UNITARIAN PSYCHOSIS THEORY. ONE INVINCIBLE DEFEAT?
A important trend in psychiatry is trying to avoid the Kraepelinian dichotomy schizophrenia vs. manic- depressive illness and using the label ‘psychosis’ to appoint the spectrum of severe mental disorders. Some investigators like G Stanghellini have shown that the characteristics of psychotic symptoms vary across different diagnostic categories. They have compared i.e. delusions in schizophrenia and major depression and demonstrated how these phenomena differ under these two psychopathological conditions. The identification of specific types of delusions is principally achieved through the differential description of subjective experiences. 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.
Nevertheless, the concept of psychosis as known today comes mainly from the nine-teenth century.
The purpose of this research is to rethink the issue of unitary psychosis from
an epistemological, mainly psychopathologica reading.
Essential to perform this exercise are theoretical developments from Bartolome
Llopis, an ancient spanish psychiatrist, who passed away 52 years ago, but which a very rich work mainly regarding to the unitarity of all the psychosis.
While asserting the existence of a unitary psychosis is controversial with current available data, it is equally true that the assertion of a schizophrenia/bipolar
disorder dichotomy is also difficult to sustain. However, the axial syn-
drome common to all psychoses, Bartolomé Llopis´s brainchild, re-
mains a fertile and very interesting idea.