RESUMO
Pinel, a fines de siglo XVIII, fundó el modelo médico en la psiquiatría. Esta se constituyó en una medicina "especial", pues no se conocían sino constelaciones sintomatológicas. Kraepelin, a inicios del siglo XX, consolidó el modelo médico, con la finalidad de establecer formulaciones pronósticas y la expectativa de llegar algún día a conocer las bases orgánicas. En las dos primeras décadas de este siglo, se cumplió la inclusión, en la psiquiatría, de los trastornos menores, que hoy conocemos como neurosis y desórdenes de la personalidad; las consecuencias fueron triples: 1) ya no podía definirse su dominio como el estudio y tratamiento de las anomalías del comportamiento que requerían internamiento; 2) se volvieron borrosas las fronteras entre lo normal y lo patológico; 3) resultó imposible conservar para todo su campo el modelo clínico-biológico. Entre los extremos de la neurología y el mero estudio de la adaptación en un contexto psicosociológico, la reflexión de los especialistas sobre la identidad de su disciplina es imprescindible, si la psiquiatría ha de continuar existiendo.
It can be established that Pinel, at the end of the 18th century, after relasing the mentally ill from their chains, founded the medical model in Psychiatry. The latter was a sort of "special" medicine due to the fact that only isolated "group of symptoms" were known, without their anatomical and pathological basis. At the beginning of this century, Kraepelin consolidated the medical model, after Pinel, Bayle, Falret and Kahlbaum. Kraepelin emphasized the evolution of mental diseases and redefined the psychiatric nosological approach. His goal was the setting of the prognosis and he was convinced that some day the organic basis of mental illness could be understood. Kraepelin paid special attention to in-patient psychotics. In the first couple of decades of this century, the minor emotional disorders, such as the neurosis and personality disorders, were included in the psychiatric mainstream. The consequences of these insertions were threefold: 1) it was impossible to define the psychiatric scope in terms of behavioral disorders requering hospitalization; 2) frontiers between normal and pathological became blurred; 3) the clinical-biological model was not the unique approach anymore. There are viewpoints-such as Jasper's and Kurt Schneider's regarding psychiatry double identity: biologically explained cases or psychologically understandable conditions. It is very important for psychiatry survival that psychiatrists find their identity somewhere between neurology and psychosociology.