The conceptual history of schizophrenia is marked by considerable dissent about its nosological status, and the question of whether it represents a distinct disease entity remains hotly debated. Another recurring feature in the conceptual history of schizophrenia is the reference to concepts of self and person. This paper brings in connection these two debates by interrogating the nosological function of “self” and “person” by means of a fictitious dialogue between Eugen Bleuler, the inventor of schizophrenia, and his contemporary Arthur Kronfeld. Introducing their respective accounts of schizophrenia with a special focus on how concepts of self and person figure therein, our analysis suggests that these concepts are primarily employed in an attempt to guarantee the nosological unity of schizophrenia: mediated by the concept of a core disturbance, alterations of the self or the person thus become the essential core of schizophrenia. Yet, rather than providing an easy solution to the nosological problem of the unity of schizophrenia, the concepts of self and person and their assumed disturbances are themselves fraught with debates about unity. We discuss these conceptual challenges in light of present-day nosological debates and the currently abounding research on the self.

1.
Allardyce J, Gaebel W, Zielasek J, van Os J: Deconstructing Psychosis conference February 2006: the validity of schizophrenia and alternative approaches to the classification of psychosis. Schizopfr Bull 2007;33:863-867.
2.
Gaebel W, Zielasek J: The DSM-V initiative “deconstructing psychosis” in the context of Kraepelin's concept on nosology. Eur Arch Psychiatry Clin Neurosci 2008;258(suppl 2): 41-47.
3.
Van Os J: “Schizophrenia” does not exist. BMJ 2016;352:375.
4.
Van Os J: The transdiagnostic dimension of psychosis: implications for psychiatric nosology and research. Shanghai Arch Psychiatry 2015;27:82-86.
5.
Ebisch SJH, Aleman A: The fragmented self: imbalance between intrinsic and extrinsic self-networks in psychotic disorders. Lancet Psychiatry 2016;3:784-790.
6.
Parnas J: A disappearing heritage: the clinical core of schizophrenia. Schizophr Bull 2011;37:1121-1130.
7.
Sass LA: Self-disturbance and schizophrenia: structure, specificity, pathogenesis (current issues, new directions). Schizophr Res 2014;152:5-11.
8.
Sass LA, Parnas J: Schizophrenia, consciousness, and the self. Schizopfr Bull 2003;29:427-444.
9.
Schneider K: Klinische Psychopathologie, ed 15. Stuttgart, Thieme, 1943.
10.
World Health Organization: International Classification of Diseases, ed 10. Geneva, WHO, 1990.
11.
Gallagher S: Philosophical conceptions of the self: implications for cognitive science. Trends Cogn Sci 2000;4:14-21.
12.
Mishara A, Bonoldi I, Allen P, Rutigliano G, Perez J, Fusar-Poli P, McGuire P: Neurobiological models of self-disorders in early schizophrenia. Schizophr Bull 2016;42:874-880.
13.
Nelson B, Whitford TJ, Lavoie S, Sass LA: What are the neurocognitive correlates of basic self-disturbance in schizophrenia? Integrating phenomenology and neurocognition. 1. Source monitoring deficits. Schizophr Res 2014;152:12-19.
14.
Nelson B, Whitford TJ, Lavoie S, Sass LA: What are the neurocognitive correlates of basic self-disturbance in schizophrenia? Integrating phenomenology and neurocognition. 2. Aberrant salience. Schizophr Res 2014;152:20-27.
15.
Hillis JD, Leonhardt BL, Vohs JL, Buck KD, Salvatore G, Popolo R, Dimaggio G, Lysaker PH: Metacognitive reflective and insight therapy for people in early phase of a schizophrenia spectrum disorder. J Clin Psychol 2015;71:125-135.
16.
Nelson B, Sass LA: Medusa's stare: a case study of working with self-disturbance in the early phase of schizophrenia. Clin Case Stud 2009;8:489-504.
17.
Ng R, Fish S, Granholm E: Insight and theory of mind in schizophrenia. Psychiatry Res 2015;225:169-174.
18.
