Today, younger psychiatrists preferably use Diagnostic and Statistical Manual of Mental Disorders: DSM-5, when they diagnose patients. This may provide them with satisfaction that they are fulfilling the policy of evidence-based medicine; however, it may not satisfy their patients. In the clinical field, we should understand the importance of the psychopathological way of diagnosing. Psychopathology has empirically established prototypes (ideal types) of each psychiatric disease using the method of understanding the total experience of patients ("verstehen" by Jaspers, K.), which makes it easy to establish beliefs between psychiatrists and patients.
However, we should note that psychopathological prototypes are especially useful to "verstehen" diseases concerned with self-structure and/or self-function, such as neurotic disorders, schizophrenia, and mood disorders. On the other hand, diseases caused by biological conditions, such as organic psychosis and developmental disorders, are difficult to "verstehen." We should also note that psychopathological prototypes are useful only under the social condition in which people widely share an "ideal-self" image. Under the condition that people do not have a certain image of the "ideal-self," just like today, psychiatric patients do not show the typical symptoms described in prototypes. Today, atypical symptoms connected with atypical self-structures, as observed in patients with developmental disorders, are increasing.
In this paper, the author presents an original vision of "developmental psychopathology" that may enable us to "verstehen" a wider range of psychiatric diseases, including developmental disorders, even under today's social conditions. In "developmental psychopathology," the author makes much of the innate trait that people select the geometrical form in order to build up self-structure, and divided people into two types: "grid-typed person" and "radiation-typed person." For example, patients with Autism Spectrum Disorder(ASD), we can "verstehen" them as a purely regarding "grid-typed person," and they build up a tach panel like self-structure and live with the feeling that they operate the panel system. Reconsidering the prototypes from the viewpoint of two innate traits, we will also become able to "verstehen" various psychopathologies seen under today's social conditions.
<Author's abstract>
Developmental Viewpoint in Psychopathology
Graduate School of Sports and Health Science, Juntendo University
Psychiatria et Neurologia Japonica
119: 846-854, 2017
<Keywords:psychopathology, DSM-5, psychiatric diagnosis, psychological development>