Skip to main content
SpringerLink
Log in

Functional Psychopathology: A Diagnostic Approach to Enhance the Return of Human Brain and Behaviour Research

  • Chapter
Nuclear Medicine in Psychiatry

  • 180 Accesses

Abstract

Diagnosis is the very bedrock of psychiatric research, particularly biological psychiatric research. If one aspires to elucidate the neurobiological underpinnings of abnormal mental phenomena precise definition of those phenomena is essential. It is hard to imagine that diagnostic constructs of substantial heterogeneity and unproven validity will turn out to have a definable pathophysiology. But that is just what the nosological constructs that psychiatry is so attached to are: crude and global, indications of abnormal mental conditions, each with substantial variability in terms of symptomatology, aetiology, course, outcome and treatment response and mostly of unproven validity. Hence the nosological model of mental disorders is ill-suited for (biological) psychiatric research. An alternative diagnostic model, called the functional psychopathological model, is formulated. An essential component of this approach forms the analysis of the psychic dysfunctions underlying psychopathological symptoms. With this model as a starting point, biological research is less geared towards the pathophysiology of categorical entities, or syndromes, but towards well-defined and carefully measured psychic dysfunctions, such as disturbances in anxiety, aggression and mood regulation, in impulse control and in particular cognitive functions, to mention only a few. Development and application of the functional approach in psychiatric diagnosing will not only enhance the chance of finding meaningful relations between neurobiological and psychic dysfunctions, but will provide psychiatric diagnosing, at last, with a solid scientific foundation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Angst J, Merikenges K, Scheiddeger P, Wicki W (1990) Recurrent brief depression: a new subtype of affective disorder. J Affect Disord 19:87–98

    Article  PubMed  CAS  Google Scholar 

  • Angst J, Sellaro R, Merikangas KR (2000) Depressive spectrum diagnoses. Compr Psychiatry 41[Suppl 1]:39–47

    Article  PubMed  CAS  Google Scholar 

  • Chen LS, Eaton WW, Gallo JJ, Nestadt G, Crum RM (2000) Empirical examination of current depression categories in a population-based study: symptoms, course, and risk factors. Am J Psychiatry 157:573–580

    Article  PubMed  CAS  Google Scholar 

  • Goldberg D (1996) A dimensional model for common mental disorders. Br J Psychiatry 168:44–49

    Google Scholar 

  • Heiligenstein JH, Tollefson GD, Faries DE (1994) Response patterns of depressed outpatients with and without melancholia: a double-blind, placebo-controlled trial of fluoxetine versus placebo. J Affect Disord 30:163–173

    Article  PubMed  CAS  Google Scholar 

  • Hellerstein DJ, Little SA (1996) Current perspectives on the diagnosis and treatment of double depression. CNS Drugs 5:344–357

    Article  Google Scholar 

  • Herpertz S, Steinmeyer EM, Sass H (1998) On the conceptualisation of subaffective personality disorders. Eur Psychiatry 13:9–17

    Article  PubMed  CAS  Google Scholar 

  • Judd LL, Rapaport MH, Paulus MP, Brown JL (1994) Subsyndromal symptomatic depression: a new mood disorder? J Clin Psychiatry 55:18–28

    PubMed  Google Scholar 

  • Judd LL, Akiskal HS, Paulus MP (1997) The role and clinical significance of subsyndromal depressive symptoms (SSD) in unipolar major depressive disorder. J Affect Disord 45:5–18

    Article  CAS  Google Scholar 

  • Kendell R, Jablensky A (2003) Distinguishing between the validity and utility of psychiatric diagnoses. Am J Psychiatry 160:4–12

    Article  PubMed  Google Scholar 

  • Klein DN (1990) Depressive personality: reliability, validity and relation to dysthymia. J Abnormal Psychol 99:412–421

    Article  CAS  Google Scholar 

  • Krueger RF (1999) The structure of common mental disorders. Arch Gen Psychiatry 56:921–926

