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From (Psycho) Pathology to Diagnosis: Psychiatry Nosology Beyond Dichotomy

Published online by Cambridge University Press:  23 March 2020

A. Erfurth  and
G. Sachs
A. Erfurth
Affiliation:
Otto-Wagner-Spital, 6th Psychiatric Department, Vienna, Austria
G. Sachs
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy, Vienna, Austria

Abstract

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As in all medical disciplines, diagnosis in clinical psychiatry should be reached in a step-wise approach: after assessing the chief complaint of the patient, a careful examination of the psychopathology follows e.g. by using the AMDP system [1] to preliminarily conclude the process with a syndromal classification [2]. This syndromal classification is of great importance as it guides the initiation of therapy in daily life practice. After gaining additional information (e.g. investigation in the course of the disease, brain imaging, thorough assessment of cognitive function, exclusion of organic causes) a final diagnosis is possible. Unfortunately, a premature jumping to diagnosis is not uncommon (with the potential consequence of incorrect therapies).

In addition to these difficulties, recent neurobiological research has shown that nosologic assignments through conventional diagnostic classifications are far less specific than assumed, revealing a large overlap between diagnostic categories [3,4], e.g. between Schizophrenia and affective disorders. Consequences of this finding are discussed both for the construction of future classification systems and for therapy.

Disclosure of interest

The authors declare that they have no competing interest.

Type
Symposium: Schizophrenia and clinical psychopathology: From research to clinical practice
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S45
Copyright
Copyright © European Psychiatric Association 2017

References

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Cross-Disorder Group of the Psychiatric Genomics Consortium Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nature genetics 45.9 2013 98499910.1038/ng.2711CrossRefGoogle Scholar
The Network and Pathway Analysis Subgroup of the Psychiatric Genomics Consortium Psychiatric genome-wide association study analyses implicate neuronal, immune and histone pathways. Nature neuroscience 18.2 2015 19920910.1038/nn.3922CrossRefGoogle Scholar
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