Skodlar B, Henriksen MG, Sass LA, Nelson B, Parnas J: Cognitive-behavioral therapy for schizophrenia: a critical evaluation of its theoretical framework from a clinical-phenomenological perspective. Psychopathology 2013;46:249-265.
19.
Stanghellini G, Lysaker PH: The psychotherapy of schizophrenia through the lens of phenomenology: intersubjectivity and the search for the recovery of first- and second-person awareness. Am J Psychother 2007:61:163-179.
20.
Lysaker PH, Lysaker JT: Schizophrenia and alterations in self-experience: a comparison of 6 perspectives. Schizophr Bull 2010;36:331-340.
21.
Bleuler E: Die Prognose der Dementia praecox (Schizophreniegruppe). Allg Z Psychiatr Psych Gerichtl Med 1908;436-464.
22.
Kronfeld A: Die Psychologie in der Psychiatrie. Berlin, Springer, 1927.
23.
Kronfeld A: Das Wesen der psychiatrischen Erkenntnis. Berlin, Springer, 1920.
24.
Kronfeld A: Perspektiven der Seelenheilkunde. Leipzig, Thieme, 1930.
25.
Hoenig J: The concept of schizophrenia - Kraepelin-Bleuler-Schneider. Br J Psychiatry 1983;142:547-556.
26.
Maatz A, Hoff P, Angst J: Eugen Bleuler's schizophrenia - a modern perspective. Dialogues Clin Neurosci 2015;17:43-49.
27.
Bleuler E: Dementia praecox oder Gruppe der Schizophrenien; in Aschaffenburg G (ed): Handbuch der Psychiatrie. Leipzig, Deuticke, 1911, pp 1-420 (Reprinted Nijmegen, Arts & Boeve, 2001).
28.
Parnas J, Møller P, Kircher T, Thalbitzer J, Jansson L, Handest P, Zahavi D: EASE: Examination of Anomalous Self-Experience. Psychopathology 2005;38:236-258.
29.
Scharfetter C: The ego/self experience of schizophrenic patients. Schweiz Arch Neurol Psychiatr 1985;146:200-206.
30.
Hoff P: Psychische Störungen: erklären, verstehen oder beschreiben? Historische und aktuelle Perspektiven einer psychopathologischen Kernfrage. Schweiz Arch Neurol Psychiatr 2010;161:200-208.
31.
Bleuler E, Jung CG: Komplexe und Krankheitsursachen bei Dementia praecox. Zentralbl Nervenheilkd Psychiatr 1908:31:220-227.
32.
Bleuler E: Lehrbuch der Psychiatrie. Berlin, Springer, 1916.
33.
Jung CG: Studies in Word-Association. New York, Moffat, Yard & Company, 1919.
34.
Jung CG: The association method. Am J Psychol 1910;21:219-269.
35.
Husserl E: Die Idee der Phänomenologie: fünf Vorlesungen, Philosophische Bibliothek. Hamburg, Meiner, 1986.
36.
Husserl E: Zur Phänomenologie des inneren Zeitbewusstseins: mit den Texten aus der Erstausgabe und dem Nachlass (Neuauflage der Studienausgabe von 1985). Philosophische Bibliothek. Hamburg, Meiner, 2013.
37.
Berrios GE, Marková IS: The self and psychiatry: a conceptual history; in Kircher T (ed): The Self in Neuroscience and Psychiatry. Cambridge, Cambridge University Press, 2003.
38.
Bleuler E: Physisch und psychisch in der Pathologie. Z Gesamte Neurol Psychiatr 1916;30:426-475.
39.
Cutting J: First rank symptoms of schizophrenia: their nature and origin. Hist Psychiatry 2015;26:131-146.
40.
Nordgaard J, Parnas J: Self-disorders and the schizophrenia spectrum: a study of 100 first hospital admissions. Schizophr Bull 2014;40:1300-1307.
41.
Nelson B, Thompson A, Yung AR: Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis “prodromal” population. Schizophr Bull 2012;38:1277-1287.
42.
American Psychiatric Association, DSM-5 Task Force: Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, APA, 2013.
43.
