Prolegomenon to the Clinical Prerequisite; Psychopharmacology and the Classification of Mental Disorders
(Volume 1)

Conceptual Development of Current Psychiatric Nosology

Thomas A. Ban and Antonio Torrez Ruiz

Psychopathology and Psychiatric Diagnosis

The term "psychopathology" was first employed by Emminghaus in 1878. However, the scientific discipline, "psychopathology," which deals with the identification, description and conceptualization of signs and symptoms which occur in patients with psychiatric disorders, was born only with the publication of Jaspers' Allgemeine Psychopathology in 1913. One of the essential prerequisites for any scientific inquiry is the development of a set of concepts, which can be communicated to others. Because of this, without the development of "psychopathology," psychiatry could not be regarded as a medical-scientific discipline. Today, "psychopathology" provides the conceptual basis of verified psychiatric knowledge that is necessary for diagnostic practice and the conceptual framework of research relevant to psychiatric problems.

Boundaries of Psychopathology

Phenomenology, or "subjective psychopathology," deals with the subjective phenomena of mental life. It is one of the four component disciplines of "psychopathology" with the special task to provide "a concrete description of the psychic states" experienced by the patient. Because of its utmost importance in the diagnostic process and classification of mental illness, the term "phenomenology" is frequently used in an interchangeable manner with "psychopathology." However, while the task of "phenomenology" is to present the "psychic states" experienced by the patient "for observation" and to render these "psychic realities," "intelligible" by concepts and "a suitable terminology," which can be communicated to others, the task of "psychopathology" is to integrate the information contributed by "phenomenology" with the information contributed by the other component disciplines. These other disciplines are "objective psychopathology" dealing with "observable performances" and "somatic (physical) accompaniments or consequences of psychic events"; "understanding psychopathology," dealing with "meaningful connections" and "comprehensible relations"; and "explanatory psychopathology," dealing with "causal connections" and "causal explanations," i.e., with findings "by repeated experience that a number of phenomena are regularly linked together" in a particular manner with another "intrinsic" or "extrinsic" factor (Jaspers, 1962; Pichot, 1983).

A closely related discipline to "psychopathology" is "pathopsychology," or "abnormal psychology." The essential difference between the two disciplines is that in "pathopsychology" abnormal "mental phenomena" are perceived and understood in terms of deviations from the statistical mean, accepted as normal for the subject's social background, whereas in "psycho- pathology," abnormal "mental phenomena" are perceived and understood within the frame of reference of mental illness (Juhasz and Petho, 1983; Schneider, 1958).