1997 issue 4

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Volume 6, issue 4

Nerwice i zaburzenia osobowości koncepcje

The problem of neuroses in recent classifications of mental disorders and the psychoanalytic tradition in psychiatry

Jacek Bomba1
1. Katedry Psychiatrii CM UJ w Krakowie
Postępy Psychiatrii i Neurologii, 1997, 6, 417-422
Keywords: neuroses, classification, psychoanalysis

Abstract

The most recent classifications of mental disorder s (DSM-IV and ICD-10) reject the idea of neurosis as a separate type of mental disorder. In DSM-IV this results from a holistic approach to mental disorders, neither discerning their "somatic" and "psychical" components, nor grouping them around basic psychopathological phenomena (such as thinking, mood, anxiety). A compromise character of the ICD-10 is reflected in the lack of a clear standpoint as to the nature of mental disorder s and in adoption of "thematic affinity" as the classification criterion. Consequently, neurosis as a diagnostic category was eliminated from both these classification systems, while the term itself was kept in the ICD-10 for historical reasons only. Thus, despite retaining the term "neurosis", the ICD-10 diagnostic criteria for particular categories (even those formerly regarded as neurotic disorders) include no premises concerning their pathogenesis and mechanism of onset or persistence. This perhaps may facilitate both the allocation of disorders into particular categories and application of medical statistics, but is of little use for the planning of treatment and for scientific research into neurotic disorders. The solution in question is entirely foreign to the psychoanalytic tradition in psychiatry which emphasized the role of underlying mechanisms of neurosis, without resigning from the holistic approach to man and his dysfunctions.

Address for correspondence:
Prof Jacek Bomba,
Katedra Psychiatrii CM UJ,
ul. Kopernika 21,
31-501 Kraków