Abstract
In this paper we try to examine some of the philosophical issues that arise from the clinical and scientific study of the prodromal phase of psychotic illness. These issues can be broadly grouped in to ethical concerns and those relating to the philosophy of psychology and science. Specifically, we discuss the notion of the prodrome as a discrete disorder as opposed to being a segment of the continuum of psychosis, and whether we can define psychopathology purely via the use of neuroscientific variables and concepts. We argue that many psychopathological terms have definitions that rely on normative notions that themselves may not be able to be reduced to terms in cognitive neuroscience and hence a purely neuroscientific conception of psychopathology and of the prodromal phase of psychosis may be unachievable. Ethical concerns arise around the treatment of ‘false positives’, that is, those who may clinically look to be at risk but do not develop psychosis, and the reification of a subtle research category into a DSM-5 diagnosis. More subtle issues lie in the clinical encounter where one has to balance communicating risk about developing psychosis with attempts to normalize experiences and decrease anxiety. We conclude by noting that studying the brain solely will not enable us to comprehensively understand prodromal phase of psychosis: a close attention to continua and normativity is also required and that several important clinical and ethical issues arise in both indentifying and intervening in this high risk group, and that these are now cast sharply in to focus with the inclusion of the risk syndrome in the draft DSM-5.
Keywords: Psychosis, schizophrenia, prodrome, neuroimaging, delusions, psychiatry, neuroscience, philosophy, psychopathology, DSM-5
Current Pharmaceutical Design
Title: Philosophical Issues in the Prodromal Phase of Psychosis
Volume: 18 Issue: 4
Author(s): Matthew Broome and Paolo Fusar-Poli
Affiliation:
Keywords: Psychosis, schizophrenia, prodrome, neuroimaging, delusions, psychiatry, neuroscience, philosophy, psychopathology, DSM-5
Abstract: In this paper we try to examine some of the philosophical issues that arise from the clinical and scientific study of the prodromal phase of psychotic illness. These issues can be broadly grouped in to ethical concerns and those relating to the philosophy of psychology and science. Specifically, we discuss the notion of the prodrome as a discrete disorder as opposed to being a segment of the continuum of psychosis, and whether we can define psychopathology purely via the use of neuroscientific variables and concepts. We argue that many psychopathological terms have definitions that rely on normative notions that themselves may not be able to be reduced to terms in cognitive neuroscience and hence a purely neuroscientific conception of psychopathology and of the prodromal phase of psychosis may be unachievable. Ethical concerns arise around the treatment of ‘false positives’, that is, those who may clinically look to be at risk but do not develop psychosis, and the reification of a subtle research category into a DSM-5 diagnosis. More subtle issues lie in the clinical encounter where one has to balance communicating risk about developing psychosis with attempts to normalize experiences and decrease anxiety. We conclude by noting that studying the brain solely will not enable us to comprehensively understand prodromal phase of psychosis: a close attention to continua and normativity is also required and that several important clinical and ethical issues arise in both indentifying and intervening in this high risk group, and that these are now cast sharply in to focus with the inclusion of the risk syndrome in the draft DSM-5.
Export Options
About this article
Cite this article as:
Broome Matthew and Fusar-Poli Paolo, Philosophical Issues in the Prodromal Phase of Psychosis, Current Pharmaceutical Design 2012; 18 (4) . https://dx.doi.org/10.2174/138161212799316190
DOI https://dx.doi.org/10.2174/138161212799316190 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Use of Quasi-SMILES and Monte Carlo Optimization to Develop Quantitative Feature Property/Activity Relationships (QFPR/QFAR) for Nanomaterials
Current Topics in Medicinal Chemistry Radiation Dose Reduction in Cardiac CT Angiography by Applying a Low Tube Voltage: A Comparison Among 120, 100 and 80 kVp Protocols
Current Medical Imaging Challenges in Small Screening Laboratories: Implementing an On-Demand Laboratory Information Management System
Combinatorial Chemistry & High Throughput Screening QSAR and Complex Network Recognition of miRNAs in Stem Cells
Current Bioinformatics A Novel Boolean Network for Analyzing the p53 Gene Regulatory Network
Current Bioinformatics Chromosomal Translocations as Biomarkers in Leukemia Diagnosis and Pharmacogenomics
Recent Patents on Biomarkers Inflammatory Bowel Disease: Etiology, Pathogenesis and Current Therapy
Current Pharmaceutical Design Regulatory Mechanism miR-302a-3p/E2F1/SNHG3 Axis in Nerve Repair Post Cerebral Ischemic Stroke
Current Neurovascular Research Scorpion Extracts Inhibit Tumor Growth in Esophageal Cancer and Lung Adenocarcinoma
Current Signal Transduction Therapy The Biotransformation of Nitrogen Containing Xenobiotics to Lactams
Current Drug Metabolism Structure and Function of MPN (Mpr1/Pad1 N-terminal) Domain- Containing Proteins
Current Protein & Peptide Science Protocatechuic Acid Alkyl Esters: Hydrophobicity As a Determinant Factor for Inhibition of NADPH Oxidase
Current Medicinal Chemistry Origin and Evolution of China Pharmacopoeia and Its Implication for Traditional Medicines
Mini-Reviews in Medicinal Chemistry Novel Optical Techniques for Imaging Microcirculation in the Diabetic Foot
Current Pharmaceutical Design Medicinal Chemistry of P2X Receptors: Agonists and Orthosteric Antagonists
Current Medicinal Chemistry Serotonin and Cancer: What Is the Link?
Current Molecular Medicine Gender Differences in Graduate Bioentrepreneurship Education - A Case Study: University of San Francisco
Technology Transfer and Entrepreneurship (Discontinued) Differential Role of Apoptosis and Autophagy Associated with Anticancer Effect of Lupulone (Hop β-Acid) Derivatives on Prostate Cancer Cells
Anti-Cancer Agents in Medicinal Chemistry A Comparative Study Among Various Statistical Tests Using Microarray Gene Expression Data
Current Bioinformatics Pharmacokinetic and Pharmacodynamic Relationship of Blinatumomab in Patients with Non-Hodgkin Lymphoma
Current Clinical Pharmacology