Psychische Störungen: erklären, verstehen oder beschreiben? Historische und aktuelle Perspektiven einer psychopathologischen Kernfrage

Abstract

Psychiatry has always been characterised by highly heterogeneous theoretical concepts regarding the etiology, diagnosis and treatment of mental disorders, but also concerning the appropriate scientific methods to be applied. A central issue is the question whether mental phenomena should preferably be explained (as in natural sciences), understood or interpreted (as in «Geisteswissenschaften») or described (with as few theoretical presuppositions as possible). This paper illustrates the main historical and actual arguments in this debate. The first conclusion is that no clear separation line exists between these three methods and that such a separation is not at all necessary for clinical or research purposes. What is needed, however, is a balanced combination of approaches, depending on the clinical or scientific questions to be answered. The second conclusion suggests a future strengthening of the role of psychopathology, a scientific field that clearly reaches beyond the reliable description of symptoms