[Evolution of diagnostic criteria for schizophrenia]

Many operational diagnostic criteria for schizophrenia, which are rooted to various degrees in the concepts of Kraepelin, E. Bleuler and K. Schneider, have been developed during the last two decades. They often incorporate prognostic factors to which Langfeldt in particular had drawn attention. These recent criteria vary considerably according to the attitude taken with regard to Jasper's hierarchical principle, which accords a diagnostic superiority to schizophrenic symptoms over affective symptomatology. Attribution to schizophrenia is very different depending upon whether the systems uphold, reject or reverse this principle. One should distinguish between classifications based upon a consensus of experts or experienced clinicians on the one hand and diagnostic research criteria destined to test etiopathogenetic hypotheses on the other. The important principles of attribution of DSM III and DSM III-R are outlined as well as their shortcomings, the latter leading to the conclusion that one should not restrict oneself to employ solely the American classification, but utilize it along with other classifications, such as the French empirical criteria or the Vienna research criteria, in order to see more clearly whether the very broad definitions of schizophrenia do not camoufly particular etiopathogenetic entities which ought to be identified.