TRADITIONAL CONCEPTS AND APPROACHES IN PSYCHIATRY AS PRECONDITIONS FOR PSYCHOSOMATIC CONCEPT: THE NEUROBIOLOGICAL ASPECT

Abstract

In the current article, conceptual approaches in psychiatry (considered as backgrounds in revising of psychosomatic conception) are discussed. The increasing development of neuroscience demonstrated the limitation of psychopathological methods. Significant differences and discrepancies in assessing the type, degree, course of psychopathological disorders at the nozological level are revealed. The widespread use of the new classification systems led to dissolving boundaries between mental and behavioral norms and pathology led to rejection of the classical approaches. It made transition from monothetic to polythetic categorization. Nozological psychiatry transformed into syndromological one. The phenomenological approach in psychiatry is considered as an alternative to the nozological principle. However, despite some advantages, they are not without disadvantages, which cover diagnostic, terminological, theoretical, pedagogical and other aspects. The phenomenological approach still leads to a disagreement among psychiatrists regarding the terminological definitions, the theoretical basis. The current classifications of mental and behavioral disorders lead to a blurring of the boundaries between the mental and behavioral norm and pathology and enormously expand the boundaries of mental abnormality, narrowing the boundaries of norm and health. Analysis of pathogenetic mechanisms of mental disorders demonstrated the failure of all the concepts, and approaches (primarily neurobiological) due to the lack of specificity for certain pathology. It is indicated that both endogenous disorders and psychosomatic ones are based on neurotransmitter processes. In this case the discrepancy in the diagnosis of mental disorders by different specialists is observed. There is no specific etiology, pathogenetic mechanisms, and environmental factors for a particular mental disorder.