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Schizophrenia Bulletin, since its inception in 1969, has played a central role in the dissemination of hypothesis-driven research findings relating to the causes and treatments of schizophrenia. Original research reports and reviews combined with cover art work, first person accounts, and special features have advanced the field while creating a strong sense of community among researchers, clinical care providers and recipients of care. As Editor-in-Chief, I have been moved by the commitment of so many colleagues to the success of the Bulletin. It is strange, therefore, that I have recently become a bit uneasy with the title of our journal. Here, I will report how the editorial office at the Maryland Psychiatric Research Center and our publisher, Oxford University Press, have considered and in some respects struggled with current trends and issues in relation to use of the term “schizophrenia.” The central issue relates to a paradigmatic shift within the field that has reduced attention on diagnostic class while increasing efforts to deconstruct clinical syndromes at levels ranging from symptoms and functioning to behavioral constructs, endophenotypes, neural circuits, genetic profiles, and neural pathways contributing to illness development. The emerging change in research priorities reflects a new emphasis on porous diagnostic boundaries with increased attention to similarities and differences between disorders. Also, a focus on deconstructing heterogeneous clinical syndromes in order to identify specific elements of pathology is advancing science, often in a dimensional framework without diagnostic specificity. Repositioning ourselves to take the lead in published this type of content was viewed as a priority. Additional concerns relating to the use of schizophrenia in the title are based on the view that the term is experienced as stigmatizing by persons afflicted with psychotic illness, impedes public education, is often misrepresented in the media, and avoided by clinicians who may prefer terms such as psychosis not otherwise specified or schizoaffective disorder. Several countries have already dropped “schizophrenia” as an official diagnostic term5 but this may not achieve the desired effect on media representation.6 In this context, we considered a title change for the Bulletin represented by these approximate options:

Shifting Paradigms and the Term Schizophrenia