit seinen Ableitungen wie "schizophren", "schizoid", "Schizo" im Laufe des 20. Jahrhunderts aber auch in die Alltags- bzw. Gemeinsprache übernommen und für neue Zwecke adaptiert worden. Statt der professionellen medizinischen Verständigung dient er dort als Mittel der Bewertung und Deutung, ist zentrale Metapher gesellschaftskritischer Diskurse und Schimpfwort der alltäglichen Kommunikation. Diese neue Verwendung hat dabei zu einer Ausweitung von Gebrauch und Bedeutung geführt, die wiederum auf die Psychiatrie und von der Diagnose Schizophrenie Betroffene zurückwirkt. Die diachron-vergleichende Studie zeichnet diese über 100-jährige Entwicklung basierend auf umfangreichen Korpora nach. Unter Rückgriff auf qualitative und quantitative Verfahren der Historischen Semantik, Diskurs- und Korpuslinguistik zeigt sie das Potenzial einer linguistisch fundierten Begriffsgeschichte. Sie leistet zugleich einen Beitrag zur Wissensgeschichte und Kulturanalyse des 20. Jahrhunderts und liefert ein empirisches Fundament für aktuelle psychiatrische Debatten um die "Abschaffung von 'Schizophrenie'"