Dimensional Approach in Psychiatry

Abstract

In psychiatry there is a traditional categorical conception stating that several disorders like schizophrenia and bipolar disorder have distinct etiologies. On the other hand, dimensional approach claims that these entities are actually the same disorder reflecting different clinical aspects of same mental disorder in the course of time. ICD and DSM classifications are based on separate categories of different mental disorders. Howewer, it is quite difficult to consider a mental disorder as a discrete entity that has absolute boundaries from other disorders. There are patients manifesting symptoms of two or more categories but do not fulfill all diagnostic criteria for any mental disorder. Dimensional approach handles the psychopathology as a continuing process and establish the patients to the different ongoing points. According to this view, in fact, multiple diagnosis reflect dimensions of the same disease.

Keywords

• Dimensional approach, categorical view, continuum of psychosis

Psikiyatride Boyutsal Yaklaşım

Öz

Psikiyatride, özellikle şizofreni ve bipolar bozukluk olmak üzere, ruhsal bozuklukların farklı etyolojilere sahip olduğunu ileri süren varsayım geleneksel kategorik yaklaşımı sergiler. Boyutsal yaklaşım ise, ruhsal bozuklukların aslında tek bir hastalığın zaman içinde farklı klinik görünümler şeklinde ortaya çıkmasından ibaret olduğunu ileri sürmektedir. DSM ve ICD sistemleri, öteden beri ruhsal bozuklukları ayrı kategoriler olarak ele almış ve öyle sınıflandırmışlardır. Oysa kategorileri her zaman birbirlerinden ayırmak mümkün olmamaktadır. Hiçbir kategorinin tanımına uymayan, fakat hasta olduğu şüphe götürmeyen, iki kategorinin kısmi özelliklerini bir arada gösteren fakat hiçbirinin ölçütlerini tam olarak karşılamayan hastalar bulunmaktadır. Boyutsal yaklaşım patolojiyi sürekli bir boyut olarak ele alır ve her hastayı bu sürekliliğin farklı bir noktasına yerleştirir. Bu yaklaşıma göre çoğul tanılar aslında aynı hastalık doğasının farklı boyutlarıdır yaklaşımı ile bir hastanın bütün semptomlarını tek bir hastalıkla açıklayabilmektir.

Anahtar Kelimeler

• Boyutsal yaklaşım, kategorik görüş, psikozun sürekliliği

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