[Schizophrenia and the self--existential perspectives on comprehension and evaluation].

Schizophrenia remains mainly an enigma for clinicians and researchers, and all levels of possible further comprehension should be explored. A fundamental characteristic existential perplexity in schizophrenia has significant bearing on the patient's suffering and functional decline, and deserves the attention of mental health professionals. Early detection, diagnosis and treatment might all profit from an explicit focus on the subjective aspects of this disorder. We developed a phenomenological and existentially oriented patient-centered programme for the diagnostic process and diagnosis mediation in schizophrenia, consistently based on self-reported patient experiences. Conventional diagnostic criteria in combination with a firm focus on additional fundamental experiential alterations constitute a framework that facilitates an open dialogue throughout the evaluation between the patient, his or her family and the therapist. The programme has been developed, adjusted and applied over five years on some 120 patients. It has strengthened diagnostic skills, precision and goal-directedness, increased the interest in precise evaluation, and deepened the theoretical understanding of early diagnosis. It is well accepted by the patients, their families and the professionals. This explicit focus on the patients' inner reality and experiences seems to vitalise the patient-therapist relationship.