Psychiatry - H.T. Sonnyk 2003

General Psychopathology and Symptomatology of Mental Illness
General Characteristics

Few clinical disciplines match psychiatry in the sheer variety of terms used to describe pathological disorders. This stems from the fact that the discipline’s historical development relied primarily not on general medical criteria—which dictate that every disease must possess distinct Etiology, Pathogenesis, and pathomorphological markers—but rather on the empirical description of various pathological syndromes.

Virtually all prominent psychiatrists of the 19th and early 20th centuries, particularly French and German clinicians, secured their place in medical history by attaching their names to specific psychopathological phenomena. In their quest for a universal theory capable of harmonizing numerous symptoms and syndromes, psychiatrists drew upon the works of 17th-century French materialists, Charles Darwin’s theory of evolution, the pathomorphological investigations of Virchow's school, and the foundational discoveries of Ivan Sechenov, Ivan Pavlov, and others.

A notable role in shaping concepts regarding the causes of illness was played by John Hughlings Jackson's (1864) theory on the localization of Nervous system Functions. Jackson categorized Brain lesion symptoms into negative symptoms (deficits resulting from tissue loss) and positive symptoms (arising from the release of lower brain centers from higher control).

Jackson’s concept was subsequently reflected in Emil Kraepelin’s (1920) research on psychopathological syndrome registers, in which he identified neurotic, affective, hallucinatory, delusional, dyskinetic, and encephalopathic disorders.

Based on the depth of psychological impairment, French researchers H. Ey and J. Rouart (1936) devised their own scale, distinguishing 8 main syndrome groups: neurotic, paranoid, oneiric, cenesthopathic, manic-melancholic, confusional-stuporous, schizophrenic, and dementing (cementing).

Jackson's ideas were further transformed and applied to clinical syndromology by A.V. Snezhnevsky. This researcher formulated THE PRINCIPLE OF the nosological Specificity of Psychopathological Syndromes, positing that as a pathological process progresses, syndromes evolve from simple to complex and from minor to major. He insisted on a rather stable correlation between positive and negative syndromes and nosological entities, arguing that an isolated clinical symptom or syndrome proves nothing on its own, merely expressing "a specific episode in the continuous Development of the disease."

He identified 9 groups (tiers) of positive syndromes and 10 groups (tiers) of negative syndromes, arranged sequentially by degree of severity and increasing nosological specificity. The former include: emotional-hyperesthetic, affective, and neurotic disorders, verbal hallucinosis and paranoid states, catatonic, hallucinatory-paranoid, and paraphrenic syndromes, states of altered consciousness, paramnesias, convulsive, and psychoorganic syndromes. The latter include: exhaustion of mental activity, subjectively perceived alteration, objectively determined alteration, personality disharmony, drop in energetic potential, personality degradation, amnestic disorders, total dementia, and psychic marasmus.

It is worth noting that to this day, no single Classification of psychiatric symptoms fully captures the vast array of concepts existing in psychiatry, providing only a General Overview of their properties.