Psychopharmacology and the Classification of Functional Psychoses

By Thomas A. Ban and Bertalan Petho




This monograph is based on the controversial contention that a nosological approach to diagnosis is an essential prerequisite for the meaningful study of mental illness. Although the subject of this monograph is restricted to the group of disorders traditionally referred to as "functional psychoses," the same contention applies to "anxiety disorders," traditionally referred to as "neuroses."

The classification proposed in this volume is based on an understanding of all four developmental stages of psychiatric illness. It differs from other classifications by the particular integration of longitudinal-developmental and cross-sectional-psychopathological features and by the shift of emphasis from the interpretation of symptoms to the detection of affected psychopathological structures.

In spite of its historical roots and assumed inner logic, the classification presented here will not be proposed for general use until it is validated in carefully conducted clinical research. To design such studies, it will be important to know to what extent the psychiatric clinical material fits the proposed diagnostic groups in different cultures and to what extent biological homogeneity can be increased by employing the proposed subtyping in the selection of experimental populations in psychiatric research.

The origin of the concepts discussed in this monograph is in the work of Clerambault and Magnan, Kahlbaum and Kraepelin, Wernicke and Kleist, Jaspers and Schneider, and Wimmer. It is hoped that in the course of the presentation no injustice has been done to the contributions of Baruk, Leonhard and Strömgren.

In the preparation of different sections of this monograph we found publications by Berner, Guze, Ey, Fish, Hamilton, Helmchen, Hirsch, Jablensky, Pichot, Robins, Sartorius, Sheppard, Spitzer and Wing extremely helpful. The accuracy of some of the information presented was improved through personal communications with Angst, Astrup, Perris and Winokur.

            We are grateful to Guy, Dreyfus, Ebert, Hoenig, Lehmann and Wilson for their recommendations which undoubtedly improved the text, and we would like to express our appreciation to Marc Hollender for reading and commenting on the manuscript in various stages of its development. We are indebted to him also for reviewing final version and for his editorial suggestions on language and content.

We are thankful to Mrs. M. Harrington for her secretarial assistance and for typing and retyping the manuscript from the first draft to the printed version.

Thomas A. Ban

Bertalan Pethö