New perspectives on the psychopathology of schizophrenic disorders

Abstract

In this paper the evolution that has taken place in the study of the psychopathology of schizophrenic disorders is studied from the application of the anatomo-clinical method to the new dimensional models. What is striking is the durability of the demarcation established by Kraeplin between Manic-Depressive Psychosis and Precocious Dementia, and the subclassifcation in four forms - paranoid, hebephrenic, catatonic and simple - in spite of the demonstration of the insufficiency of these classifications for explaining the clinical evolution of schizophrenic disorders. 25 years ago a new positive/negative dichotomic focus was introduced for the classification of symptoms and disorders, which made it possible to develop the tools for evaluating symptoms. Factorial analyses carried out using the different scales found that the symptoms were grouped around three or more factors or dimensional syndromes. This dimensional approach is what has guided the greater part of research into schizophrenia in recent years. Attention is also drawn to the importance of other clinical dimensions of great value in schizophrenic disorder which were passed over by the measurement tools that were developed. Present tendencies in psychopathological research into schizophrenia are delimited, with the advantage offered by dimensional approaches.