DESCRIPTIVE PSYCHIATRY

A systematic approach to psychiatry based upon the observation, study, and classification of directly observable symptoms and clinical patterns. It contrasts with the dynamic approach, which puts the emphasis on the conscious and unconscious forces that produce symptoms and disorders.The leading figure in modem descriptive psychiatry was Emil Kraepe- lin, who gave an exhaustive account of manic-depressive psychosis, schizophrenia (“dementia praecox”) and all other major mental disorders, based upon the case histories of thousands of patients. His classification was so comprehensive and factual that it is the principal basis for the standard system of psychiatric classification in use today.Ia general, descriptive psychiatry takes the position that certain groups of symptoms occur together with such regularity that they can be regarded as specific diseases, in much the same way that we think of pneumonia and typhoid fever as distinct ailments. With Kraepelin this approach led to the conviction that each type of mental illness is separate and distinct from all others, and that the course and outcome of these illnesses was as predictable as any physical illness. In fact, Kraepelin believed that mental illness does not basically differ from physical illness since he held that it is caused by brain pathology. His work launched an entire “descriptive era” in which description and classification were greatly furthered by Golgi, Broca, Head, Alzheimer, and many others, all of whom also championed the organic point of view. They succeeded both in describing the symptoms and uncovering the pathological basis of such disorders as general paresis, cerebral arteriosclerosis, senile psychosis, toxic psychosis, and certain types of mental retardation.The development of descriptive psychiatry is still continuing-—in fact, the American Psychiatric Association has included a number of new clinical entities in its revised classification of psychiatric disorders (1952). Among these are Transient Situational Personality Disorders, Personality Pattern Disturbances, and Personality Trait Disturbances. Also, psychosomatic disorders have been renamed Psychophys- iologic Autonomic and Visceral Disorders. Nevertheless, the primary emphasis has shifted from descriptive to dynamic psychiatry, and today most psychiatrists are far more concerned with the motivational forces that produce better or worse adjustment than with the classification of symptoms and syndromes.