Reassessing "Praecox Feeling" in Diagnostic Decision Making in Schizophrenia: A Critical Review.

Abstract:

:The "Praecox Feeling" (PF) is a classical concept referring to a characteristic feeling of bizarreness experienced by a psychiatrist while encountering a person with schizophrenia. Although the PF used to be considered a core symptom of the schizophrenia spectrum, it fell into disuse since the spread of operationalized diagnostic methods (Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases systems). In contemporary research on schizophrenia, it remains largely unaddressed. This critical review investigates the evolution of the PF in historical and contemporary literature and presents an exhaustive overview of empirical evidence on its prevalence in clinical decision making, its reliability and validity. The review demonstrates that the PF is a real determinant of medical decision making in schizophrenia, although, without further research, there is not enough evidence to sustain its rehabilitation as a reliable and valid clinical criterion. PF-like experiences should not be opposed to any criteriological attitude in diagnosis and would be clinically useful if the conditions of descriptive precaution and rigorous epistemology are maintained. The aim of teaching clinical expertise is to transform this basic experience into a well-founded clinical judgment. Finally, the article discusses the possible relevance of the PF for basic science and clinical research according to a translational approach inspired by phenomenology.

journal_name

Schizophr Bull

journal_title

Schizophrenia bulletin

authors

Gozé T,Moskalewicz M,Schwartz MA,Naudin J,Micoulaud-Franchi JA,Cermolacce M

doi

10.1093/schbul/sby172

subject

Has Abstract

pub_date

2019-09-11 00:00:00

pages

966-970

issue

5

eissn

0586-7614

issn

1745-1701

pii

5200781

journal_volume

45

pub_type

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