Zoghbi Anthony W, Lieberman Jeffrey A
Department of Psychiatry,Columbia University College of Physicians & Surgeons,New York, NY.
Psychol Med. 2018 Jan;48(2):245-246. doi: 10.1017/S0033291717001969. Epub 2017 Oct 26.
Guloksuz & van Os boldly challenge the status quo as pertains to schizophrenia. In 'The Slow Death of the Concept of Schizophrenia, and the Painful Birth of the Psychosis Spectrum' (Guloksuz & van Os, 2017) they thoughtfully review long-standing concerns about this diagnostic category and present a new conceptualization. The authors question the validity of the schizophrenia concept citing variable clinical outcomes, transdiagnostic manifestations of psychosis, and the difficulty in identifying biomarkers, among other concerns. They also point toward the over-representation of schizophrenia in the psychosis literature and lament that patients and clinicians have come to associate this illness with predominantly poor outcomes. Finally, they propose removing the diagnosis of schizophrenia from the diagnostic nomenclature and instituting a broad new classification system, 'psychosis spectrum disorder' (PSD), to capture the many manifestations of psychosis. In this commentary, we advise against the institution of a psychosis spectrum due to the potential negative effects this framework would have on clinical care and progress in biological research.
古洛克斯苏和范·奥斯大胆挑战了与精神分裂症相关的现状。在《精神分裂症概念的缓慢消亡与精神病谱系的痛苦诞生》（古洛克斯苏和范·奥斯，2017年）一文中，他们认真回顾了对这一诊断类别的长期担忧，并提出了一种新的概念化方法。作者质疑精神分裂症概念的有效性，理由包括临床结果的多变性、精神病的跨诊断表现以及识别生物标志物的困难等。他们还指出精神分裂症在精神病学文献中的过度呈现，并 lament 患者和临床医生已开始将这种疾病主要与不良结果联系起来。最后，他们提议从诊断术语中删除精神分裂症的诊断，并建立一个广泛的新分类系统，即“精神病谱系障碍”（PSD），以涵盖精神病的多种表现形式。在这篇评论中，我们建议不要设立精神病谱系，因为这个框架可能会对临床护理和生物学研究进展产生负面影响。 （注：lament 这个词原译文有误，这里根据语境推测应该是“遗憾地表示”之类意思，整体译文根据正确理解进行了调整）
