Abstract
One of Kraepelin’s major contributions has been the introduction of the nosological principle in psychiatry. Mental pathology, he presumed, is subdividable in discrete entities each based on a specific pathophysiology. Kraepelin provided the diagnostic process in psychiatry with a solid infrastructure. It has been used in biological psychiatric research until this very day. Searching for the biological determinants of categorical entities has been its major goal. The yield of those efforts has been meagre, in that none of the biological findings reported so far seemed to be specific for a particular nosological entity. The question thus arises: is nosology the right model to classify mental disorders. It is suggested that it is not. The disease categories presently delineated are utterly heterogeneous, and therefore cannot be expected to have a well-defined pathophysiology. The nosological system cannot be rejected (as yet), but it has to be upgraded by incorporation of a strong dynamic-functional component. The functional components should become the focus of biological psychiatric research. The question whether an alternative classificatory model, such as the reaction form model, has to be preferred in biological psychiatry should become a matter of serious discussion.
Similar content being viewed by others
References
Cloninger CA (2002) The discovery of susceptibility genes for mental disorders. Proc Natl Acad Sci USA 99:13365–13367
Craddock N, Owen MJ (2007) Rethinking psychosis: the disadvantages of a dichotomous classification now outweigh the advantages. World Psychiatry 6:20–27
Harrison PJ, Owen MJ (2003) Genes for schizophrenia? Recent findings and their pathophysiological implications. Lancet 361:417–419
Praag van HM (1976) About the impossible concept of schizophrenia. Compr Psychiatry 17:481–497
Praag van HM (2000) Nosologomania: a disorder of psychiatry. World J Biol Psychiatry 1:151–158
Praag van HM (2001) Anxiety/aggression-driven depression. A paradigm of functionalization and verticalization of psychiatric diagnoses. Progress Neuro Psychopharm Biol Psychiatry 12:28–39
Praag van HM, De Kloet R, Os van J (2004) Stress, the brain and depression. Cambridge University Press, Cambridge
Straub RE, Weinberger DR (2006) Schizophrenia genes – famine to feast. Biol Psychiatry 60:81–83
Disclosure
The author has no conflict of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
van Praag, H.M. Kraepelin, biological psychiatry, and beyond. Eur Arch Psychiatry Clin Neurosc 258 (Suppl 2), 29–32 (2008). https://doi.org/10.1007/s00406-008-2006-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00406-008-2006-1