Both within clinical and wider societal discourses, the term 'schizophrenia' has achieved considerable potency as a signifier, privileging particular conceptual frames for understanding and responding to mental distress However, its status has been subject to instability, as it has lacked indisputable biological correlates that would anchor its place within the canon of medical diagnosis Informed by a semiotic perspective, this paper focuses on its recent history: how 'schizophrenia' has been claimed, appropriated and contested-and how this connects with its earlier history of signification It also explores how the dominance of this signifier has influenced the ways in which people with the diagnosis may find themselves constructed in their interactions with professionals, family and wider society, and hence how they may come to see themselves It is argued that, from a point in the 1990s when 'schizophrenia' had achieved an almost iconic status, the term is now subject to greater instability, with concerns and challenges being raised from both within and outside psychiatry On the one hand, this uncertainty has triggered a 'calls to arms' from those within the psychiatric establishment who see diagnoses such as 'schizophrenia' as crucial to their professional identity and status On the other hand, this has created spaces for new conversations and alliances between elements within neurology, psychiatry, social work and other professions, and between these and service users Some of these conversations are casting doubt on the validity and utility of 'schizophrenia' as a construct, and are beginning to posit alternative regimes of signification

/pdf/a-crisis-of-meaning-can-schizophrenia-survive-in-the-21st-n413b4a2tq.pdf

A crisis of meaning: can 'schizophrenia' survive in the 21st century?

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has been partitioning mental illnesses into discrete disease entities for over 60 years. The diagnostic class of schizophrenia has undergone several different labels and some profound changes to its criteria over all these iterations. In trying to develop the least-imperfect pragmatic description, the DSM has had to make several assumptions about the disease, and over the various iterations several critics – from within and without psychiatry – have increasingly felt that the APA have accepted their own assumptions as truth, creating a self-justifying and self-perpetuating ideology of schizophrenia. The latest edition, DSM-5, has incorporated some of this criticism, but it is unclear whether the dominant ideology of the diagnostic labels will be over-turned or will simply incorporate this challenge to its authority into its own “continuity myth” of ever-improving diagnostic criteria.

“[L]abels of Themselves Condition Our Perceptions”: The DSM and the Diagnostic Sign of Schizophrenia

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“[L]abels of Themselves Condition Our Perceptions”: The DSM and the Diagnostic Sign of Schizophrenia