Mental diseases: a public health problemMay, James Vance
Science
Mental diseases: a public health problem
May, James Vance
Mental health services; Psychology, Pathological
At that time there were practically as many different forms of
statistical reports in the United States as there were hospitals. In
the meanwhile almost every textbook published during the last fifty
years has announced a new classification of mental diseases. They have
been based on etiology, pathology, symptomatology and psychology.
English, French, German, Italian and American classifications
have appeared, each representing, as a rule, different schools of
psychiatry. Kempf[143] would discard the term psychosis altogether
and speak only of neuroses as "more consistent with the integrative
functions of the nervous system." For diagnostic purposes he proposes
to separate the benign from the pernicious processes and classify them
according to their psychological mechanisms as suppression, repression,
compensatory, regression and dissociation neuroses. The easiest way
out of all these difficulties, as Southard[144] has said, would be "to
deny the existence of entities in mental disease. There are two forms
of this contention; first, that mental disease is nothing more or less
than insanity, an entity itself, a genus with but one species, or
secondly, that all victims of mental disease are individually to be
provided with entities, that is, all examples of mental disease are sui
generis. The development of psychiatry has killed the former contention
stone dead, but the latter contention still flourishes to an extent
among those who overstress the individual factor. And this latter
contention is bolstered up by the existence of so many psychopathic
patients of whom a diagnosis cannot be rendered for practical or
theoretical reasons. However, there are no really consistent advocates
of the sui generis plan of classification." It is interesting to
note that he concedes ... "that the American Medico-Psychological
Association's classification, adopted as it has been by a great number
of American institutions and by the United States Government for war
purposes, is a reasonably good classification and aware that its
constituent elements fairly well correspond with what all American
psychiatrists agree upon."
Southard[145] raises the question as to how this classification can
be used for diagnostic purposes. He answers this query by suggesting
"A key to the practical grouping of mental diseases"[146] ... "to be
followed, when necessary, like a botanical key in the search for
the classification of a plant."... "It is a key to study and not an
analytical classification with any pretence to finality."... "The plan
is not so much an excursion into nosology as an essay in the technique
of psychiatric diagnosis for the tyro."
Public-domain text, read in full here on John Shaqi.
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