The disadvantages of a dichotomous classification now outweigh the advantages. “Recent molecular genetic findings have demonstrated very clearly the inadequacies of the dichotomous view, and highlighted the importance of better classifying cases with both psychotic and affective symptoms.” (PubMed abstract)
As readers of FmH know, I have always been a psychiatric classificatory skeptic. In particular, the attempt to decide whether a patient presenting with psychotic symptoms has a schizophrenic disorder or an affective psychosis has always seemed flawed to me. Rarely have I seen a patient present as a pure, unmixed exemplar of one of those categories. The central distinction between ‘thought disorder’ and ‘affective disorder’ may be specious. (Should we, in fact, rethink our dichotomization of ‘thoughts’ and ‘feelings’?)
