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Psychiatry is the branch of medicine that deals with the treatment of mental illness. The word psychiatry is derived from psyche, meaning “mind,” and iatreia, meaning “medical treatment.” Medical treatment has traditionally attempted to rest upon sound diagnosis; thus, it is not surprising to find much of the work of general psychiatrists centering around the activity of diagnostic assessment. In what follows, I discuss diagnosis in the field of both psychiatry and psychoanalysis.
The word diagnosis is derived from dia, which means “through” or “throughout,” and gnosis, which means “knowledge.” Diagnosis implies knowing throughout. In medical tradition, the object of diagnosing has been to distinguish one disease from another based on observable signs or subjectively reported symptoms. Although there has been much study concerning psychiatric diagnosis from many diverse fields, including biochemistry, physiology, and the neurosciences, the same basic division of patients has endured. As Havens has recently stated: “For all the emphasis on sectarianism and subjectivism … two elements of diagnosis have remained the same: first, the structure of diagnosis has remained the same and second, there have been very few losses of patients from psychiatry to internal medicine or neurology as occurred with syphilitic insanity, the vitamin psychoses, and epilepsy.”1 By structure of diagnosis, Havens meant the distribution of patients “among the organic states, psychoses, neuroses, and the personality or character disorders.”1 This structure was laid down by Kraepelin at the end of the nineteenth century. Although there are