We have gladly read Dr Marques’ article in response to our letter. Indeed, we must congratulate Dr Marques for the heart he pours into his topics of interest. However, our capacity to perceive his enthusiasm comes at the expense of our ability to decipher the arguments hidden within his words. Nonetheless, our reply follows in separate parts.
First, we welcome the recognition that secondary schizophrenia (SSz) and pseudoschizophrenia are obsolete and inadequate concepts. However, Dr Marques’ recognition is accompanied by the relativisation of the schizophrenia entity, so much that he implies that schizophrenia, SSz, and pseudoschizophrenia have the same diagnostic dignity. They do not. For better or for worse, schizophrenia is still a diagnosis; SSz and pseudoschizophrenia – if something – are non-diagnoses, so they are certainly not equals. We agree that the concept of schizophrenia faces significant challenges, and evidence suggests that a new paradigm for this clinical entity is needed.

Full paper available here.