Learning empathy can help cure schizophrenia

Psychiatry: "There is no such thing as schizophrenia"

Imagine you are young and diagnosed with schizophrenia. This means: an incurable brain disease that you will probably not be able to make a living for, that you will have to take medication with many side effects for the rest of your life and that you have an increased risk of dying early.

Pure nonsense, says the psychiatrist and epidemiologist Jim van Os from the University of Utrecht. Van Os is known for its commitment to patient-oriented diagnostics. After 50 years of intensive research, there are still no brain markers and no blood tests for schizophrenia, he says. »There is no clearly defined clinical picture, just various psychotic symptoms that differ in severity and duration. In other words: it is a spectrum with a mix of symptoms that is different for each person. "

This article is contained in Spectrum Psychology, 2/2020 (March / April)

Why can a patient do without the label »schizophrenia«?

When I say that schizophrenia does not exist, that is a pragmatic observation. The term schizophrenia is confusing and medically useless. The DSM-5, the American psychiatry bible, paints a very pessimistic picture of schizophrenia. Of course there are those affected who need care. But the DSM confuses diagnosis and prognosis: In order to receive the diagnosis, the symptoms have to be somewhat chronic. However, medically speaking, mixing the two is not a good idea. In the United States, schizophrenia is also considered a brain disease. That is wrong from a scientific point of view. The epidemiology shows that psychologically it is a broad phenomenon.

Only 30 percent of people with psychosis suffer from schizophrenia
(Sinan Guloksuz, Jim van Os: The Slow Death of the Concept of Schizophrenia and the Painful Birth of the Psychosis Spectrum. Psychological Medicine 2018)

In her opinion, the patients themselves prefer the term »susceptibility to psychosis«.

Indeed, and that's how I see it. Everyone is prone to psychosis to a certain extent, some more, others less. 3.5 percent of people suffer from it; then one can speak of a psychosis spectrum syndrome. As a member of the Psychoses Working Group for the DSM-5, I found that the experts on the Autism Working Group had come to an interesting conclusion: All of the different diagnoses of autism - Asperger's and the like - lead nowhere. From a scientific point of view, they overlap, have the same causes and cannot be distinguished from one another in terms of their course and symptoms. In other words, there are no clear boundaries. Then why not just say it's a spectrum? Hence the term Autism Spectrum Disorders or ASD. We have also known for a long time that psychosis is a broad spectrum with many manifestations that depend on genetic, social and environmental factors. But because psychiatrists view all psychoses as schizophrenia, around 90 percent of scientific studies focus solely on this. In the renowned journal “Science”, American scientists describe schizophrenia as a “devastating genetic brain disease”. You suffer from it for the rest of your life. That is quite fatalistic and, moreover, scientifically wrong. Because we know from many genetic studies that thousands of gene variants contribute to the risk of psychosis and schizophrenia. Some people have a very high hereditary risk, but do not require treatment or are of a very mild form. For example, you notice strange things. But that happens to everyone from time to time. If you hear voices, don't panic. It's a very human experience.