Psychopathologie und Verlaufsforschung

Zusammenfassung

Psychopathologie und Verlaufsforschung sind traditionell eng miteinander verbunden. Historisch bestand ein zentrales Ziel der Verlaufsforschung in der Validierung der auf der klinisch-psychopathologischen Querschnittssymptomatik basierenden, kategorialen Klassifikationen von bestimmten Patientenpopulationen. Die Ätiopathogenese der so gefundenen Zustands-Verlaufs-Einheiten sollte biologisch entschlüsselt werden. Jedoch fanden sich weder einheitliche Verlaufstypen noch konnte die Ätiopathogenese der meisten psychiatrischen Erkrankungen aufgeklärt werden. Auch die durch operationalisierte Diagnosemanuale erhöhte Reliabilität psychiatrischer Diagnosen änderte an diesem Umstand nichts. Die mit der globalen Einführung operationalisierter Diagnosemanuale einhergehende Dekonstruktion psychiatrischer und psychopathologischer Schulen hinterließ ein Theoriendefizit, welches, solange die biologische Ursachenaufklärung psychischer Erkrankungen in greifbarer Nähe schien, hinnehmbar war, nun aber überwunden werden muss. Funktionale und theoretische Psychopathologie oder die Entwicklungspsychopathologie bieten vielversprechende Ansätze, die durch integrative Forschungsansätze weiterentwickelt werden müssen. Die konzeptuellen Rahmenbedingungen hierfür können z. B. aus der Systemtheorie oder der Theorie zu komplexen adaptiven Systemen abgeleitet werden.

Summary

Psychopathology, course and outcome studies are traditionally closely connected with each other. From an historical perspective a major purpose of course and outcome studies can be seen in the validation of nosological concepts based on descriptive psychopathology. In a second step, etiopathogenesis of those nosological concepts were to be deciphered. Unfortunately however, so far neither the nosological concepts have been validated nor has the etiopathogenesis been explained. This situation has not been changed by an improved reliability of operationalized diagnoses either. The global introduction of operationalized diagnostic systems led to a deconstruction of psychiatric and psychopathological schools and traditions and left psychiatry with a theoretical deficit which was tenable as long as there was hope for an early uncovering of the biological causes of mental illnesses. However, in the current situation this theoretical deficit needs to be overcome. In that respect, functional and theoretical psychopathology as well as developmental psychopathology are promising new approaches which should be further developed by an integration of other disciplines. The conceptual framework for this scientific venture can be derived from systems theory or theory of complex adaptive systems.

Schlüsselwörter

Psychopathologie - Verlaufsstudien - Ätiopathogenese - Systemtheorie

Keywords

Psychopathology - course and outcome studies - etiopathogenesis - systems theory

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