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Diagnosis: psychiatric and psychoanalytic perspectives.

H A Paul

    American Journal of Psychoanalysis
    |January 1, 1983
    PubMed
    Summary

    This review explores descriptive psychiatry, diagnostic criteria, and the psychoanalytic movement. It argues psychoanalysts are accurate diagnosticians, proposing Horneyan concepts for a new nosology.

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    Area of Science:

    • Psychiatry
    • Psychoanalysis
    • Psychopathology

    Background:

    • Review of post-Kraepelinian descriptive psychiatry.
    • Exploration of the psychoanalytic movement's influence on patient assessment.
    • Discussion of the perceived and actual diagnostic accuracy of psychoanalysts.

    Purpose of the Study:

    • To outline key developments in descriptive psychiatry.
    • To re-evaluate the diagnostic capabilities of psychoanalysts.
    • To propose a psychoanalytic nosology based on Horneyan concepts.

    Main Methods:

    • Literature review of descriptive psychiatry and psychoanalytic theory.
    • Analysis of diagnostic categorization and dimensionality.
    • Examination of the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) criteria.

    Main Results:

    • Identified emerging areas in psychiatry: borderline concept, genetics, pharmacogenetics, and DSM-III advancements.
    • Challenged the notion of psychoanalysts as poor diagnosticians, asserting their deep understanding.
    • Introduced two Horneyan concepts: vicious cycle diagnosis and diagnosis of underlying alienation.

    Conclusions:

    • Psychoanalysts possess a unique and accurate diagnostic perspective.
    • Proposed Horneyan concepts offer a foundation for a diagnostic psychoanalytic nosology.
    • Highlighted the need to also diagnose constructive forces in psychoanalytic assessment.

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