ANXIETY DISORDERS
Composite Diagnostic Evaluation
Thomas A. Ban, M.D.
Totality
The fifth and final organizing principle of psychiatric nosology, totality, is based on Lasegue’s (1852) concept of partial insanity, i.e., mental illness without personality deterioration, Westphals’ (1871-72) concept of abortive insanity, i.e., mental illness with recognition of the pathologic nature of the psychopathologic symptoms and Leonhard’s (1957) concept of incomplete insanity (Pethö and Ban, 1989) in which the pathologic process remains restricted to one or two components of the psychic reflex. In terms of anxiety disorders, introduction of the fifth organizing principle has not led to any further diagnostic differentiation. On the other hand, since anxiety disorders as a rule are partial, abortive and incomplete, it is on the basis of the fifth organizing principle that anxiety disorders are separated from the other psychiatric disorders (Table 3).