Neurotic illness: conserving a threatened concept.

With the advent of the American Psychiatric Association's Classification DSM III, the usefulness of the term neurosis as a unitary concept has been questioned. This is largely because of the psychodynamic connotations that invest the term in the USA. However there has been pragmatic development, since the word was introduced into the English language in 1784, that carries epidemiological, behavioural and phenomenological implications. This is demonstrated in the definition contained in ICD 9. Disturbance of self-experience and problems with interpersonal relationships are common to all neurotic disorders, and bodily symptoms of non-organic cause are usual. Neurotic disorders are extremely frequent in the general population, amongst those who consult general practitioners and in psychiatric out-patients; they necessarily concern doctors. It is concluded that what different neurotic disorders have in common is more important for classification than the differences between them. An important practical consideration is that there are general aspects of treatment appropriate for all neuroses which are of less relevance in the treatment of other psychiatric disorders. Also the provision of treatment services require different emphases for the neuroses.