Factors Involved in Delusion Formation

I write as one who has grappled with improving the classification of the psychoses, but I believe that the strategy of developing a set of descriptive concepts, and using such preliminary groupings to search for the primary causes of the ‘diseases‘ defined (genes, brain damage, social and psychological stressors, etc.) is insufficiently ambitious. Psychiatry has been too reductionist in its attitude to both the causes and the treatment of symptoms (such as delusions), placing the entire emphasis on investigating and treating the ‘underlying disease‘, not the delusional process itself. Internal medicine has often been able to unfold the whole disease process from primary causes and preconditions through disordered physiology to symptoms. In psychiatry it is also important to understand the pathogenesis of symptoms, that is, to specify the stages in the transposition of stress and cerebral pathology into the phenomena of mental illness.