Vincent van Gogh: a pathographic analysis.

The life and artistic legacy of Vincent van Gogh has generated great interest among physicians from different areas of specialization in proposing a retrospective differential diagnosis. The aim of the present study is to present a systematic pathographic analysis of the artist and to suggest a diagnosis consistent with the extant evidence. To this end, the available evidence is classified into five types: type I evidence (clinical opinion of an attending physician), type II evidence (description of symptoms in correspondence), type III evidence (historical accounts from first-hand sources or direct observation), type IV evidence (interpretation of the artist's work) and type V evidence (family medical history). Three basic prerequisites for a successful analysis are: (1) consideration of type II, III and V evidence as carrying the greatest pathographic weight, (2) consideration of the course of symptoms over time as a key element in the analysis, and (3) consideration of a single diagnostic hypothesis as the most probable explanation. After reviewing the available evidence in the light of these criteria, the author supports the diagnosis of acute intermittent porphyria (AIP) as the most likely cause of van Gogh's ailment.