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Psychiatry has long identified schizophrenia as its defining disorder, its heartland as it has been called. In the past 20 years, this has had a number of negative consequences for psychiatry as a medical specialty, which result from the uncertainty of diagnosis and an increasing emphasis on demedicalising services in an attempt to provide social care outside hospital. These changes have probably increased the stigma attached to psychiatric practice and threaten to deskill doctors. They have also meant that services for other disorders do not meet the needs of patients. To continue to allow schizophrenia to be the paradigm condition is against the interests of psychiatrists and their patients.

Original publication




Journal article


Br J Psychiatry

Publication Date





189 - 191


Bipolar Disorder, Combined Modality Therapy, Deinstitutionalization, Forecasting, Health Policy, Health Services Needs and Demand, Humans, Physician's Role, Prejudice, Psychiatry, Psychotherapy, Psychotropic Drugs, Resource Allocation, Schizophrenia, Schizophrenic Psychology, Sociology, Specialization, United Kingdom