How to improve psychiatric nosography in the XXI century: a phenomenologist”s viewpoint

Classifications of mental disorders reflect much more the minds of psychiatrists than the patients’ minds since these classifications are more focused on the interests of stakeholders (including governmental agencies, advocacy groups, medical insurance, and pharmaceutical companies) than on the expe...

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Main Author: Giovanni Stanghellini
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933825000112/type/journal_article
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author Giovanni Stanghellini
author_facet Giovanni Stanghellini
author_sort Giovanni Stanghellini
collection DOAJ
description Classifications of mental disorders reflect much more the minds of psychiatrists than the patients’ minds since these classifications are more focused on the interests of stakeholders (including governmental agencies, advocacy groups, medical insurance, and pharmaceutical companies) than on the experiences of patients. We live in times of rapid socio-cultural changes, and respective changes in the forms of mental suffering are increasingly characterized by fragmentariness and episodicity. These new forms of suffering may escape nosographic framing based on the identification of symptoms and syndromes. A paradigm shift in the psychiatric nosography is necessary. The way forward could be to enhance the ability of clinicians to grasp the “fragments” provided by patients rather than aggregations of symptoms. “Existential knots” can manifest themselves in these fragments to be used as “floating buoys” for clinical navigation, in the absence of exhaustive and detailed “maps” of the symptoms and syndromes that afflict patients. A tentative collection of these existential knots is provided, building on and extending the legacy of existential philosophy and phenomenological psychopathology.
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spelling doaj-art-217a72ccdd904a169e397535aafba7802025-02-11T03:18:08ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.11How to improve psychiatric nosography in the XXI century: a phenomenologist”s viewpointGiovanni Stanghellini0https://orcid.org/0000-0001-5164-7013Department of Health Sciences, University of Florence, Florence, Italy Centro de Estudios de Fenomenologia y Psiquiatria, Universidad ‘Diego Portales’, Santiago, ChileClassifications of mental disorders reflect much more the minds of psychiatrists than the patients’ minds since these classifications are more focused on the interests of stakeholders (including governmental agencies, advocacy groups, medical insurance, and pharmaceutical companies) than on the experiences of patients. We live in times of rapid socio-cultural changes, and respective changes in the forms of mental suffering are increasingly characterized by fragmentariness and episodicity. These new forms of suffering may escape nosographic framing based on the identification of symptoms and syndromes. A paradigm shift in the psychiatric nosography is necessary. The way forward could be to enhance the ability of clinicians to grasp the “fragments” provided by patients rather than aggregations of symptoms. “Existential knots” can manifest themselves in these fragments to be used as “floating buoys” for clinical navigation, in the absence of exhaustive and detailed “maps” of the symptoms and syndromes that afflict patients. A tentative collection of these existential knots is provided, building on and extending the legacy of existential philosophy and phenomenological psychopathology.https://www.cambridge.org/core/product/identifier/S0924933825000112/type/journal_articlecritique of psychiatric nosographyexistential knotsfragment-oriented listeninghumanistic approachstructural psychopathology
spellingShingle Giovanni Stanghellini
How to improve psychiatric nosography in the XXI century: a phenomenologist”s viewpoint
European Psychiatry
critique of psychiatric nosography
existential knots
fragment-oriented listening
humanistic approach
structural psychopathology
title How to improve psychiatric nosography in the XXI century: a phenomenologist”s viewpoint
title_full How to improve psychiatric nosography in the XXI century: a phenomenologist”s viewpoint
title_fullStr How to improve psychiatric nosography in the XXI century: a phenomenologist”s viewpoint
title_full_unstemmed How to improve psychiatric nosography in the XXI century: a phenomenologist”s viewpoint
title_short How to improve psychiatric nosography in the XXI century: a phenomenologist”s viewpoint
title_sort how to improve psychiatric nosography in the xxi century a phenomenologist s viewpoint
topic critique of psychiatric nosography
existential knots
fragment-oriented listening
humanistic approach
structural psychopathology
url https://www.cambridge.org/core/product/identifier/S0924933825000112/type/journal_article
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