The Differentiation of Neuroses and Psychoses, with Special Reference to States of Depression and Anxiety

The problem of the differentiation between neurosis and psychosis has given rise to much confused literature and discussion. This is particularly true of those cases in which anxiety or depression is the outstanding feature of the illness, and which do not show any gross symptoms of psychotic illness. Such confusion as exists appears to be due to a variety of causes. For example, the social implications of psychotic illness tend to favour a diagnosis of neurosis in many of the milder cases. Again, the same diagnostic terms are often used with quite different meanings by different workers. An even more potent cause of difficulty is the temptation to search for fixed disease entities in psychiatry which can be sharply separated one from the other.