From the crisis of the neo-kraepelinian paradigm toward a new psychiatric nosography: DSM-V

Abstract

With this article we intend to outline the story of American psychiatry starting at the end of the 19th century until the present time, describing the cultural, political and economic context which culminated in the development and diffusion of biological psychiatry and its nosography. The diffusion of psychoanalysis and of A. Meyer’s psychological psychiatry, beginning at the end of the Second World War until the end of the Sixties, determined such as an enlargement of psychiatric diagnosis which no longer allowed one to distinguish a sane individual from an ill individual. This “dimensional” model caused a slow process of de-medicalization of psychiatry which removed consent and legitimacy from the discipline. The answer was the publication in 1980 of DSM III, the work of a small number of psychiatrists known as the “Neo-Kraepelinians”. The new nosography based on a categorial diagnostic system, emphasized what is directly observable and therefore measurable, and not what is clinically significant. Whit DSM III and the successive versions the interest of the psychiatrists moved from the clinical to the epidemiological research. In the attempt to take psychiatry back to one of the medical sciences DSM III has in reality continued the process of undermining started whit Meyer and psychoanalysis. And now with the forthcoming publication of DSM V, psychiatry will be confused ever more with neurosciences.