Descriptive Psychopathology: The Signs and Symptoms of ...

4The neuropsychiatric evaluation:principles of descriptive psychopathologyand the diagnostic processAs one takes up mental alienation as a separate object of investigation, it would be making abad choice indeed to start a vague discussion on the seat of reason and on the nature of itsdiverse aberrations; nothing is more obscure and impenetrable. But if one wisely confines one’sself to the study of the distinctive characteristics which manifest themselves by outward signsand if one adopts as a principle only a consideration of the results of enlightened experience,only then does one enter a path which is generally followed by natural history; moreover, ifin doubtful cases one proceeds with reserve, one have no fear of going astray. 1The principles of descriptive psychopathology91Descriptive psychopathology has long been the foundation for psychiatric diagnosis.Despite advances in neuroscience and efforts to define psychiatricsyndromes by genotype and endophenotype, the delineation of behavioral syndromesremains centered on accurate description of their characteristic signs andsymptoms.Descriptive psychopathology has been equated with phenomenology, originallya philosophical effort to gain understanding of the human condition throughcritical analysis of subjective experience. 2 Karl Jaspers is credited with adaptingthe principles of phenomenology to the study of psychopathology, but using thediscipline’s early concern with outward appearances rather than inner meanings. 3To best characterize the outward appearance of behavioral syndromes, Jaspersapplied objective observation and precise definitions in assessing psychopathology.The definitions also required the separation of the content of psychopathology fromits form, the form capturing best the characterization of the psychopathology.This approach diverged from phenomenologic philosophy, 4 although Jaspers andhis followers also relied on the philosophy’s focus on “empathic understanding”of the experiences of others.Empathy in a psychiatric context meant the equivalent of “putting oneself intothe other person’s emotional and cognitive shoes”. The goal was to so well