Tandon R, Gaebel W, Barch DM, Bustillo J, Gur RE, Heckers S, Malaspina D, Owen MJ, Schultz S, Tsuang M, Van Os J, Carpenter W: Definition and description of schizophrenia in the DSM-5. Schizophr Res 2013;150:3-10.
44.
Soares-Weiser K, Maayan N, Bergman H, Davenport C, Kirkham AJ, Grabowski S, Adams CE: First rank symptoms for schizophrenia. Cochrane Database Syst Rev 2015;1: CD010653.
45.
Blankenburg W: Der Verlust der natürlichen Selbstverständlichkeit: ein Beitrag zur Psychopathologie symptomarmer Schizophrenien - Beiträge aus der allgemeinen Medizin. Stuttgart, Enke, 1971.
46.
Heinz A, Voss M, Lawrie SM, Mishara A, Bauer M, et al: Shall we really say goodbye to first rank symptoms? Eur Psychiatry J Assoc Eur Psychiatr 2016;37:8-13.
47.
Picardi A, Viroli C, Tarsitani L, Miglio R, Girolamo G: Heterogeneity and symptom structure of schizophrenia. Psychiatry Res 2012;198:386-394.
48.
Dacquino C, De Rossi P, Spalletta G: Schizophrenia and bipolar disorder: the road from similarities and clinical heterogeneity to neurobiological types. Clin Chim Acta 2015;449:49-59.
49.
Van Os J, Reininghaus U: Psychosis as a transdiagnostic and extended phenotype in the general population. World Psychiatry 2016;15:118-124.
50.
Reininghaus U, Böhnke JR, Hosang G, Farmer A, Burns T, McGuffin P, Bentall RP: Evaluation of the validity and utility of a transdiagnostic psychosis dimension encompassing schizophrenia and bipolar disorder. Br J Psychiatry 2016;209:107-113.
51.
Wigman JTW, de Vos S, Wichers M, Van Os J, Bartels-Velthuis AA: A transdiagnostic network approach to psychosis. Schizophr Bull 2017;43:122-132.
52.
Kretschmer E: Körperbau und Charakter, ed 1. Berlin, Springer, 1921.
53.
Rössler W, Ajdacic-Gross V, Haker H, Rodgers S, Müller M, Hengartner MP: Subclinical psychosis syndromes in the general population: results from a large-scale epidemiological survey among residents of the canton of Zurich, Switzerland. Epidemiol Psychiatr Sci 2015;24:69-77.
54.
Van Os J: Are psychiatric diagnoses of psychosis scientific and useful? The case of schizophrenia. J Ment Health 2010;19:305-317.
55.
Bleuler E: Freudsche Mechanismen in der Symptomatologie von Psychosen. Psychiatr Neurol Wochenschr 1906;34-36:316-340.
56.
Mishara AL: Is minimal self preserved in schizophrenia? A subcomponents view. Conscious Cogn 2007;16:715-721.
57.
Zahavi D: Subjectivity and Selfhood: Investigating the First-Person Perspective. Boston, MIT Press, 2005.
58.
Zahavi D: Schizophrenia and Self-Awareness. Philos Psychiat Psychol 2001;8:339-341.
59.
Zahavi D, Kriegel U: For-me-ness: what it is and what it is not; in Dahlstrom DO, Elpidrou A, Hopp W (eds): Philosophy of Mind and Phenomenology: Conceptual and Empirical Approaches. New York, Routledge, 2016, pp 36-53.
60.
Hoff P: Arthur Kronfeld und Karl Jaspers; in Lammel M, Bormuth M, Sutarski S, Bauer M, Lau S (eds): Karl Jaspers' Allgemeine Psychopathologie - Standortbestimmungen. Berlin, Medizinische Wissenschaftliche Verlagsgesellschaft, 2017, pp 46-59.
61.
Fuchs T: Der Begriff der Person in der Psychiatrie. Nervenarzt 2002;73:239-246.
62.
Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, Sanislow C, Wang P: Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 2010;167:748-751.
63.
Van Praag HM, Kahn RS, Asnis GM, Wetzler S, Brown SL, Bleich A, Korn ML: Denosologization of biological psychiatry or the specificity of 5-HT disturbances in psychiatric disorders. J Affect Disord 1987;13:1-8.
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