[Is the schizophrenia diagnosis still appropriate?].

To analyse what psychotic, depressive and manic syndromes have in common and what separates them, we compared 130 population-based first-admission cases of schizophrenia and depression from illness onset until first admission and 130 "healthy" controls. We also studied 107 first-episode cases of schizophrenia over 11.2 years. Illness onset in depression and schizophrenia is marked by identical symptoms, mostly depressive in type. Throughout the course of schizophrenia depression is the most frequent symptom. Psychosis risk increases when depressive and anxiety symptoms increase and decreases when these symptoms decrease. The depressive syndrome is an integral part of schizophrenia. Schizophrenia diagnosis should be replaced by a four-dimensional construct, with each dimension associated with a mainly specific indication for therapy.