0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Article   |    
THE PROBLEM OF PSYCHIATRIC NOSOLOGY A Contribution to a Situational Analysis of Psychiatric Operations
THOMAS S. SZASZ
Am J Psychiatry 1957;114:405-413.
View Author and Article Information

Professor, Department of Psychiatry, State University of New York, Upstate Medical Center, Syracuse, N. Y.

text A A A
PDF of the full text article.
Abstract

The thesis of this essay is that most problems of psychiatric nosology, as currently formulated, are refractory to solution because of certain basic ambiguities in psychiatric concepts and operations. Scientific clarity and progress in this area depend upon clear agreement on the following issues: 1. The scope and subject matter that is to be designated as "psychiatry" (e.g., brain, mind, or behavior); 2. The scientific and technical methods that characterize this branch of knowledge (e.g., physics or psychology, physico-chemical techniques or psychotherapy); 3. The precise nature of the phenomena that we seek to classify (e.g., physical or chemical changes in the brain, social behavior, or behavior toward specific individuals). These are not three separate categories, but represent rather interlocking aspects of what must be, in the last analysis, operational descriptions of specific "psychiatric situations."It is suggested that we distinguish sharply between the following principal psychiatric situations on the current American scene: the mental hospital, private psychiatric practice (including the psychoanalytic situation), the child guidance clinic, the psychoanalytic training system, military service, the court of law and jail. Illustrative samples of an operational analysis of a few of these situations are presented. A similar scrutiny of the psychiatric situations that characterized the work of each of the principal figures in the history of psychiatry since Kraepelin is suggested and briefly sketched. This mode of approach prompts one to take a more "relativistic" view of psychiatry, by which is meant the appreciation that different observational methods imply differences in the very nature of the observed "material." Thus, global approaches to psychiatry may have to be abandoned in favor of more limited, and socially and methodologically better defined, plans of attack on specific problems. It is further inherent in this line of thought that a nosological system developed in, and appropriate to, one type of psychiatric situation cannot be validly transferred to another, radically different psychiatric situation. This is a principle familiar to us from other branches of science and technology and the various systems of classification that they employ.Considerations of nosology also prompt a scrutiny of the specific items that are classified. At present, probably the single most important diagnostic label in psychiatry is "schizophrenia." Some epistemological aspects of the problem of schizophrenia are briefly discussed, and it is suggested that this word may now function as a "panchreston" ( or "explain-all") which, instead of illuminating, obscures the essential problems that face psychiatry today.In conclusion, some observations are offered on the currently widespread disregard of nosological rules by psychiatrists and its inhibiting influence on progress in psychiatry.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

+

References

+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 57

Related Content
Books
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 2.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 37.  >
DSM-5™ Clinical Cases > Chapter 19.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 2.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 4.  >
Topic Collections
Psychiatric News
PubMed Articles