Clinical Neurobiology of Atypical Psychoses
Edited by: Takuji Hayashi
After 1980, operational diagnostic methods, such as the DSM-III, became reliable international standards. During this period, the concept of atypical psychoses was sidelined and considered to be outdated because of their emphasis on symptoms with low objective evaluation. Operational diagnostic criteria are clear-cut and easily understandable, and are valuable for medical students, nursing staff, and basic researchers. However, in recent years, internal critique was submitted from a notable American psychiatrist involved in drafting of the DSM diagnostic criteria, who put forth the limitations of the operational diagnostic methods. Facing the shortcomings of these operational diagnostic methods, many psychiatrists are aware of the superficiality of this diagnostic system. The importance increases in disease classification based on "nosology" and in detailed clinical investigations concerning psychiatric symptoms and clinical course. Despite much criticism, atypical psychoses still survives as a clinical concept based on the concrete clinical clues. Current practices in psychiatry cannot furnish objective evidence to distinguish between schizophrenia and manic-depressive psychosis. More than half a century ago, Schneider stated that the endogenous psychoses could only be classified into different types. Although evidence to classify atypical psychoses as an independent disease has not been obtained, the symptoms and clinical course of this condition are clearly different from those of schizophrenia and manic-depressive psychosis. Eventually, psychiatry should be further developed by introducing novel concepts as well as restructure the accumulated knowledge. Parallel with the future trajectory of DSM, Clinical Neurobiology of Atypical Psychoses takes off with a firm expectation that the time has come to reappraise the concept of atypical psychoses.
Publication Date: 8/1/2009