Феномен некорригируемых ложных умозаключений в современных психиатрических классификациях

Abstract

The article analyzes the phenomenon of uncorrectable false conclusions and its representation in modern psychiatric classifications (ICD-11 and DSM 5). Attention is drawn to the tendency to confuse the concepts of delusional, overvalued, dominant and obsessive ideas. In particular, we are talking about hypochondria, dysmorphic disorder, pathological preoccupation with one’s own smell and pathological hoarding (hording) “with a decrease or absence of criticality”, which are presented not under the heading of chronic delusional disorders, but under the heading of obsessive-compulsive disorders. The paradox is that the lack of criticality, the conviction of the correctness of one’s own false judgments and their incorrigibility are traditionally considered as criteria for delusional ideas. On the other hand, the fact is analyzed that outside psychiatric classifications there are phenomena that are clinically similar to delusional ones, but in fact are not delusional ones. Analysis of the phenomenon of uncorrectable false conclusions and the attitude towards it as a psychopathological syndrome shows the ambiguity of psychiatrists' views on this problem. Some of these phenomena (hypochondria, preoccupation with one’s own smell, dysmorphia) have found their place in modern classifications of mental and behavioral disorders, others (racism, anti-semitism, homophobia, transphobia) turned out to be outside the group of chronic delusional disorders and continue to be considered non-psychopathological. It is argued that the process of attitude towards this problem is significantly influenced by society, which puts pressure on the psychiatric community and dictates the development of diagnostic criteria based on sociocultural, rather than medical factors.