Jim van Os (born 1960) is a Dutch academic and psychiatrist. He is Professor of Psychiatry and medical manager of the Brain Center at Utrecht University Medical Center, the Netherlands. [1]
Jim van Os (born 1960) is a Dutch academic and psychiatrist. He is Professor of Psychiatry and medical manager of the Brain Center at Utrecht University Medical Center, the Netherlands. [1]
Van Os studied medicine in Amsterdam, psychiatry in Jakarta, Casablanca, Bordeaux, and London, and subsequently epidemiology at the London School of Hygiene and Tropical Medicine.
He was formerly Professor of Psychiatry, Chair of the Department of Psychiatry and Psychology, and Director of Psychiatric Services at the Maastricht University Medical Center. [2] He is currently Professor of Psychiatry with a focus on psychiatric epidemiology and public mental health and medical manager of the Brain Center at Utrecht University Medical Centre, as well as visiting professor and fellow at the Institute of Psychiatry, King's College London, United Kingdom.
In 2011 he was elected member of the Royal Netherlands Academy of Arts and Sciences, [3] and in 2023, of the Koninklijke Hollandsche Maatschappij der Wetenschappen. Since 2014 he has been listed in the Thomson Reuters Web of Science list of "the world’s most influential scientific minds of our time". [4] He is on the editorial board of several major psychiatric journals, including Acta Psychiatrica Scandinavica, European Psychiatry, Psychological Medicine, Schizophrenia Research, and Schizophrenia Bulletin, additionally serving as an academic editor for PLOS One. He also served on the psychosis group for the DSM-5 Task Force. [5] His colleagues have voted him "best psychiatrist in the Netherlands" multiple times. [6] In 2023 van Os received a Lifetime Achievement Award from the Schizophrenia International Research Society. [7]
In 2009, van Os proposed the retirement of the diagnosis, schizophrenia, citing its lack of validity and the risk of fundamental attribution error associated with the label. The label "schizophrenia" could cause difficulties on the clinician's part in communicating with the diagnosed person, due to erroneous preconceptions associated with the label.
In its place, van Os proposed a broad and general syndromal definition, more suited to personal diagnosis, which would reduce attribution error. [8] He cited previous work by other researchers that explains psychosis as aberrant salience regulation. [9]
In 2014 he explained his views in a TED talk. [10]
In 2015 he co-authored an article in a national newspaper, suggesting that "schizo-labels" be abandoned and replaced with more scientific and patient-friendly terminology. [11] The following week, his colleagues Rene Kahn, Iris Sommer, and Damiaan Denys published a counter-article, labeling Van Os and his colleagues as "antipsychiatrists". [12]
In 2016 he published an editorial in the BMJ arguing that disease classifications should drop the concept of schizophrenia, as it is an unhelpful description of symptoms. [13] This was followed by an article in 2018 in Psychological Medicine, [14] describing the slow death of the concept of schizophrenia and the painful birth of the psychosis spectrum, and a related 2021 article in Frontiers in Psychiatry [15] on the waiting for the Funeral of “Schizophrenia” and the Baby Shower of the Psychosis Spectrum.
In 2021, he argued, in an article in Schizophrenia Research, [16] that the term "Schizophrenia" can be seen as a symptom of psychiatry's reluctance to enter the moral era of medicine.
Since 2020, van Os, together with colleague Prof. Philippe Delespaul, has been working on setting up social trials in the context of mental health service transformation according to the principle of a Mental Health Ecosystem, as described in the book 'We Are Not God', which he wrote together with Myrrhe van Spronsen, and the book 'Kopzorgen: Understanding Psychosis In 33 Questions', which he wrote with Stijn Vanheule.
Catatonia is a complex neuropsychiatric behavioral syndrome that is characterized by abnormal movements, immobility, abnormal behaviors, and withdrawal. The onset of catatonia can be acute or subtle and symptoms can wax, wane, or change during episodes. It has historically been related to schizophrenia, but catatonia is most often seen in mood disorders. It is now known that catatonic symptoms are nonspecific and may be observed in other mental, neurological, and medical conditions. Catatonia is not a stand-alone diagnosis, and the term is used to describe a feature of the underlying disorder.
The Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria. It is the main book for the diagnosis and treatment of mental disorders in the United States and is considered one of the principal guides of psychiatry, along with the ICD, CCMD, and the Psychodynamic Diagnostic Manual. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations, delusions, and disorganized thinking. Other symptoms include social withdrawal, decreased emotional expression, and apathy. Symptoms typically develop gradually, begin during young adulthood, and in many cases never become resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. To be diagnosed with schizophrenia, symptoms and functional impairment need to be present for six months (DSM-5) or one month (ICD-11). Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder.
Dissociative identity disorder (DID), formerly known as multiple personality disorder, and commonly referred to as split personality disorder or dissociative personality disorder, is a member of the family of dissociative disorders classified by the DSM-5, DSM-5-TR, ICD-10, ICD-11, and Merck Manual for diagnosis. It remains a controversial diagnosis.
A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some other misleading effects of perception, as individuals with those beliefs are able to change or readjust their beliefs upon reviewing the evidence. However:
Richard Bentall is a Professor of Clinical Psychology at the University of Sheffield in the UK.
