The Structure of Psychosis

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Abstract
THE NOSOLOGIC structure of psychotic illness has been debated since the beginnings of psychiatry.1-4 While many diagnostic systems have been proposed, most attention has focused recently on 3: (1) the unitary model, (2) Kraepelin's dichotomous model, and (3) the DSM-III model. The unitary model of psychosis, dating back into the 19th century5 and recently championed by Menninger et al6 and Crow,1,4 hypothesizes a single continuum of psychotic illness. The clinical diversity of psychosis is explained as resulting either from quantitative variation along this single dimension or from different stages in the longitudinal course of one illness entity.