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Madness explained : Why we must reject the Kraepelinian paradigm and replace it with a 'complaint-orientated' approach to understanding mental illness
This article is a synopsis of the argument outlined in my book Madness explained: Psychosis and human nature, in which I describe a new paradigm (which might be called a 'complaint-orientated' approach) for understanding the psychotic disorders, the most disabling forms of psychiatric illness. Despite extensive efforts to study the genetics, pathophysiology and neuropsychology of the psychoses, replicable findings have been rare. I argue that this is because the phenomena concerned have been poorly defined. Since the end of the 19th century, research into the psychoses has been dominated by the system of classification first proposed by the German psychiatrist Emil Kraepelin, which assumes that the severe mental illnesses fall into discrete types such as 'schizophrenia' and 'manic depression', and that there is a clear dividing line between madness and normal functioning. However, Kraepelinian diagnoses fail all empirical tests of their validity. For example, they do not identify patients with common symptoms, with common aetiologies, who respond to specific treatments. I suggest that we therefore need to abandon psychiatric diagnoses altogether and must instead attempt to explain the specific complaints ('symptoms') that patients bring to our attention. These include hallucinations, delusional beliefs, thought and communication disorders, which are much more widely experienced than was previously thought (for example, about 10% of the population have experienced hallucinatio
ISSN : 0306-9877
Medical hypotheses A. 2006, vol. 66, n° 2, pp. 220-233 [14 pages]
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