[The concept of disease in psychiatry]

To draw the line between health and disease has considerable consequences for medical action and financing of medical services as well. It will be shown that satisfying scientific reasons cannot be given for a general and practicable definition either of health or of disease. This is possible only for a specific concept of disease that can be assessed by a diagnosis. However, even such a specific term may be ambiguous, particularly in psychiatry, for which it is of central importance how and what the patient communicates of his experiences. The reason lies in different ways of assessing: the physician describes phenomena of the patient that are controllable by standardisation, the patient ascribes his own experience uncontrollably individually. Moreover, the moment of appeal in the ascriptive mode indicates a call from the specific need for the help of others, of the community. The descriptive mode is relevant for the generalisable assessment of a disease, the ascriptive mode for the assessment of the individual illness.