Is psychiatry only neurology? Or only abnormal psychology? Deja vu after 100 years

被引:15
作者
de Leon, Jose [1 ,2 ,3 ]
机构
[1] Univ Kentucky, Mental Hlth Res Ctr, Eastern State Hosp, Lexington, KY USA
[2] Univ Granada, Inst Neurosci, Psychiat & Neurosci Res Grp CTS 549, Granada, Spain
[3] Univ Basque Country, Biomed Res Ctr Mental Hlth Net CIBERSAM, Santiago Apostol Hosp, Vitoria, Spain
关键词
Diagnostic and Statistical Manual of Mental Disorders; history; 20th century; 21st century; mental disorders; psychiatry; United States; DIAGNOSTIC VALIDITY; JASPERS; PSYCHOTHERAPY; SCHNEIDER; KURT; NEUROSCIENCE; DISORDERS; INTERVIEW; ILLNESS;
D O I
10.1017/neu.2014.34
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Forgetting history, which frequently repeats itself, is a mistake. In General Psychopathology, Jaspers criticised early 20th century psychiatrists, including those who thought psychiatry was only neurology (Wernicke) or only abnormal psychology (Freud), or who did not see the limitations of the medical model in psychiatry (Kraepelin). Jaspers proposed that some psychiatric disorders follow the medical model (Group I), while others are variations of normality (Group III), or comprise schizophrenia and severe mood disorders (Group II). In the early 21st century, the players' names have changed but the game remains the same. The US NIMH is reprising both Wernicke's brain mythology and Kraepelin's marketing promises. The neo-Kraepelinian revolution started at Washington University, became pre-eminent through the DSM-III developed by Spitzer, but reached a dead end with the DSM-5. McHugh, who described four perspectives in psychiatry, is the leading contemporary representative of the Jaspersian diagnostic approach. Other neo-Jaspersians are: Berrios, Wiggins and Schwartz, Ghaemi, Stanghellini, Parnas and Sass. Can psychiatry learn from its mistakes? The current psychiatric language, organised at its three levels, symptoms, syndromes, and disorders, was developed in the 19th century but is obsolete for the 21st century. Scientific advances in Jaspers' Group III disorders require collaborating with researchers in the social and psychological sciences. Jaspers' Group II disorders, redefined by the author as schizophrenia, catatonic syndromes, and severe mood disorders, are the core of psychiatry. Scientific advancement in them is not easy because we are not sure how to delineate between and within them correctly.
引用
收藏
页码:69 / 81
页数:13
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