title: [Diagnosing schizophrenia: from Bleuler to DSM-V].
abstract: The diagnosis of schizophrenia has undergone substantial change during the last 100 years since its first descriptions by Kraepelin and Bleuler, this process is still continuing at present. The never ending changes of the diagnosis are partially attributable to the symptomatologic heterogeneity seen in schizophrenia and the complex etiology understood only to a small extent. On the other hand, the evolution of the diagnostic systems reflects the standpoints, priorities, and possibilities in the treatment of the disorder in the given period of time. The original accounts of Kraepelin and Bleuler grasped distinct features of schizophrenia, these works still influence our understanding and concepts about the disorder. To resolve the problem of phenotypic heterogeneity there have been two conceptual approaches appearing throughout the history of schizophrenia diagnostics. The categorical approach has defined subgroups within the disorder, whereas dimensional thinking puts emphasis on the severity of different symptom clusters. The present revision of the DSM is characterized by the strengthening of the dimensional approach. Ongoing and future research about pathophysiologically determined biomarkers will have a major impact on the diagnostic system of schizophrenia. The overall aim of these changes is to improve our understanding and indirectly the treatment possibilities of patients suffering from this complex disorder.
authors.affiliation: Semmelweis Egyetem, Pszichiátriai és Pszichoterápiás Klinika, Budapest, Hungary. rethelyi.janos@med.semmelweis-univ.hu
authors.forename: Janos
authors.initials: J
authors.lastname: Réthelyi
mesh_terms: D000339:Affect; D017668:Age of Onset; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000473:pathology; D003071:Cognition; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004569:Electroencephalography; D005060:Europe; D005819:Genetic Markers; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D011379:Prognosis; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis* / Q000235:genetics / Q000266:history / Q000473:pathology / Q000628:therapy; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D013240:Stereotyping; D009626:Terminology as Topic; D013850:Thinking; D014481:United States
chemical_list: D015415:Biomarkers; D005819:Genetic Markers