Les discussions sur les classifications psychiatriques à la Société Médico-Psychologique (1860-2014)

The Société Médico-Psychologique has devoted in the 19th century two series of discussions during several months about psychiatric classification. In 1860-1861, the discourse of Jules Falret recommends to use the evolutive criteria rather than the psychological one (Delasiauve). It allows the transition from unitary mental alienation to several psychiatric diseases and the decline of the monomanias. The aetiological criteria of Morel are discussed. In the same way, in 1888-1889, the classification of Magnan, axed on mental degeneracy, presented by his pupil Paul Garnier, is not admitted by all. Its opponents propose symptomatic (Dagonet, Ball) or anatomic classifications (Voisin, Luys). The discussion came to nothing, but the word psychosis begins to be currently used. Only 75 years later, the Société Médico-Psychologique debates again about the nosology. Between 1966 and 2014, seven discussions, each during one day (two days in 1994), are brought by clinical innovations or by the publication of official classifications, either French, or international. In 1966, are discussed the progresses involved by psychopharmacology and statistics. In 1978, the French classification of the Inserm is compared with the ICD-9 and the DSM-III, in preparation. In 1988, the clinical applications of the DSM are discussed, but there are always communications about the French classification of delusional disorders and about the paraphrenias. In 1994, the transnosography tries to open the way from a “categorical” classification to a “dimensional” one. In 2001 and 2010, two revised versions of the CFTMEA (French Classification of Mental Disorders of Child and Adolescent) are presented. In 2014, a discussion is devoted to the DSM-5. There is an agreement since 50 years about the interest of “mixed” classifications (symptomatic, evolutive and aetiological), about the necessity to avoid too frequent revisions, to obtain a consensus and to simplify the nosology.