ABSTRACT: Psychiatry has been struggling with two different basic paradigms for the past 30 years. One, traditionally medical, devised by Emil Kraepelin early in the 19th century essentially recapitulates standard medical nosography. Another paradigm championed by many psychologists, clinicians and researchers, draws on a larger much larger referential framework and believes endogenous and environmental factors to be intertwined. Massive inflation in psychiatric diagnoses in the USA over the past 15 years is denounced in three books by specialists recently published. Marcia Angell, professor of Psychiatry at Harvard synthesises these criticisms and concludes that the scientific base for such diagnostic inflation is non-existent and that the upshot is mainly confusion, secondary suffering and vast expense. Psychotherapy, especially integrative psychotherapy is measured against this backdrop and is seen to be a potentially important element in redressing an increasingly disastrous misappliance of medical research and treatment.

Key Words: Kraepelin, manifesto, pathology, statistical research, endogenous, environmental, diagnostic inflation, false-positives, infantile psychosis, paradigms, integrative psychotherapy, relating, co-reponsibility.