[Prognosis as a treatment frame. Considerations on schizophrenia]

Prognosis holds an ambiguous position in today clinical practice, specially in psychiatry. It is either an impossible prediction or, worse, an oracle dangerous for its predetermined effects. Hippocratic tradition follows a different path: prognosis is what is being said publicly to the patient about his or her disease. It thus allows the doctor to get the patient's trust and to start the treatment. Those two meanings of the word prognosis have been used alternatively through the history of schizophrenia. Firstly, because of medical shortcomings, diagnosis and prognosis were mingled as they both were course criteria. Today, prognosis seems to be based more on actual therapeutic actions and then we are back to the hippocratic meaning of the word: prognosis as a therapeutic frame.