Samuel Gershon’s comment
From the dichotomy to a three-part grouping of endogenous psychoses
By Ernst J. Franzek

          This is a very erudite compendium and historical record of the many diagnostic qualifications, definitions and atypical case types. In general, it is a very valuable vade mecum as the basis of further discussion          

            The real practical and therapeutic impact is relatively small, particularly as we have very little treatment specificity. These two factors strongly impair the real-world usage of a currently agreed upon diagnostic system. For example, I can select one marketed antipsychotic and use it to treat mania, manic-depressive disorder, schizoaffective disorder and/or paranoid disorders.

            This list is still incomplete as many of this antipsychotic class are claimed for use in “depression”; this is another diagnostic category that is used for a myriad of mental states. I can certainly respect the enormous effort Franzek has put into this project. I feel we do not have a system that is effective for differential diagnosis, or prognosis of course or outcome.  This is also demonstrated by the marathon efforts extended in giving us DSM V.

       This dissatisfaction is being demonstrated again. One of our “leading psychiatrists” is planning to set up another group of “wise men” to try produce the necessary magic to deliver the “true gospel” …sad.


March 22, 2018