{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T20:30:56Z","timestamp":1781209856016,"version":"3.54.1"},"reference-count":28,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T00:00:00Z","timestamp":1517184000000},"content-version":"unspecified","delay-in-days":12112,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[1984,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>The author fundamentally questions the traditional concept of the disease-entity (or several disease entities) of \u2018schizophrenia\u2019 and discusses an alternative concept, based on vulnerability and information-processing. According to this, schizophrenia-like psychotic phenomena develop in three phases. In the first, premorbid phase, combined biological (genetic and possibly other organic) and psycho-social influences lead to a premorbid \u2018vulnerability\u2019, characterised by a low tolerance of cognitive and emotional stress, corresponding to an insufficient capacity for the adequate processing of complex information. In the second phase, stressful life-events can lead to unique or repeated acute productive psychotic episodes. The third phase, that of long-term evolution, depends more on psycho-social influences than on biological factors. Under unfavourable conditions, it may lead to predominantly unproductive residual states of various degrees, which can largely be understood as regulatory mechanisms to restrict stressful over-stimulation. There is no clearly delimitable disease entity of schizophrenia with constant causes, psychopathological picture, or course, but rather a multi-conditioned life-process, occuring in people with a particular vulnerability, interacting with complex life-events and circumstances. This new concept has important consequences for therapy and prevention.<\/jats:p>","DOI":"10.1192\/bjp.145.6.636","type":"journal-article","created":{"date-parts":[[2008,8,12]],"date-time":"2008-08-12T23:20:52Z","timestamp":1218583252000},"page":"636-640","source":"Crossref","is-referenced-by-count":59,"title":["Is there really a Schizophrenia? The Long-term Course of Psychotic Phenomena\u2217"],"prefix":"10.1192","volume":"145","author":[{"given":"Luc","family":"Ciompi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,1,29]]},"reference":[{"key":"S0007125000119452_ref9","volume-title":"Psychosocial Intervention in Schizophrenia","author":"Ciompi","year":"1983"},{"key":"S0007125000119452_ref18","volume-title":"Psychosen im Kindes- und Jugendalter; eine Realit\u00e4tsbezugsst\u00f6rung.","author":"Lempp","year":"1973"},{"key":"S0007125000119452_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/5.4.568"},{"key":"S0007125000119452_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-01606-0"},{"key":"S0007125000119452_ref25","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.129.2.125"},{"key":"S0007125000119452_ref16","first-page":"133","article-title":"Wandlungen des Schizophreniebegriffes. (Changements in the concept of schizophrenia]","volume":"49","author":"Janzarik","year":"1978","journal-title":"Nervenarzt"},{"key":"S0007125000119452_ref11","first-page":"366","article-title":"Ein Forschungsprogramm zur Rehabilitation psychisch Kranker. III. L\u00e4ngsschnittuntersuchungen zum Rehabilitationserfolg und zur Prognostik [A research program on the rehabilitation of the mentally ill. III Longitudinal investigation on the success of rehabilitation and on prognostic factors]","volume":"50","author":"Ciompi","year":"1979","journal-title":"Nervenarzt"},{"key":"S0007125000119452_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/bs.3830010402"},{"key":"S0007125000119452_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/7.1.12"},{"key":"S0007125000119452_ref3","volume-title":"Psychiatric Aspects of Minimal Brain Destruction in Adults.","author":"Bellak","year":"1979"},{"key":"S0007125000119452_ref4","volume-title":"The Schizophrenic Disorders: Long-term Patient and Family Studies.","author":"Bleuler","year":"1978"},{"key":"S0007125000119452_ref19","volume-title":"Cognitive Defects in the Development of Mental Illness","author":"Mednick","year":"1978"},{"key":"S0007125000119452_ref26","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511753374"},{"key":"S0007125000119452_ref5","unstructured":"Bleuler M. (1984) Schlusswort. [Conclusion]. Yverdon: 106. Annual Meeting of the Swiss Society of Psychiatry (in press)."},{"key":"S0007125000119452_ref20","volume-title":"General Systems Theory and Psychiatry","author":"Miller","year":"1969"},{"key":"S0007125000119452_ref28","doi-asserted-by":"publisher","DOI":"10.1017\/S003329170004798X"},{"key":"S0007125000119452_ref1","volume-title":"Mind and Nature. A Necessary Unit.","author":"Bateson","year":"1980"},{"key":"S0007125000119452_ref6","doi-asserted-by":"publisher","DOI":"10.2307\/2948405"},{"key":"S0007125000119452_ref8","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.136.5.413"},{"key":"S0007125000119452_ref15","volume-title":"Schizophrenie. Eine Verlaufs- und sozialpsychiatrische Studie.","author":"Huber","year":"1979"},{"key":"S0007125000119452_ref17","volume-title":"Internal World and External Reality. Object Relation Theory Applied.","author":"Kernberg","year":"1980"},{"key":"S0007125000119452_ref21","unstructured":"Mueller Ch. (1983) Ueber sp\u00e4te Besserungen von Schizophrenie. [On late improvements of schizophrenia]. Lecture for the 80th birthday of Prof. Manfred Bleuler (in press)."},{"key":"S0007125000119452_ref22","volume-title":"Die Aequilibration der kognitiven Stukturen.","author":"Piaget","year":"1976"},{"key":"S0007125000119452_ref23","volume-title":"Dialog mit der Natur. Neue Wege wissenschaftlichen Denkens.","author":"Prigogine","year":"1981"},{"key":"S0007125000119452_ref24","volume-title":"Schizophrenie.","author":"Suellwold","year":"1983"},{"key":"S0007125000119452_ref27","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.86.2.103"},{"key":"S0007125000119452_ref12","first-page":"257","article-title":"Ein Forschungsprogramm zur Rehabilitation psychisch Kranker. IV. Untersuchungen zur Rolle von Zukunftserwartungen bei chronisch Schizophrenen. [A research program of the rehabilitation of the mentally ill. IV Investigations on the role of expectations in chronic schizophrenics]","volume":"55","author":"Dauwalder","year":"1984","journal-title":"Nervenarzt"},{"key":"S0007125000119452_ref14","volume-title":"Schizophrenia as a Brain Disease","author":"Erlenmeyer-Kimling","year":"1982"}],"container-title":["British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125000119452","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T00:18:37Z","timestamp":1558570717000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125000119452\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,12]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[1984,12]]}},"alternative-id":["S0007125000119452"],"URL":"https:\/\/doi.org\/10.1192\/bjp.145.6.636","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[1984,12]]}}}