In an article in the Brisish Journal of Psychiatry, Jim van Os states that we should essentially do away with the construct of schizophenia and replace it, and other psychotic disorders, with the concept of “salience dysregulation syndrome.”
Getting rid of schisophrenia is nothing new. A few years ago some people were advocating doing away with schizophrenia and replacing it with Bipolar II with Psychotic Symptoms because of the similarity in presentation. This leads me to wonder, why not get rid of Bipolar II with psychotic symptoms? I guess the naming was a sort-of arbitrary choice.) Vaughn at MindHacks notes that the salience argument has been kicked around for a number of years as well.
Von Os notes that the diagnosis of schizophrenia is not cut and dry (as we see with the Bipolar argument) and that it should be replaced by something with more validity. Furthermore, many people with psychotic experiences have shown an alteration in salience attribution. Salience, for those who don’t know, including me until about 5 minutes ago, is the state or quality of standing out against neighboring items. Van Os seems to be arguing that a name change is important because medical professionals are likely to continue to treat schizophrenia as a disease rather than a syndrome.
Van Os makes some interesting points in the paper (you can read it here). And it would certainly be good to package all disorders of similar cause and expression under one umbrella. It will be curious to see how the DSM-V committee takes this recomendation.
J. van Os (2009). A salience dysregulation syndrome The British Journal of Psychiatry, 194 (2), 101-103 DOI: 10.1192/bjp.bp.108.054254