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The crossroads in front of psychiatric diagnosis

Publication at Faculty of Medicine in Hradec Králové |
2014

Abstract

The present state of psychiatric diagnostics is fluid. There is a stready increase in the number of diagnoses during the last 60 years.

There is a fluctuation of the bordres of basic diagnostic concepts. In the course of 20th century schizophrenia had expanded, shrank again and tends to expand again.

Bipolar disorder has multiple varieties and expands into the areas of childhood psychiatry (ADHD) and personality disorders (unstable personality disorder). DSM V appears to be a result of an incomplete compromise that continues in the recent tradition of poor validity and strong reliability.

NIMH developed recently Research Domains Criteria (RDoC) for mapping the terrain in psychiatric research. They classify the processes behind psychopathology and provide a methodological guideline for the assesment of fundamental dysfunctions in he brain.

Their clinical significance may not be great as yet, their significance for research is undeniable. Psychodynamically oriented psychiatrists developed OPD-2 system for psychodynamic approach to treatment.

This system integrates the psychopathological symptoms into a multiaxial descriptive network, parts of which are psychopathological syndromes, subjective experience, interpersonal relationships, personality structure, conflicts and defense mechanisms. The diagnostic approaches in psychiatry are an exciting area of inquiry and discussion for researchers and practioners alike.