Is it time to awaken Sleeping Beauty? European psychiatry has been sleeping since 1980.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-III), published in 1980, has led to a dead end, the DSM-V. Following the allegory of Sleeping Beauty, the DSM-III put European psychiatry to sleep; it now must wake up to create a 21st century psychiatric language for descriptive psychopathology and psychiatric nosology. Four topics are reviewed. First, the review of descriptive psychopathology focuses on: a) Chaslin's and Jaspers's books, and b) Schneider's transmittal of Jaspers's ideas and involvement with Kraepelin in incorporating neuroscience into psychiatric nosology. Second, US psychiatry's historic steps include: a) the pseudoscience of psychoanalysis, b) the low level of pre-DSM-III diagnostic expertise, c) the neo-Kraepelinian revolution which led to DSM-III, d) the failure to improve diagnostic skills, and e) the reprise of Kraepelin's marketing ("neuroscience will save psychiatry"). Third, the DSM-III devastated European psychiatry by destroying: a) the national textbooks which increased consistency but eliminated creative European thinking; and b) the Arbeitsgemenschaft fur Methodic und Dokumentation in der Psychiatrie, the most reasonable attempt to reach diagnostic agreement: start with symptoms/signs (first level) rather than disorders (second level). Fourth, Berrios elaborated upon Jaspers, who described psychiatry as a hybrid science and heterogeneous. Berrios affirmed that psychiatric symptoms/signs are hybrid. Some symptoms are in the "semantic space" and cannot be "explained" by neuroscience.
University of Kentucky Mental Health Research Center, Eastern State Hospital, Lexington, KY, Estados Unidos; Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, España. Electronic address: jdeleon@uky.edu.
Jose
J
de Leon
D039721:Diagnostic and Statistical Manual of Mental Disorders; D005060:Europe; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000266:history*; D058027:Neuropsychiatry / Q000266:history / Q000379:methods; D011570:Psychiatry / Q000193:education / Q000266:history* / Q000379:methods / Q000639:trends; D014481:United States
Diagnostic and Statistical Manual of Mental Disorders; Estados Unidos; Europa; Europe; Historia del siglo xix; Historia del siglo xx; History 19th century; History 20th century; United States