Nosography and classification of mental diseases in the history of psychiatry

Abstract

ObjectiveRetrace the history regarding the classification of diseases, notably mental diseases, from the birth of psychiatry at the beginning of the 19th century and up to the 10th revision of the International Classification of diseases published by the WHO (in 1993). MethodStudy the classifications proposed successively by the nosographists during this period. ResultsIn the 18th century, physicians classified diseases in the same way as animal and vegetal species (Carl von Linné). In the 19th century, following several attempts in France and Germany to classify mental diseases according to known or suspected aetiological and pathogenic factors (B.-A. Morel, Griesinger), psychiatrists classified psychosis and neurosis according to their clinical symptomatology and their development over time, from their onset up to the terminal stage. In 1893, J. Bertillon proposed a “Nomenclature of diseases” during the International Congress of Statistics in Chicago that permitted their classification, so as to classify-collect statistical epidemiological data on international level. Revisions were made between the two world wars by the Office of Health of the Society of Nations (Geneva). Following the foundation in 1948 of the WHO, it was the latter that continued the revisions of the International classification of diseases (ICD), Chapter V (F) of which is dedicated to disorders. DiscussionThe debate on the question of classifications in psychiatry has always taken place during the World Congress on Psychiatry since its initiation in Paris in 1951. In 1976, during the sixth congress in Honolulu, a resolution was adopted requesting the national psychiatric societies that had a classification of mental diseases to revise the latter so that they tallied with Chapter V(F) of the ICD. The American Psychiatric Association revised its Diagnosis and Statistical Manuel of mental disorders (DSM) and published the DSM III. In France, a group of pedopsychiatrists published a French classification of Mental disorders in children and adolescents (Classification Française des Troubles Mentaux de l’Enfant et de l’Adolescent [CFTMEA]), the last revision of which was published in 2012 (CFTMEA R 2012). ConclusionThis study shows that it is not possible to propose a classification of mental diseases, in particular according to the development of psychiatry at the time it is drawn up; it can only be of value within the cultural context of the country in which it is to be used.