Experiential Psychopathology - Dr John Howells

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I - Experiential Psychopathology

A Note on Nosology

Nosology (nosis – disease, logy – word) in psychiatry and psychology can be confusing and variously employed in different countries.  Part of the difficulty is due to an inability to establish agreed criteria for clinical categories.

Two main divisions are the fields of :  1. Neurosis; 2. Psychosis.  Here the nomenclature is unsatisfactory. ‘Neurosis’ means ‘disorder of neurone’ implying a physical origin.  But it is used to cover psychological states, emotional disorder, personality disorder.  These states could strictly come under the term ‘psychonosis’, disorder of the psyche.  The term ‘psychosis’ means ‘disorder of psyche’ implying a psychological origin.  But it is used to cover states such as toxic psychosis, alcoholic psychosis, drug psychosis and schizophrenia.  These states have a cerebral basis and could better come under the term ‘encephalonosis’, disorder of the encephalon.

The term ‘insanity’ is also not useful.  It is derived from ‘insanus’, not sound in mind.

Sometimes strength of the disorder is used to determine nosology.  Severe conditions are termed ‘psychotic’; less severe conditions are termed ‘neurotic’.  This is contrary to clinical experience.  Neurotic states can be very severe, ending in the death of an individual.

There are also mixed states, e.g. a personality disorder (neurosis) can be aggravated by a drug psychosis, sometimes making a very serious condition.

The term ‘schizophrenia’ – ‘split mind’, first used by Bleuler lacks proper descriptive value.  Kraepelin’s original term, dementia praecox, early dementia, is nearer the mark.  When its cerebral origin is finally proved it may merit a term such as enchaloataxia.

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