A thought disorder (TD) is a disturbance in cognition which affects language, thought and communication. Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing poverty of ideas, neologisms, paralogia, word salad, and delusions - all disturbances of thought content and form. Two specific terms have been suggested — content thought disorder (CTD) and formal thought disorder (FTD). CTD has been defined as a thought disturbance characterized by multiple fragmented delusions, and the term thought disorder is often used to refer to an FTD: a disruption of the form of thought. Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of schizophrenia and other psychoses. Disorganized speech leads to an inference of disorganized thought. Thought disorders include derailment, pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking. One of the first known cases of thought disorders, or specifically OCD as we know it today, was in 1691. John Moore, who was a bishop, had a speech in front of Queen Mary II, about "religious melancholy."
In psychology, schizotypy is a theoretical concept that posits a continuum of personality characteristics and experiences, ranging from normal dissociative, imaginative states to extreme states of mind related to psychosis, especially schizophrenia. The continuum of personality proposed in schizotypy is in contrast to a categorical view of psychosis, wherein psychosis is considered a particular state of mind, which the person either has or does not have.
The Hearing Voices Movement (HVM) is the name used by organizations and individuals advocating the "hearing voices approach", an alternative way of understanding the experience of those people who "hear voices". In the medical professional literature, ‘voices’ are most often referred to as auditory verbal hallucinations. The movement uses the term ‘hearing voices’, which it feels is a more accurate and 'user-friendly' term.
The trauma model of mental disorders, or trauma model of psychopathology, emphasises the effects of physical, sexual and psychological trauma as key causal factors in the development of psychiatric disorders, including depression and anxiety as well as psychosis, whether the trauma is experienced in childhood or adulthood. It conceptualises people as having understandable reactions to traumatic events rather than suffering from mental illness.
An auditory hallucination, or paracusia, is a form of hallucination that involves perceiving sounds without auditory stimulus. While experiencing an auditory hallucination, the affected person would hear a sound or sounds which did not come from the natural environment.
In medicine, a prodrome is an early sign or symptom that often indicates the onset of a disease before more diagnostically specific signs and symptoms develop. It is derived from the Greek word prodromos, meaning "running before". Prodromes may be non-specific symptoms or, in a few instances, may clearly indicate a particular disease, such as the prodromal migraine aura.
Brief psychotic disorder — according to the classifications of mental disorders DSM-IV-TR and DSM-5 — is a psychotic condition involving the sudden onset of at least one psychotic symptom lasting 1 day to 1 month, often accompanied by emotional turmoil. Remission of all symptoms is complete with patients returning to the previous level of functioning. It may follow a period of extreme stress including the loss of a loved one. Most patients with this condition under DSM-5 would be classified as having acute and transient psychotic disorders under ICD-10. Prior to DSM-IV, this condition was called "brief reactive psychosis." This condition may or may not be recurrent, and it should not be caused by another condition.
Substance-induced psychosis is a form of psychosis that is attributed to substance use. It is a psychosis that results from the effects of chemicals or drugs. Various psychoactive substances have been implicated in causing or worsening psychosis in users.
Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention deficit hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.
The prognosis of schizophrenia is varied at the individual level. In general it has great human and economics costs. It results in a decreased life expectancy of 12–15 years primarily due to its association with obesity, little exercise, and smoking, while an increased rate of suicide plays a lesser role. These differences in life expectancy increased between the 1970s and 1990s, and between the 1990s and 2000s. This difference has not substantially changed in Finland for example – where there is a health system with open access to care.
The diagnosis of schizophrenia, a psychotic disorder, is based on criteria in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or the World Health Organization's International Classification of Diseases (ICD). Clinical assessment of schizophrenia is carried out by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Diagnosis is usually made by a psychiatrist. This can be assisted by artificial intelligence for more automated pre-diagnosis. Associated symptoms occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made. Schizophrenia has a prevalence rate of 0.3-0.7% in the United States
The Kraepelinian dichotomy is the division of the major endogenous psychoses into the disease concepts of dementia praecox, which was reformulated as schizophrenia by Eugen Bleuler by 1908, and manic-depressive psychosis, which has now been reconceived as bipolar disorder. This division was formally introduced in the sixth edition of Emil Kraepelin's psychiatric textbook Psychiatrie. Ein Lehrbuch für Studirende und Aerzte, published in 1899. It has been highly influential on modern psychiatric classification systems, the DSM and ICD, and is reflected in the taxonomic separation of schizophrenia from affective psychosis. However, there is also a diagnosis of schizoaffective disorder to cover cases that seem to show symptoms of both.
René Sylvain Kahn is a neuropsychiatrist and the Esther and Joseph Klingenstein Professor and System Chair of Psychiatry at the Icahn School of Medicine at Mount Sinai in the United States, a position he has held since 2017. He previously served as Professor of Psychiatry and Director of the Brain Center Rudolf Magnus at the University Medical Center Utrecht in the Netherlands. Kahn is recognized for his research on the neurobiology of schizophrenia. He served as a former president of the Schizophrenia International Research Society and was elected to the Royal Netherlands Academy of Arts and Sciences in 2009. He received the Neuropsychopharmacology Award from the European College of Neuropsychopharmacology in 2014.
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