Abstrakt
A concept of a 'mental disorder' is always a semiotical construction. A 'mental disorder' is a complex sign consisting of symptoms, epidemiology, treatment, variations etc.
I shall argue that unpredictibility derives from the fact that a definition of a mental disorder is inherently semiotical and thus it requiers specific interpretation. History of psychiatry and psychology provides us with many examples of how certain mental disorders changed their 'nature' within different theoretical frameworks.
Prominent example would be schizophrenia, which was conceptualized as a disease by Kraepelin and Bleuler as late as in the first half of the 20th century, and is still a subject of theoretical debate (Weinberger & Harrison 2011). In the latest version of the International Classification of Diseases (World Health Organization 2004), the variety of schizophrenic subtypes includes different psychotic conditions as paranoia on the one hand and catatonia on the other.
Where is the border between an 'objective basis' of the disease and its construction in the scientific and clinical discourse? In the second part of the presentation, I shall outline a semiotic construction of schizophrenia by analyzing DSM-V, the Diagnostic and Statistical Manual of Mental Disorders, vol. V (American Psychiatric Association 1994).
DSM-V is one of the most used handbooks in clinical psychiatry. However, a tension between objective nosology of the disease and subjetive sematics of the discourse is apparent.
Especially definitions of hallucinations and delusions rely on heuristic understanding of what is 'normal' and what is 'abnormal'. I will argue that such a discourse intrinsically presupposes a concept of the 'normal', or, more strictly speaking, constructs it.
The psychiatrist interprets symptoms as 'normal' or 'abnormal' in the process of diagnosis, for example whether a suspicion is a 'normal suspicion' or a 'pathological dellusion'.