SCHIZOPHRENIA - NOT A DISEASE ENTITY - A STUDY OF 57 LONG-TERM HOSPITALIZED CHRONIC-SCHIZOPHRENICS

Karl Leonhard divided schizophrenia into two large categories: unsystematic forms with marked heredity and fluctuating course, and systematic forms without heredity and with a primarily chronic non-remittent course. We examined 57 long-term hospitalized schizophrenics in 1985 and 50 of then five years later, using a coefficient of agreement of 0.88. Blind retrospective correlation of family data showed that 11 of 30 unsystematic schizophrenics had unequivocally psychotic first degree relatives, and 5 others had a first degree relative with severe psychical disturbances. Only one out of 24 systematic schizophrenics of the cohort had a positive family history. Further, significant differences between both categories were found in the duration of hospitalization and in the frequency of admissions both in men and women. In addition there are significant differences as regards distribution of gender within diagnostic subgroups, ie. females were more frequently suffering from parahrenia than males and vice versa males from catatonia. The clinical classification of chronic schizophrenia according to Leonhard appears to offer a valuable clinical method of investigating different entities of the illness and their individual etiology.