Differential typology of delusions in major depression and schizophrenia. A critique to the unitary concept of 'psychosis'.
Giovanni Stanghellini, Andrea Raballo
Journal of Affective Disorders January 15, 2015 DOI: 10.1016/j.jad.2014.09.027 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Philosophy of mind Depression |
| Keywords | Classification Delusion Major depression Psychosis Schizophrenia |
| Key points | Argues that delusions in schizophrenia and major depression differ radically and can be distinguished by intrinsic features (form and content) and extrinsic features (background from which delusions arise, including changes in the field of experience, background feelings, ontological framework, and existential orientation). Proposes that systematic exploration of subjective experience can complement symptom-based approaches and support a differential typology of psychosis aligned with the Kraepelinian dichotomy. |
Abstract
It is a current trend in psychiatry to discard the Kraepelinian dichotomy schizophrenia vs. manic-depressive illness and use the overinclusive label 'psychosis' to broadly indicate the whole spectrum of severe mental disorders. In this paper we show that the characteristics of psychotic symptoms vary across different diagnostic categories. We compare delusions in schizophrenia and major depression and demonstrate how these phenomena radically differ under these two psychopathological conditions. The identification of specific types of delusions is principally achieved through the differential description of subjective experiences. We will use two general domains to differentiate schizophrenic and depressive delusions, namely the intrinsic and extrinsic features of these phenomena. Intrinsic features are the form and content of delusions, extrinsic ones include the background from which delusions arise, that is, changes in the field of experience, background feelings, ontological framework of experience, and existential orientation. This kind of systematic exploration of the patients' experience may provide a useful integration to the standard symptom-based approach and can be used to establish a differential typology of the clinical manifestation of psychosis based on the fundamental alterations of the structures of subjectivity characterizing each mental disorder, particularly with respect to the Kraepelinian dichotomy schizophrenic vs. manic-depressive illness.
Comparable studies
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| Mindfulness-based cognitive therapy for depression | 2006 | Theoretical or philosophical paper | |
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| The Yale Manual for Psilocybin-Assisted Therapy of Depression (using Acceptance and Commitment Therapy as a Therapeutic Frame) | 2020 | Theoretical or philosophical paper | |
| Neuroinflammation and neuroprogression in depression: Effects of alternative drug treatments | 2022 | Theoretical or philosophical paper | |
| Improving cognitive functioning in major depressive disorder with psychedelics: A dimensional approach | 2021 | Theoretical or philosophical paper |
Citations in the library
Cited by 5
- Abnormal Time Experiences in Major Depression: An Empirical Qualitative Study Psychopathology December 15, 2016
- Phenomenology yesterday, today, and tomorrow: a proposed phenomenological response to the double challenges of contemporary recovery-oriented person-centered mental health care Frontiers in Psychology September 21, 2023
- Schizophrenic Consciousness in the Light of the Phenomenological Epoché: A Foundational Map for Psychiatry. Brain Sciences May 1, 2026
- Subjective experience and meaning of delusions in psychosis: a systematic review and qualitative evidence synthesis. The Lancet Psychiatry May 1, 2022
- Reassessment of amphetamine- and phencyclidine-induced locomotor hyperactivity as a model of psychosis-like behavior in rats. Journal of Integrative Neuroscience January 28, 2022
Cites 6
- Self, Solipsism, and Schizophrenic Delusions Philosophy, psychiatry & psychology June 1, 2001
- Schizo-Affective Psychoses from a Phenomenological-Anthropological Point of View Psychiatria Clinica February 5, 2010
- A disappearing heritage: the clinical core of schizophrenia. Schizophrenia Bulletin July 19, 2011
- What is it like to be a person with schizophrenia in the social world? A first-person perspective study on Schizophrenic dissociality--part 1: state of the art. Psychopathology 2011
- Values in persons with schizophrenia. Schizophrenia Bulletin August 29, 2006
and 1 more in the library