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THE PSYCHIATRIST AND THE PSYCHOTIC PSYCHOPATH

A Study in Interpersonal Relations
Published Online:https://doi.org/10.1176/ajp.106.8.594

We have been, for some time, perturbed by the extraordinary looseness with which the term "psychosis with psychopathic personality" seems to be applied. A study of written opinions solicited from a number of colleagues when contrasted with a number of cases so diagnosed disclosed discrepancies between theory and practice. It is our opinion that these discrepancies are due to factors operating within the psychiatrist in his role of "participant observer." This problem of the psychiatrist is intensified by the present nosological confusion. We believe that it is more handicapping than helpful at this time to consider "psychopathic personality" and "psychosis with psychopathic personality" as distinct entities rather than as varieties of the conventional neuroses and psychoses.

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