Bentall on the “Kraepelinian paradigm”


Bentall, R. Madness explained: why we must reject the Kraepelinian paradigm and replace it with a `complaint-orientated’ approach to understanding mental illness. Medical Hypotheses, 2006, 66, 220-233:

“Instead of attempting to explain mythical diagnostic entities, we should try and explain the actual complaints that patients bring to the clinic, such as hallucinations, delusions, disordered communication and mania. This strategy assumes that, once these complaints have each been explained in turn, there will be no ‘schizophrenia’ or ‘bipolar disorder’ leftover to account for.”

“a simple list of a patient’s complaints contains much more useful information than a Kraepelinian diagnosis, and takes less effort (because complaints have to be assessed in order to generate a diagnosis). In fact, cognitive-behaviour therapists have long argued that lists of this kind – the ‘problem list’ in the jargon of the approach – is the best starting point for clinical intervention… A complaint-orientated approach implies that treatments should be delivered according to patients’ needs.”