Research Topic

Thinking through the Schizophrenia Spectrum: Nosological Scenarios and Perspectives beyond Psychosis

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The idea of a broad psychotic spectrum is often evoked together with the recurrent funeral eulogy of the concept of schizophrenia. Nonetheless, such “slow death” of the concept of schizophrenia is more an effect of scientific sensationalism rather than an ongoing paradigm shift. Indeed, torn between the ...

The idea of a broad psychotic spectrum is often evoked together with the recurrent funeral eulogy of the concept of schizophrenia. Nonetheless, such “slow death” of the concept of schizophrenia is more an effect of scientific sensationalism rather than an ongoing paradigm shift. Indeed, torn between the nouvelle vague of the trans-nosographic hype of the concept of psychosis and occasional pleas for a change of its name (e.g integration disorder, aberrant salience syndrome and similar), the notion of schizophrenia and its spectrum disorders remains a central nosological organizer in modern psychiatry. Some researchers in the field, argue that schizophrenia should be better considered as the poor outcome fraction of a “truly complex, multidimensional psychotic syndrome”. Such multidimensional psychotic syndrome, however, resonates with two widespread ideas: a) that psychotic mental states are just extreme expressions of quantitative traits continuously distributed in the general population, and 2) that psychotic symptoms are not limited to any specific psychotic disorder but rather represent a continuous expression across the broad spectrum of mental illnesses.

To some extent, the last edition of the DSM, partly aligned with this trend by revising the criteria for schizophrenia (e.g. elimination of classic subtypes and removal of Schneiderian ‘first-rank symptoms’), while the chapter “Schizophrenia Spectrum and Other Psychotic Disorders” aimed to capture the underlying dimensional structure of psychosis. From a different vantage point, two contemporary, alternative research projects addressing nosological organizers, i.e. the Research Domain Criteria and the Hierarchical Taxonomy of Psychopathology Consortium, have been launched with complementary initiatives to address the general validity crisis of current nosography and pave the way to new nosological horizons.

While in contemporary literature the concept of schizophrenia is slowly fading and being superficially re-adsorbed in the monolithic notion of psychosis, many of the non-psychotic configurations of schizophrenia disappear outside the diagnostic radar and only partly resurface in marginally adjacent construct (e.g. non-remitting ultra-high risk, borderline conditions, atypical affective syndromes), family high risk studies seem to once again corroborate the value of schizotaxic and schizotypic vulnerability.

This Research Topic is therefore aiming at an overview of possible nosological scenarios for schizophrenia and its spectrum disorders. Its ultimate goal, however, is to avoid “throwing away the baby with the bathwater” with respect to the immanent phenotypic complexity of schizophrenia spectrum.

This Research Topic welcomes a broad range of article types, with particular emphasis placed on research into:

• Applying Research Domain Criteria and the Hierarchical Taxonomy of Psychopathology Consortium to define the psychotic spectrum disorders
• Delineation of biomolecular and genetic research strategies in order to strengthen the biological basis of schizophrenia
• Psychopathological trajectories and clinical pathways of childhood neuropsychiatric disorders: establishing the extent of the relationship between neurodevelopmental disorders and schizophrenia
• Defining Phenotype and Endophenotype: Experimental studies using behavioral, neurocognitive, neurophysiologic, or neuroimaging measures as biomarkers, endpoints, or clinical correlates in the schizophrenia spectrum disorders
• Psychosis risk criteria and the extended psychosis phenotype: epidemiological and clinical data from preventive services
• Development and characterization of measures and methods for the assessment of psychosis risk and clinical staging
• Theoretical contributions enriching our understanding of how traditional psychopathology and current neuroscientific research contribute to nosological perspective for schizophrenia and psychosis spectrum disorders
• Neuropsychological development, cognitive functions and consciousness in schizophrenia: theoretical bases and neuroscientific advancements.


Keywords: Schizophrenia, Psychosis, Nosology, Spectrum, Psychotic Disorder


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