La diagnosi psicopatologica. Le parole di ieri per la clinica di oggi

At the dawn of the twentieth century, psychopathology was described in narrative terms, and the typical patient was portrayed with great detail, paying close attention to even the most subtle nuances; it was told in a dynamic manner, emphasizing the evolution of the disorder, the relationship between symptoms, without neglecting the impact of the disturbance on social and relational life. Since 1980, the year of the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) by the American Psychiatric Association, psychopatological diagnosis has been based on precise and reproducible criteria, known as ‘operational criteria.’ The description of disorders therefore relies almost exclusively on listing these criteria, which are essentially reducible to symptoms. The author compares the descriptions of psychopathology from the past with today’s diagnostic criteria (DSM-5-TR and ICD-11). The result is an accurate synthesis, where the focus of clinical attention is on patients, not just symptoms, without neglecting the rigorous objectivity of current diagnoses.