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Towards a new psychiatry: Philosophical and ethical issues in classification, diagnosis and care

Edited by: Prof James Giordano

The profession and practise of psychiatry is in a state of change. To some extent, this reflects, and is also consequential to, ongoing influences of neuroscience and neurotechnology, genetics, and the revised nosology of the new fifth edition of theDiagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association. However psychiatry, like any form of medicine, exists in the public sphere, and so socio-cultural and economic forces also exert effects upon the nature, scope and conduct of the field. This point is particularly important, because as modern society becomes more pluralised, the profession of psychiatry must confront new opportunities and challenges. International ethnic, religious and political beliefs and behaviours are becoming evermore prevalent, and the field is gaining prominence in non-western nations (e.g.- Japan, China, India).

These changes prompt reflection and insight to the philosophical and scientific bases of the profession, and the ethical, legal, and social implications, as well as questions and problems that may be incurred. Namely, how will - and perhaps should - advances in neuroscience, neurotechnology and genetics alter the concepts and practise of psychiatry? In what ways might the new DSM affect the practical, ethical and legal aspects of the field and its role in society? How might psychiatric diagnostic and therapeutic practices be best suited to meet the contingencies of non-Western societies? What specific tools and techniques might shape and define this future path?

This thematic issue addresses these questions, concepts, problems and possible solutions from multi-disciplinary perspectives, and seeks to bring together researchers, scholars, and clinicians in discourse, debate and dialectic about the historicity, canon, science, philosophy and ethics of psychiatry as profession and practise, and what the field can - and perhaps should - become in the years ahead.

The information, ideas, and speculations detailed in these papers represent insights to the ways that neuroscience and its technologies and changing conceptualisations of mental function, health, disorder and illness inform and direct current and future practises of psychiatric research and treatment.

Collection published: 13 January 2012
Last updated: 22 February 2015

  1. Commentary

    Patient advocacy and DSM-5

    The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a useful opportunity to revisit debates about the nature of psychiatric classification. An important debate concerns the...

    Dan J Stein and Katharine A Phillips

    BMC Medicine 2013 11:133

    Published on: 17 May 2013

  2. Review

    Personalized medicine in psychiatry: problems and promises

    The central theme of personalized medicine is the premise that an individual’s unique physiologic characteristics play a significant role in both disease vulnerability and in response to specific therapies. Th...

    Uzoezi Ozomaro, Claes Wahlestedt and Charles B Nemeroff

    BMC Medicine 2013 11:132

    Published on: 16 May 2013

  3. Editorial

    The DSM-5: Hyperbole, Hope or Hypothesis?

    The furore preceding the release of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is in contrast to the incremental changes to several diagnostic categories, which are de...

    Michael Berk

    BMC Medicine 2013 11:128

    Published on: 14 May 2013

  4. Debate

    Clinical classification in mental health at the cross-roads: which direction next?

    After 30 years of consensus-derived diagnostic categories in mental health, it is time to head in new directions. Those categories placed great emphasis on enhanced reliability and the capacity to identify the...

    Ian B Hickie, Jan Scott, Daniel F Hermens, Elizabeth M Scott, Sharon L Naismith, Adam J Guastella, Nick Glozier and Patrick D McGorry

    BMC Medicine 2013 11:125

    Published on: 14 May 2013

  5. Opinion

    Diet, a new target to prevent depression?

    Research on the role of diet in the prevention of depression is scarce. Some evidence suggests that depression shares common mechanisms with cardiovascular disease.

    Almudena Sanchez-Villegas and Miguel A Martínez-González

    BMC Medicine 2013 11:3

    Published on: 3 January 2013

  6. Review

    The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion

    In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the c...

    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…

    Philosophy, Ethics, and Humanities in Medicine 2012 7:14

    Published on: 18 December 2012

  7. Research

    The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities

    Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that...

    Micol Ascoli, Andrea Palinski, John Arianda Owiti, Bertine De Jongh and Kamaldeep S Bhui

    Philosophy, Ethics, and Humanities in Medicine 2012 7:12

    Published on: 28 September 2012

  8. Review

    The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis

    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 furthe...

    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…

    Philosophy, Ethics, and Humanities in Medicine 2012 7:8

    Published on: 5 July 2012

  9. Review

    The six most essential questions in psychiatric diagnosis: a pluralogue part 3: issues of utility and alternative approaches in psychiatric diagnosis

    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 furthe...

    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…

    Philosophy, Ethics, and Humanities in Medicine 2012 7:9

    Published on: 23 May 2012

  10. Review

    The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

    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 furthe...

    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…

    Philosophy, Ethics, and Humanities in Medicine 2012 7:3

    Published on: 13 January 2012

  11. Opinion

    Towards a genuinely medical model for psychiatric nosology

    Psychiatric nosology is widely criticized, but solutions are proving elusive. Planned revisions of diagnostic criteria will not resolve heterogeneity, comorbidity, fuzzy boundaries between normal and pathologi...

    Randolph M Nesse and Dan J Stein

    BMC Medicine 2012 10:5

    Published on: 13 January 2012

  12. Research

    Psychopharmacological enhancement: a conceptual framework

    The availability of a range of new psychotropic agents raises the possibility that these will be used for enhancement purposes (smart pills, happy pills, and pep pills). The enhancement debate soon raises ques...

    Dan J Stein

    Philosophy, Ethics, and Humanities in Medicine 2012 7:5

    Published on: 13 January 2012

  13. Editorial

    A brief historicity of the Diagnostic and Statistical Manual of Mental Disorders: Issues and implications for the future of psychiatric canon and practice

    The Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, currently in its fourth edition and considered the reference for the characterization and diagnosis of mental disorders, has un...

    Shadia Kawa and James Giordano

    Philosophy, Ethics, and Humanities in Medicine 2012 7:2

    Published on: 13 January 2012

  14. Review

    Novel pharmacotherapeutic treatments for cocaine addiction

    Cocaine is a stimulant that leads to the rapid accumulation of catecholamines and serotonin in the brain due to prevention of their re-uptake into the neuron that released the neurotransmitter. Cocaine depende...

    Daryl Shorter and Thomas R Kosten

    BMC Medicine 2011 9:119

    Published on: 3 November 2011

  15. Minireview

    Advances in understanding and treating ADHD

    Attention deficit hyperactivity disorder (ADHD) is a neurocognitive behavioral developmental disorder most commonly seen in childhood and adolescence, which often extends to the adult years. Relative to a deca...

    Kevin M Antshel, Teresa M Hargrave, Mihai Simonescu, Prashant Kaul, Kaitlin Hendricks and Stephen V Faraone

    BMC Medicine 2011 9:72

    Published on: 10 June 2011

  16. Research

    Defining mental disorder. Exploring the 'natural function' approach

    Due to several socio-political factors, to many psychiatrists only a strictly objective definition of mental disorder, free of value components, seems really acceptable. In this paper, I will explore a variant...

    Somogy Varga

    Philosophy, Ethics, and Humanities in Medicine 2011 6:1

    Published on: 21 January 2011

  17. Review

    Nosologomania: DSM & Karl Jaspers' Critique of Kraepelin

    Emil Kraepelin's nosology has been reinvented, for better or worse. In the United States, the rise of the neo-Kraepelinian nosology of DSM-III resuscitated Kraepelin's work but also differed from many of his i...

    S Nassir Ghaemi

    Philosophy, Ethics, and Humanities in Medicine 2009 4:10

    Published on: 23 July 2009

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