472 – Rethinking schizophrenia: toward a new concept of staging

Abstract

Our nosology is clearly weak and it slows the process of knowledge. The concept of psychosis and schizophrenia is related to obsolete constructs; this can not seem to grasp the “quid novum” resulted from research about vulnerability and prodromal conditions. The current nosology of schizophrenia tends to give only a categorical framework that flattens any evolutionary perspective on the one hand but on other hand it neglects the autistic nuclearity. The early intervention model proposed a new way of “stage-modelling” of early and prodromal psychotic conditions. This model focuses the attention on a fluid conceptualization of the perspective of illness, where the auroral elements show a weak clinical relevance and even more weak during prodromal or premorbid phases of schizophrenia. In phenomenological psychopathology these early disturbances are better investigated as anomalous self-experiences and could be interpreted as an expression of a late disturbance of the self-pre-reflexive consciousness. Unfortunately, the current diagnostic construct fits only the conditions of overt disease. Is it possible, then, to link the research contributions from phenomenological psychopathology of basic self and neuroscientific evidences in order to define a new model of staging? Is it possible to imagine a non-predetermined disorder that turns to disease “on the road”?