    Article  PubMed  CAS  Google Scholar 

  • Krueger RF, Caspi A, Moffit TE, Silva PA (1998) The structure and stability of common mental disorders (DSM-III-R): a longitudinal-epidemiological study. J Abnorm Psychol 107:216–227

    Article  PubMed  CAS  Google Scholar 

  • Mayberg HS, Liotti M, Brannan SK, McGinnis S, Mahurin RK, Jerabek PA, Silva JA, Tekell JL, Martin CC, Lancaster JL, Fox PT (1999) Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am J Psychiatry 156:675–682

    PubMed  CAS  Google Scholar 

  • Olfson M, Broadhead WE, Weissman MM, Leon AC, Farber L, Hover C, Kathol R (1996) Subthreshold psychiatric conditions in a prepaid primary care group practice. Arch Gen Psychiatry 53:880–886

    Article  PubMed  CAS  Google Scholar 

  • Ormel J, Oldehinkel AJ, Brilman EI (2001) The interplay and etiological continuity of neuroticism, difficulties, and life events in the etiology of major and subsyndromal, first and recurrent depressive episodes in later life. Am J Psychiatry 158:885–891

    PubMed  CAS  Google Scholar 

  • Pincus HA, Frances AF, Davis WW, First MB, Widiger TA (1992) DSM-IV and new diagnostic categories: holding the line on proliferation. Am J Psychiatry 149:112–117

    PubMed  CAS  Google Scholar 

  • Pincus HA, Davis, WW, McQueen LE (1999) “Subthreshold” mental disorders. Br J Psychiatry 174: 288–296

    Article  PubMed  CAS  Google Scholar 

  • Roth M (2001) Unitary or binary nature of classification of depressive illness and its implications for the scope of manic depressive disorder. J Affect Disord 64:1–18

    Article  PubMed  CAS  Google Scholar 

  • Roy-Byrne P, Katon W, Broadhead WE, Stein MB (1994) Subsyndromal (“mixed”) anxiety-depression in primary care. J Gen Intern Med 9:507–512

    Article  PubMed  CAS  Google Scholar 

  • Sherbourne CD, Wells KB, Hays RD, Rogers W, Burnam MA, Judd LL (1994) Subthreshold depression and depressive disorder: clinical characteristics of general medical and mental health specialty outpatients. Am J Psychiatry 151:1777–1784

    PubMed  CAS  Google Scholar 

  • Van Os J, Fahy TA, Jones P, Harvey I, Sham P, Lewis S, Bebbington P, Toone B, Williams M, Murray R (1996) Psychopathological syndromes in the functional psychoses: associations with course and outcome. Psychol Med 26:161–176

    Article  PubMed  Google Scholar 

  • Van Praag HM (1962) A critical investigation of the significance of monoamine oxidase inhibition as a therapeutic principle in the treatment of depression. Thesis, Utrecht

    Google Scholar 

  • Van Praag HM (1982a) A transatlantic view of the diagnosis of depression according to the DSM III. I. Controversies and misunderstandings in depression diagnosis. Compr Psychiatry 23: 315–329

    Article  PubMed  Google Scholar 

  • Van Praag HM (1982b) A transatlantic view of the diagnosis of depressions according to the DSM III. II. Did the DSM III solve the problem of depression diagnosis? Compr Psychiatry 23:330–337

    Article  PubMed  Google Scholar 

  • Van Praag HM (1989) Diagnosing depression. Looking backward into the future. Psychiatry Dev 7:375–394

    Google Scholar 

  • Van Praag HM (1993) Barking up the wrong tree. Towards a more effective system of psychiatric diagnosing. Neuropsychopharmacology 9:52S–53S

    Google Scholar 

  • Van Praag HM (1996) Comorbidity (psycho-) analyzed. Br J Psychiatryl68:129–134

    Google Scholar 

  • Van Praag HM (1997) Over the mainstream: diagnostic requirements for biological psychiatric research. Psychiatry Res 72:201–212

