Des paradigmes à l'étio-pathogénie en psychiatrie

A French psychiatrist who died recently, G. Lantéri-Laura described three main paradigms in the evolution of western psychiatry since the eighteenth century : mental alienation, mental diseases and psychopathological structures. We shall outline this author's references to philosophy, history and epistemology in his reflexion about identity, evolution and the development of psychiatry, as clinical science. We shall insist upon his admiration of medical semiology, anatomo-clinical correlations and diagnostic procedures, brilliantly illustrated by the Paris School of Medicine, with Corvisart , Bouillaud, Laënnec and P. Louis in the nineteenth century. We may observe that the contemporaneous authors of the Research Agenda for DSM V, Kupfer, First and Regier criticize sharply the DSM III and IV. They criticize this classification which is blind to the research works about etio-pathogeny of mental diseases and allows a reification of statistically -based syndromes , to the detriment of research outcomes about mental diseases. A wide confrontation of all the research trends in psychiatry, including dynamic psychopathology as well as neuro-sciences, might this be the fourth paradigm of our time ?