2022-12-11 Sun 11:31 AM https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421898/ > Kraepelin maintained a skeptical attitude towards subjective, especially biographically determined, aspects of mental disorders, which could not or at least not easily be studied experimentally. This general assumption also led to Kraepelin’s harsh, not to say polemical, criticism towards psychoanalysis. > Pathological anatomy, etiology, or clinical symptomatology including long-term course of illness (the latter being his own life-long focus of research): for Kraepelin, all these approaches would necessarily converge in the same “natural disease entities,” simply because they are natural kinds. These natural kinds will, in the best case, be detected by research; they are not seen as being constructed by research. As opposed to the idea that there are natural kinds of disease, > many authors supported the concept of “unitary psychosis” (“Einheitspsychose”). They postulated a continuum of all psychotic, if not all psychiatric disorders, denying any clear boundary between single diagnostic entities, whether they are believed to have a neurobiological basis or not.47 In more recent years, neuroscience etc have led to a new kind of krepelianism > Neo-Kraepelinian authors are at risk, as was Emil Kraepelin, of overestimating the explanatory power of neurobiological findings and concepts.They could, for example, generally render biological data and criteria more reliable and valid than psychopathological or social ones. In that case, the result could be what Michels52 ironically labeled “HyperKraepelinianism.” The whole debate about whether mental diseases are [[Natural kind]] depends on the set of problems involved in specifying what a natural kind is. > As for the scientific credit given to descriptive psychopathology,there is a strong link between“Neo-Kraepelinianism” and operationalized diagnostic manuals, at present the International Classification of Diseases, 10th edition (ICD-10)54 and Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).55-58 For both, it is of crucial importance to reliably describe and delineate different mental disorders from each other (and, what usually is tacitly included, from the area of mental health). The question of whether there are “natural kinds” in psychiatric nosology or not, is of minor relevance in this context. The main intention is to improve the reliability of psychiatric diagnoses by establishing and continuously developing clear diagnostic criteria and algorithms. Describing what is observable on the behavioral level becomes the most important method, whereas heuristic approaches are rated as problematic, if not unscientific, the programmatic headline being “description, not interpretation.” Such a position is very close to Emil Kraepelin’s view of the diagnostic process in psychiatry.