Schizophrenia, language and evolution (or the schizophrenias as logopathies)

Abstract

Ever since the distinction between praecox dementia and manic-depressive illness made by Kraepelin in 1899, many changes have occurred in the way these conditions and especially their boundaries are conceived. The clearest example is the extraordinary increase in the diagnoses of bipolar disease with respect to those of schizophrenia. But there have also been important changes within each one of these categories. In the first case, the separation of schizoaffective and cycloid psychoses, and in the second, the distinction between mono and bipolar disease. Then there is the description of innumerable forms of monopolar depression1 or, on the contrary, the postulation of the existence of only one endogenous-melancholic syndrome by Tellenbach2,3, an idea which is shall come up again, although from another methodological perspective, in the concept of major depression of DSM III. The present author thinks that this state of nosological confusion has to do, on one hand, with the improper combination of descriptive and etiological criteria, and on the other, with the application of categorical criteria to complex realities, without an organic basis supporting them.

The present author proposes a logopathies/thymopathies dichotomy. The first would include all forms of schizophrenia, paraphrenias and paranoias. The second would correspond to the affective disorders and also to a great part of the so called “anxiety disorders”. In this first part he develops the subject of the logopathies, trying to demonstrate the legitimacy of the concept upon the basis of three fundamental arguments: (i) Alteration of the thought/language as a nucleus of schizophrenic suffering. (ii) Schizophrenia is a constitutive element of the human condition. And (iii) Schizophrenia appears as a perturbation of Verstehen (understanding), as described by Heidegger in Being and Time as one of the ways Dasein (human being) is present in the world, together with Befindlichkeit (attunement or state-ofmind), which is precisely what would be altered in thymopathies.