Title |
The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis
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Published in |
Philosophy, Ethics, and Humanities in Medicine, January 2012
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DOI | 10.1186/1747-5341-7-3 |
Pubmed ID | |
Authors |
James Phillips, Allen Frances, Michael A Cerullo, John Chardavoyne, Hannah S Decker, Michael B First, Nassir Ghaemi, Gary Greenberg, Andrew C Hinderliter, Warren A Kinghorn, Steven G LoBello, Elliott B Martin, Aaron L Mishara, Joel Paris, Joseph M Pierre, Ronald W Pies, Harold A Pincus, Douglas Porter, Claire Pouncey, Michael A Schwartz, Thomas Szasz, Jerome C Wakefield, GScott Waterman, Owen Whooley, Peter Zachar |
Abstract |
In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 9 | 20% |
United Kingdom | 7 | 16% |
India | 1 | 2% |
Netherlands | 1 | 2% |
Switzerland | 1 | 2% |
Spain | 1 | 2% |
Norway | 1 | 2% |
Mexico | 1 | 2% |
Ireland | 1 | 2% |
Other | 0 | 0% |
Unknown | 22 | 49% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 32 | 71% |
Practitioners (doctors, other healthcare professionals) | 7 | 16% |
Scientists | 5 | 11% |
Science communicators (journalists, bloggers, editors) | 1 | 2% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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United States | 2 | <1% |
France | 1 | <1% |
Uruguay | 1 | <1% |
Australia | 1 | <1% |
Brazil | 1 | <1% |
Norway | 1 | <1% |
India | 1 | <1% |
Sweden | 1 | <1% |
Canada | 1 | <1% |
Other | 1 | <1% |
Unknown | 219 | 95% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 40 | 17% |
Researcher | 36 | 16% |
Student > Bachelor | 22 | 10% |
Other | 21 | 9% |
Professor | 19 | 8% |
Other | 62 | 27% |
Unknown | 30 | 13% |
Readers by discipline | Count | As % |
---|---|---|
Psychology | 75 | 33% |
Medicine and Dentistry | 53 | 23% |
Neuroscience | 18 | 8% |
Social Sciences | 15 | 7% |
Philosophy | 7 | 3% |
Other | 23 | 10% |
Unknown | 39 | 17% |