[Syndromal versus nosological diagnosis]

Against the background of the current preparation of ICD-11 and DSM-5, there is a discussion whether syndromal approaches should replace the traditional nosological diagnosis in psychiatry. From a historical point of view the syndromal approach results from a reaction to the nosological model of Emil Kraepelin. Later the syndromal diagnostic approach became more important because it enabled a quantitative-dimensional assessment and analysis of psychopathological data using modern statistical procedures. However, attempts to ascribe the traditional nosological categories to psychopathological syndromes using multivariate statistical methods have failed. The syndromal approach allows a differentiated recording of the cross-sectional symptomatology; however, a plurality of different syndromes might be registered without considering meaningful principles of classification and longitudinal aspects. The syndromal approach should be complemented by a nosological classification based mainly on the psychopathological course due to the absence of consistent neurobiological findings.