Abstract
In the course of a long-term historical development, two different systems of reference evolved in German and Anglo-American psychiatry. Which now confront each other, obviously without actually mixing. Based on classical German philosophy, in Germany the ideas of clinical vignette (Krankheitsbild) and phenomenon-symptom (Phänomen) were on developed. Based on classical English philosophy, English and American psychiatry for long periods were just interested in the best possible humane care for the mentally ill, but not in diagnosing clinical entities or in diagnostic classification. During the two last decades, a first comprehensive classification system, based on the redefinition of criteria by contemporary American philosophy, has been developed. In a short time this system has gained international significance. Both reference systems are outlined in respect of their historical development and differences to make these differences apprehensible by the reader. Unreflected differences result in problems of understanding.

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