    Article  Google Scholar 

  • Van Praag HM (1998) Inflationary tendencies in judging the yield of depression research. Neuropsychobiology 37:130–141

    Article  PubMed  Google Scholar 

  • Van Praag HM (2000) Nosologomania: a disorder of psychiatry. World J Biol Psychiatry 1:151–158

    Article  PubMed  Google Scholar 

  • Van Praag HM (2001) Anxiety/aggression-driven depression. A paradigm of functionalization and verticalization of psychiatric diagnosis. Prog Neuro Psychopharm Biol Psychiatry 25: 893–924

    Article  Google Scholar 

  • Van Praag HM, Leijnse B (1962) The influence of so-called mono-amineoxydase-inhibiting hydrazines on oral loading-test with serotonin and 5-hydroxyindoleacetic acid. Psychopharmacology 3:202–203

    Article  Google Scholar 

  • Van Praag HM, Leijnse B (1963a) Die Bedeutung der Monoamineoxydasehemmung als antide-pressives Prinzip I. Psychopharmacology 4:1–14

    Article  Google Scholar 

  • Van Praag HM, Leijnse B (1963b) Die Bedeutung der Monoamineoxydasehemmung als antide-pressives Prinzip I. Psychopharmacology 4:91–102

    Article  Google Scholar 

  • Van Praag HM, Leijnse B (1965) Neubewertung des Syndroms. Skizze einer funktionellen Pathologie. Psychiatr Neurol Neurochir 68: 50–66

    Google Scholar 

  • Van Praag HM, Uleman AM, Spitz JC (1965) The vital syndrome interview. A structured Standard interview for the recognition and registration of the vital depression symptom complex. Psychiatr Neurol Neurochir 68:329–346

    PubMed  Google Scholar 

  • Van Praag HM, Kahn R, Asnis GM, Wetzler S, Brown S, Bleich A, Korn M(1987) Denosologization of biological psychiatry or the specificity of 5-HT disturbances in psychiatric disorders. J Affect Disord 13:1–8

    Article  PubMed  Google Scholar 

  • Van Praag HM, de Kloet R, Van Os J (2004) Stress, the brain and depression. Cambridge University Press, Cambridge

    Book  Google Scholar 

  • Vollebergh WAM, Ledema J, Bijl RV, De Graaf R, Smit F, Ormel J (2001) The structure and stability of common mental disorders. Arch Gen Psychiatry 58:597–603

    Article  PubMed  CAS  Google Scholar 

  • Zinbarg RE, Barlow DH, Liebowitz M, Street L, Broadhead E, Katon W, Roy-Byrne P, Lepine JP, Theherani M, Richards J (1994) The DSM-IV field trial for mixed anxiety depression. Am J Psychiatry 151:1153–1162

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry and Neuropsychiatry, Academic Hospital Maastricht and to the Brain and Behaviour Research Institute, Maastricht University, P.O. Box 616, 6200 MD, Masstricht, The Netherlands

    Herman M. van Praag (Scientific Advisor)

Authors
  1. Herman M. van Praag
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Nuclear Medicine, University Hospital Ghent, De Pintelaan 185, 9000, Gent, Belgium

    Andreas Otte  & Rudi A. Dierckx  & 

  2. University Department of Psychiatry, University Hospital Ghent, De Pintelaan 185, 9000, Gent, Belgium

    Kurt Audenaert  & Kees van Heeringen  & 

  3. Department of Medical Imaging Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium

    Kathelijne Peremans

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

van Praag, H.M. (2004). Functional Psychopathology: A Diagnostic Approach to Enhance the Return of Human Brain and Behaviour Research. In: Otte, A., Audenaert, K., Peremans, K., van Heeringen, K., Dierckx, R.A. (eds) Nuclear Medicine in Psychiatry. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18773-5_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-18773-5_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62287-8

  • Online ISBN: 978-3-642-18773-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation