Triadic system
The triadic system of the German psychiatry tradition is a system of psychiatric illnesses that classifies according to cause. The first description goes back to Emil Kraepelin (1856–1926); Further developments are linked to the names Ernst Kretschmer (1888–1964) and Karl Jaspers (1883–1969).
construction
The mental or psychiatric illnesses were divided into three groups according to their cause:
- Organic mental illnesses triggered by tangible physical changes (such as a brain tumor) (physically justifiable psychoses, also organic psychosyndromes ). Examples of this are dementia or delirium . The triggering of schizophrenia-like symptoms by the neurolues was much discussed .
- Endogenous mental illnesses , which are presumably caused by physical changes, which, however, cannot yet be precisely specified (hereditary and “not yet physically justifiable” psychoses). Examples of this are schizophrenia and manic-depressive psychoses (bipolar affective disorder).
- The third group contains the diseases that are presumably psychologically triggered, for example personality disorders, neuroses, stress reactions and adjustment disorders. Kraepelin called this abnormal variations of mental nature .
Further development
Since the early 1980s, attempts to classify psychiatric diseases according to their causes ( etiological ) have increasingly been abandoned. In particular, the previously controversial question of "endogeneity" (i.e. whether the specific symptom pattern can be explained reactively to an external event or not) has taken a back seat in practice, because experience shows that it is seldom possible to agree on this between the representatives of different theories of origin. The modern classifications try to be as descriptive as possible and get along without assumptions, because an orientation on the observed symptom complex without taking into account assumptions about the causes of the disease a higher reliability of the diagnoses is achieved, which facilitates the scientific work. The various nosological theories have therefore not disappeared, but only play a very subordinate role in classification.
While the ICD-9 ( International Classification of Diseases, WHO ) still followed the triadic system, the current ICD-10 is based on symptoms and the course, as does the American Diagnostic and Statistical Manual of Mental Disorders ( DSM-5 ) Psychiatric Association ( APA ) .
Overview
Development of psychiatric classification systems:
- 1840: US census - “nonsense / madness” as the only category
- 1880: U.S. census - 7 categories (mania, melancholy, monomania, paresis, dementia, dipsomania, and epilepsy)
- 1917: American Medico-Psychological Association - 22 categories according to Kraepelin
- 1933: Standard Classified Nomenclature of Diseases - 24 categories with 82 subgroups
- 1948: ICD-6 - First chapter on mental disorders with 10 psychoses, 9 psychoneuroses, 7 character disorders
- 1952: DSM-I - classification according to Adolf Meyer (mental disorders are reactions to psychological, social and biological factors)
- 1965: ICD-8 - expansion to include new disease groups
- 1975: ICD-9 - organic psychoses, other psychoses, neuroses, personality disorders and others
- 1980: DSM-III - multiaxial classification
- 1987: DSM-III-R - Introduction of the comorbidity principle
- 1992: ICD-10 - Clinical Diagnostic Guidelines
- 1994: ICD-10 - Research Criteria
- 1994: DSM-IV - 395 diagnosable disorders (developed on the basis of empirical results)
Individual evidence
- ↑ Hans Bangen: History of the drug therapy of schizophrenia. Berlin 1992, ISBN 3-927408-82-4
- ↑ List modified from Andrea Keller (2000): The classification of mental disorders according to DSM-IV with the help of a structured interview (F-DIPS) - an examination of the retest reliability and validity. P. 9 f. Dissertation, Heidelberg University.