Subjectivity and intersubjectivity in psychiatric diagnosis

Area of Science:

• Psychiatry
• Psychopathology
• Mental Health Research

Background:

• Criteriological diagnostic systems since the 1980s improved psychiatric diagnosis reliability.
• Limitations in assessing subjective experience negatively impact diagnostic validity, research, and therapy.

Purpose of the Study:

• To highlight the necessity of integrating multiple perspectives in mental illness assessment.
• To compare the values of three distinct approaches for psychopathological description, diagnosis, research, and therapy.

Main Methods:

• Comparison of three assessment approaches: positivistic (3rd-person), phenomenological (1st-person), and hermeneutic (2nd-person).
• Evaluation of each approach's utility for observable symptoms, self-experience, and narrative interpretation.

Main Results:

• The positivistic approach (DSM-IV, ICD-10) focuses on observable behaviors.
• The phenomenological approach prioritizes patient self-experience and its structures.
• The hermeneutic approach emphasizes co-constructed narratives of self-concept, relationships, and conflicts.

Conclusions:

• Integrating 3rd-person, 1st-person, and 2nd-person approaches is crucial for comprehensive psychiatric assessment.
• A multi-perspectival framework improves diagnostic validity, empirical research, and therapeutic effectiveness.