Dear Editor, Psychopathology was originally conceived as a framework to understand the full range of human mental experiences from normal variations to severe disturbances. The foundational works of Jaspers and Schneider emphasized the phenomenological study of emotions, volition, perception, and consciousness as central to understanding the person as a whole.1 Its purpose was not only diagnostic but also to bridge subjective experience with clinical observation within medicine and human sciences. Over time, the scope of psychopathology has gradually narrowed. With the rise of descriptive psychiatry and diagnostic systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD), clinical focus shifted to psychotic symptoms including delusions, hallucinations, and thought disorder because they seemed more objective and measurable. As a result, psychopathology has become largely psychosis-centric, focusing on schizophrenia-related features while giving less attention to affective, anxiety, and personality disorders.2 This psychosis-centric focus carries major conceptual and clinical consequences. It risks reducing psychopathology from a broad study of mental life to a narrow tool for distinguishing psychosis from non-psychosis, even though nonpsychotic disorders such as depression, anxiety, and stress-related conditions account for most psychiatric morbidity worldwide, especially after the COVID-19 pandemic.3 This reductionism sidelines key domains such as affectivity, self-experience, and personality structure, leading to a fragmented view of mental illness and a limited understanding of mental suffering. The impact of this psychosis-centered approach is evident in psychiatric practice and education. Psychopathology becomes equated with detecting psychosis rather than understanding lived experience. As a result, physicians may miss subtle changes in selfhood, time experience, embodiment, and relationships, which are vital for a full psychiatric formulation. Psychiatry, therefore, risks losing its interpretive and humanistic core, reducing itself to categorical checklists that cannot capture the complexity of individual suffering. Training programs often focus on recognizing psychotic symptoms as core skills. While important, this emphasis makes psychosis appear as the main form of psychopathology, leaving mood, anxiety, and personality disturbances secondary. This results in the production of clinicians adept at identifying psychosis but less skilled in understanding emotional and experiential aspects of mental life. To address this bias, psychopathology should be revitalized with greater emphasis on neurotic psychopathology to keep psychiatry relevant to present-day mental health needs.4 A broader focus will improve diagnostic accuracy, empathy, and reflection. Integrating these elements can restore psychopathology as the foundation of psychiatry rather than a narrow diagnostic tool. Even the term “psychopathology” may perpetuate conceptual and social distortions. Removing the prefix “psycho-” and retaining “pathology” could help align psychiatry with the rest of medicine, reduce stigma, and affirm that mental disturbances are legitimate medical conditions deserving equal scientific and clinical rigor.5 On top of it, deleting prefix “psycho-” could help in understanding real psychiatry is beyond psychosis. Fellow physicians, medical students, as well as lay people, often feel confused about the distinction between psychiatry and other disciplines in which the prefix “psych” appears, for example psychology and psychotherapy.6 Psychopathology is not different in this regard, in fact, medical students and physicians think of it as psychosis-centric psychopathology related to non-medical field. Ultimately, the future of psychiatry depends on restoring a broad, deep, and balanced vision of psychopathology by viewing psychosis not as the center but as one among many expressions of disordered human experience. Author’s contribution Conceptualization, literature review, writing the original draft: MJN. Conceptualization, literature review, writing , review and editing : NM. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Naik et al. (Fri,) studied this question.