ANXIETY DISORDERS

Composite Diagnostic Evaluation

Thomas A. Ban, M.D.

 

From Psychopathology to Neurobiology

Within the traditional, symptom-oriented psychopathologic frame of reference, the elementary units which serve as the building blocks of mental illness (disorder) are psychopathologic symptoms. Each psychopathologic symptom in perceived as a concept, which is based on pathologic or abnormal subjective experiences (phenomena) with a content derived from past experience and a form which is characteristic of the illness (Jaspers, 1913). It was within this psychopathologic frame of reference that the nosologic concept of anxiety disorders has been formulated and separated into three distinct forms, i.e., generalized anxiety disorder, phobic disorders and obsessive-compulsive disorder.

Introduction of therapeutically effective psychotropic drugs led to the replacement of the traditional symptom-oriented psychopathologic with a neurobiologic conceptualization of mental illness. Regardless of conceptualization, however, attempts to replace psychopathologic symptoms with neurobiologic measures as the building blocks of mental illness have remained so far without success.