Breakthrough the current psychiatric nosology : prospects and illusions I

Abstract EN

This paper is but a trial to show, out of our clinical practice, some of how we actually see and categorize our patients.

Since the publication of the DMP I (E.P.A.

1975) and its adoption by the First Arab Congress of Psychiatry as the main reference for psychiatric nosology in the Arab World in 1978, it was neither generally applied in actual practice nor evaluated in a systematic or comparative approach except sporadically.

Simultaneously we are going on practicing psychiatry in our own way inspite of the conscious claims that we predominantly follow this or that imported nosological discipline.

Our patients, our language, our history as much as ourselves, bearing the finger prints of our culture, direct our clinical sense and practice towards its unique special delineation that colors classification, management and prognosis of psychiatric disorders.

A run through the nosological categories as ordered in the DMP I was tried then certain proposed dimensions are introduced.

Such dimensions could be translated into parallel axes with special bearing on both prognosis, management and scientific research.

The main axes to be considered are: the discomposition-organizational, the psychotic-non psychotic, the active-established, the affective-nonaffective and the periodical-lasting/residual axes.

In this preliminary introduction I am not going to delineate such proposed axes.

It is mainly revising the current nosology in the ongoing common language.

This is to be followed in Part II by a trial to delineate such axes in some sort of well defined operational definitions.

Part III will be devoted to revision of our practice and research activities in the light of these introduced concepts.