chapter  3
13 Pages

Modern schizophrenia and racism

A standard British textbook on psychiatry (Gelder et al., 1989) states that ‘of all the major psychiatric syndromes, schizophrenia is much the most difficult to define and describe’ (1989:268), referring to ‘radical differences of opinion’ (among psychiatrists) that persist to the present day. The modern definition of schizophrenia refers to first-rank symptoms largely based on work of Kurt Schneider (1959). It is described entirely in terms of behavioural and experiential phenomena. Physical symptoms (prominent in the descriptions by Kraepelin and Bleuler) are hardly mentioned now. ‘Insight’, which is generally understood to be present when the person concerned agrees with the person making the diagnosis that the ‘symptoms’ recognised by the latter are alien or strange (i.e. ‘abnormal’), is now regarded as rarely present in schizophrenia, although Bleuler had claimed it was always present and Kraepelin too considered his dementia præcox patients to have been capable of recognising their symptoms as abnormal (Boyle, 1990).