The time-consuming works on diagnosis of psychoses may have hampered progress. Chronic mood disorders may appear as schizophrenic or paranoid psychosis, end-stages like heart failure in heart diseases. This underscores the importance of early and optimal treatment of mood disorders.
Mental-health conditions, such as post-traumatic stress disorder (PTSD), obsessive–compulsive disorder (OCD), eating disorders, schizophrenia and depression, affect one in four people worldwide. Depression is the third leading contributor to the global burden of disease, according to the World Health Organization. Psychological treatments have been subjected to hundreds of randomized clinical trials and hold the strongest evidence base for addressing many such conditions. These activities, techniques or strategies target behavioural, cognitive, social, emotional or environmental factors to improve mental or physical health or related functioning. Despite the time and effort involved, they are the treatment of choice for most people (see ).
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Specifically, there is good evidence that family intervention (FI) in schizophrenia can reduce relapse rates and improve social functioning.4 There is also evidence that cognitive-behavioral therapy (CBT) can be adapted from its successful treatment of panic disorders,5 posttraumatic stress disorder,6 obsessive-compulsive disorder,7 depression,8,9 and borderline personality disorder10 for treating patients with positive symptoms of psychosis.4,11 In addition, there is some evidence that therapies such as social skills training12 or cognitive remediation aimed at improving memory and attention13 can be helpful for negative symptoms by improving motivation or poor confidence, or by helping to recover work skills.
2The present state of research provides sound evidence for the efficacy of psychological therapy in the treatment of schizophrenia.”1It used to be clear that talking about symptoms to those with delusions and hallucinations was not only unwise but might also make things worse.
The categories of functional psychoses build on views of influential professionals. There have long been four main categories – affective, schizophrenic, schizoaffective/cycloid/reactive/polymorphic, and delusional/paranoid psychoses. The last three are included in “psychotic disorders”. However, this dichotomy and the distinctions between categories may have been over-estimated and contributed to lack of progress.
The occurrence and distribution of the groups described above have varied with time, place and the views of professionals. For example, in 1990 Der, Gupta and Murray  published an article in Lancet with the heading “Is schizophrenia disappearing?” The first admission rates of patients diagnosed with schizophrenia, schizoaffective and paranoid psychosis in England and Wales had decreased about 50 % from the mid-1960s to the 80s. This was neither due to increase in other diagnoses, nor to more patients being treated ambulatory. The authors assumed that there had been a real fall in the incidence of the psychotic disorders.
Lake and Hurwitz  later argued that the distribution of diagnoses has also changed during the last 70 years. They outlined that most psychotic patients were diagnosed with schizophrenia from the 1930s to the 60s. During the 1970s to 90s there was a shift towards an equal distribution of schizophrenia, schizoaffective disorders and affective psychoses, whereas affective psychoses became the most frequent group in the 2000s. The authors pictured that the concepts of schizophrenia and schizoaffective psychosis might disappear, and thought that would be favourable to the patients [, ].
The Norwegian psychiatrist Gabriel Langfeldt (1895–1983) followed in the 1920–30s a similar patient group, which he labelled schizophreniform psychosis . However, a later follow-up examination of the case records indicated that most of his patients had suffered from affective disorders . The term existed in ICD-8 (1967) and ICD-9 (1978), but was removed in ICD-10 (1993), whereas it remains in the DSM system.
The terms paranoid psychosis and paranoid schizophrenia are often used interchangeably, the latter preferentially later in an illness course or if hallucinations are present . However, one should always suspect hidden mood disorder behind persecutory and bodily delusions [, ].
The extensive concept of schizophrenia was increasingly criticized, particularly in USA. For example, Pope Jr and Lipinski Jr  wrote: “… most so-called schizophrenic symptoms, taken alone and in cross section, have remarkably little, if any, demonstrated validity in determining diagnosis, prognosis, or treatment response in psychosis… overreliance on such symptoms alone results in overdiagnosis of schizophrenia and underdiagnosis of affective illnesses, particularly mania. This compromises both clinical treatment and research.”
In 1980 this critic was taken account of in DSM-III . The hierarchy of Jaspers was reversed by making depressive and manic/hypomanic symptoms exclusion criteria for schizophrenia, and it was emphasized that mood incongruent psychotic symptoms, as delusions and hallucinations about persecution and influence, could occur in affective disorders.