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Psychiatria pre prax 2/2025
Categorical and dimensional approach in psychiatry
The diagnosis of mental disorders relies on two largely contrasting yet complementary approaches: categorical and dimensional. The categorical approach defines mental disorders through fixed sets of symptoms and diagnostic thresholds, facilitating standardization in diagnosis and treatment – albeit at the risk of oversimplifying clinical complexity. In contrast, the dimensional approach conceptualizes psychopathology along continuous variables and spectra, offering a more nuanced understanding of symptoms, dysfunctions, and interindividual variation. The clinical utility of each approach varies depending on context, particularly in relation to comorbidity, thresholds for therapeutic intervention, and implications for research and personalized care. Integrating both approaches may enhance diagnostic accuracy and therapeutic sensitivity: while categorical frameworks provide necessary structure, dimensional models enrich our grasp of individual psychopathological profiles.
Keywords: categorical approach, dimensional approach, comorbidity, psychopathology, personalized treatment, diagnostic thresholds
