[LIGHT AND SHADOWS OF PSYCHIATRIC NOSOLOGY].

An R Acad Nac Med (Madr)

Published: September 2016

Psychiatry is going through a deep crisis, both as a scientific discipline as a medical specialty. In the present paper we consider in length what we consider to be the two aspects that could explain the situation: the recurring disappointment with classification systems and the persistence of a localizacionism inadequate to explain normal and pathological behavior. Psychiatry lacks a definition of mental disorder that covers all situations, there are difficulties in drawing a precise distinction between normality and psychopathology, and the majority of these "diagnostic" categories are not validated by biological criteria. Furthermore, there is still a debate on the nature of the symptoms of mental disorders, a confusion classification and diagnosis and a preoccupation with the growing inflation of diagnostic categories. Localizationism, that is, the approach to brain function considering that particular pychological functions are carried out by particular brain areas or centers, helps to understand many clinical and psychological phenomena, but have largely failed to explaining the nature of most mental disorders. The crisis should be confronted by putting emphasis on psychopathology instead than in classification, in functions rather than in diagnostic criteria, to be aware in the progress in neuroscientific monistic perspectives and by importing the methods of the emerging connectomics.

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