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An historical framework for psychiatric nosology

Published online by Cambridge University Press:  16 April 2009

K. S. Kendler
K. S. Kendler*
Affiliation:
Virginia Institute of Psychiatric and Behavioral Genetics, Department of Psychiatry and Department of Human and Molecular Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA, USA
*
*Address for correspondence: K. S. Kendler, M.D., Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University Medical School, Box 980126, 800 E. Leigh Street, Room 1-123, Richmond, VA 23298-0126, USA. (Email: [email protected])
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Abstract

This essay, which seeks to provide an historical framework for our efforts to develop a scientific psychiatric nosology, begins by reviewing the classificatory approaches that arose in the early history of biological taxonomy. Initial attempts at species definition used top-down approaches advocated by experts and based on a few essential features of the organism chosen a priori. This approach was subsequently rejected on both conceptual and practical grounds and replaced by bottom-up approaches making use of a much wider array of features. Multiple parallels exist between the beginnings of biological taxonomy and psychiatric nosology. Like biological taxonomy, psychiatric nosology largely began with ‘expert’ classifications, typically influenced by a few essential features, articulated by one or more great 19th-century diagnosticians. Like biology, psychiatry is struggling toward more soundly based bottom-up approaches using diverse illness characteristics. The underemphasized historically contingent nature of our current psychiatric classification is illustrated by recounting the history of how ‘Schneiderian’ symptoms of schizophrenia entered into DSM-III. Given these historical contingencies, it is vital that our psychiatric nosologic enterprise be cumulative. This can be best achieved through a process of epistemic iteration. If we can develop a stable consensus in our theoretical orientation toward psychiatric illness, we can apply this approach, which has one crucial virtue. Regardless of the starting point, if each iteration (or revision) improves the performance of the nosology, the eventual success of the nosologic process, to optimally reflect the complex reality of psychiatric illness, is assured.

Keywords

DSMphilosophy of sciencepsychiatric nosologySchneiderian symptoms
Type
Review Article
Information
Psychological Medicine , Volume 39 , Issue 12 , December 2009 , pp. 1935 - 1941
Copyright
Copyright © Cambridge University Press 2009

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References

Bleuler, E (1950). Dementia Praecox or the Group of Schizophrenias. International Universities Press: New York.Google Scholar
Chang, H (2004). Inventing Temperature: Measurement and Scientific Progress. Oxford University Press: New York, NY.CrossRefGoogle Scholar
Dear, P (2006). The Intelligibility of Nature: How Science Makes Sense of the World. The University of Chicago Press: Chicago, IL.CrossRefGoogle Scholar
Edgerton, RB (1976). Deviance: A Cross-Cultural Perspective. Cummings Publishing Company, Inc.: Menlo Park, CA.Google Scholar
Feighner, JP, Robins, E, Guze, SB, Woodruff, RA Jr., Winokur, G, Munoz, R (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 57–63.CrossRefGoogle ScholarPubMed
Hacking, I (1998). Mad Travelers: Reflections on the Reality of Transient Mental Illnesses. University Press of Virginia: Charlottesville, VA.Google Scholar
Kendler, KS (1990). Toward a scientific psychiatric nosology. Strengths and limitations. Archives of General Psychiatry 47, 969–973.Google Scholar
Kendler, KS, Parnas, J (2008). Philosophical Issues in Psychiatry: Explanation, Phenomenology and Nosology. Johns Hopkins University Press: Baltimore, MD.CrossRefGoogle Scholar
Kleinman, A (2004). Culture and depression. New England Journal of Medicine 351, 951–953.CrossRefGoogle ScholarPubMed
Kraam, A (2008). Karl Ludwig Kahlbaum by Dr. Ewald Hecker (1899). History of Psychiatry 19, 77–80.Google Scholar
Kraepelin, E (1987). Memoirs/Emil Kraepelin. Springer-Verlag: Berlin.Google Scholar
Kuhn, TS (1996). The Structure of Scientific Revolutions. University of Chicago Press: Chicago, IL.CrossRefGoogle Scholar
Locke, J (1870). An Essay Concerning Human Understanding, 29th edn.Thomas Tegg: London.Google Scholar
Mayr, E (1982). The Growth of Biological Thought. Belknap Press: Cambridge, MA.Google Scholar
Mellor, CS (1970). First rank symptoms of schizophrenia. I. The frequency in schizophrenics on admission to hospital. II. Differences between individual first rank symptoms. British Journal of Psychiatry 117, 15–23.CrossRefGoogle Scholar
Menezes, NM, Arenovich, T, Zipursky, RB (2006). A systematic review of longitudinal outcome studies of first-episode psychosis. Psychological Medicine 36, 1349–1362.CrossRefGoogle ScholarPubMed
Murphy, JM (1976). Psychiatric labeling in cross-cultural perspective. Science 191, 1019–1028.Google Scholar
Shorter, E (2005). A Historical Dictionary of Psychiatry. Oxford University Press: New York, NY.Google Scholar
Sloan, PR (1972). John Locke, John Ray, and the problem of the natural system. Journal of the History of Biology 5, 1–53.Google Scholar
Spitzer, RL, Endicott, J, Robins, E (1975). Research Diagnostic Criteria for a Selected Group of Functional Disorders. New York Psychiatric Institute: New York.Google Scholar
Spitzer, RL, Endicott, J, Robins, E (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry 35, 773–782.CrossRefGoogle ScholarPubMed
Westermeyer, J (1979). Folk concepts of mental disorder among the Lao: continuities with similar concepts in other cultures and in psychiatry. Cultural and Medical Psychiatry 3, 301–317.CrossRefGoogle ScholarPubMed
Wikipedia (2008). Kurt Schneider. In Wikipedia, The Free Encyclopedia (http://en.wikipedia.org/wiki/Kurt_Schneider). Accessed 2 July 2008.Google Scholar
Wing, JK, Birley, JL, Cooper, JE, Graham, P, Isaacs, AD (1967). Reliability of a procedure for measuring and classifying ‘present psychiatric state’. British Journal of Psychiatry 113, 499–515.Google Scholar
Zilboorg, G (1967). A History of Medical Psychology. New York: W. W. Norton & Company.Google Scholar