Van Gogh'S Puzzling Diagnosis: Reflecting on the Fuzzy Boundaries of DSM Syndromes

An increasing body of literature suggests that autism spectrum disorder (ASD) exists along a continuum, with higher prevalence among individuals affected by other mental disorders.Vincent van Gogh, one of the most universally celebrated artists and a timeless icon, may provide a compelling case for exploring the role of autism spectrum in the development of psychopathological trajectory throughout life. The present report debates the possibility that van Gogh's ASD contributed both to his frenetic artistic production and his severe mental illness, ultimately complicated by catatonia and to his premature death.

The analysis is based on a review of scientific papers, biographies, artwork, and van Gogh's extensive correspondence (902 letters, including 820 to his brother Theo), along with numerous contemporary eye-witness accounts. Throughout the psychobiographical exploration of van Gogh's life, we reference a series of historical elements that align with DSM-5-TR ASD criteria (APA, 2022). Rather than imposing a rigid categorical diagnosis, we use these criteria to highlight the transdiagnostic nature of his symptoms, acknowledging the limitations of modern nosology when applied to historical figures.

This study reconstructs a hypothetical illness trajectory for van Gogh, originating from ASD and culminating in severe catatonia, followed by his premature death whose cause remains unclear. We also address potential comorbidities (e.g., bipolar disorder, substance use), emphasizing the non-specific, transdiagnostic features of many psychopathological symptoms.

We propose Vincent van Gogh as a potential prototypical case of ASD with catatonia, as described in DSM-5-TR (2022), in an adult without intellectual impairment or language developmental delays. This retrospective hypothesis underscores the complexities of retrospective diagnosis and the possible weaknesses of strictly categorical models, given the overlapping nature of neurodevelopmental, affective, and psychotic symptoms in real-world clinical practice.