Towards a new psychiatry: Philosophical and ethical issues in classification, diagnosis and care
Edited by:
Prof James Giordano
New submissions to the series will be considered until the 31st July 2013, details of the participating journals are available here.
Collection published: 13 January 2012
Last updated: 16 July 2013
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 the Diagnostic 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.
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Culture, salience, and psychiatric diagnosis: exploring the concept of cultural congruence & its practical application
Mohammed Abouelleil Rashed Philosophy, Ethics, and Humanities in Medicine 2013, 8:5 (16 July 2013)
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Rethinking psychiatry with OMICS science in the age of personalized P5 medicine: ready for psychiatome?
Nicola Bragazzi Philosophy, Ethics, and Humanities in Medicine 2013, 8:4 (12 July 2013)
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Patient advocacy and DSM-5
Dan J Stein, Katharine A Phillips BMC Medicine 2013, 11:133 (17 May 2013)
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Editor’s summary
Dan Stein and Katharine Phillips comment on the patient experience that has helped define the psychiatric classification of obsessive-compulsive spectrum disorders (OCD) in DSM-5, and describe the importance of taking patient opinion into account.
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Personalized medicine in psychiatry: problems and promises
Uzoezi Ozomaro, Claes Wahlestedt, Charles B Nemeroff BMC Medicine 2013, 11:132 (16 May 2013)
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Editor’s summary
Charles Nemeroff and colleagues review the genetics, epigenetics, biomarkers, treatment response and environmental factors of mood disorders and schizophrenia, and describe the impact of neuroimaging on personalized medicine in psychiatry.
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Depression as a risk factor for adverse outcomes in coronary heart disease
Kenneth E Freedland, Robert M Carney BMC Medicine 2013, 11:131 (15 May 2013)
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Kenneth Freedland and Robert Carney argue that depression predicts coronary heart disease (CHD) but better methods are required to ascertain whether depression is a causal risk factor for CHD, which could help determine treatment strategies for CVD prevention.
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Depression as a non-causal variable risk marker in coronary heart disease
Anna Meijer, Marij Zuidersma, Peter de Jonge BMC Medicine 2013, 11:130 (15 May 2013)
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Peter de Jonge and colleagues argue that, although there is a link between coronary heart disease (CHD) and depression, this association is confounded by heterogeneity, such that depression is a non-causal risk factor CHD.
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Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profile
Brenda WJH Penninx, Yuri Milaneschi, Femke Lamers, Nicole Vogelzangs BMC Medicine 2013, 11:129 (15 May 2013)
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Consequences of depression include somatic diseases, such as obesity and cardiovascular disease; Brenda Penninx and colleagues review the biological pathways and their dysregulation between depressive symptoms and somatic health, and describe the therapeutic implications.
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The DSM-5: Hyperbole, Hope or Hypothesis?
Michael Berk BMC Medicine 2013, 11:128 (14 May 2013)
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Editor’s summary
In an editorial to launch our article collection on Current Controversies in Psychiatry, Michael Berk discusses the debate on diagnostic categories in mental health based on the new edition of diagnostic criteria; the DSM-5.
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Informing DSM-5: biological boundaries between bipolar I disorder, schizoaffective disorder, and schizophrenia
Victoria E Cosgrove, Trisha Suppes BMC Medicine 2013, 11:127 (14 May 2013)
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Victoria Cosgrove and Trisha Suppes agree that boundaries between the diagnosis of bipolar disorder I, schizophrenia and schizoaffective disorder are preserved in the DSM-5 criteria, as there is not yet enough data to justify a continuous model of psychosis.
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Toward the future of psychiatric diagnosis: the seven pillars of RDoC
Bruce N Cuthbert, Thomas R Insel BMC Medicine 2013, 11:126 (14 May 2013)
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Editor’s summary
Bruce Cuthbert and Thomas Insel argue that future psychiatric nosologies will be informed by the Research Domain Criteria (RDoC) that is based on genetics, neuroscience and behavioural science, which will help achieve precision medicine for mental disorders.
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Clinical classification in mental health at the cross-roads: which direction next?
Ian B Hickie, Jan Scott, Daniel F Hermens, Elizabeth M Scott, Sharon L Naismith, Adam J Guastella, Nick Glozier, Patrick D McGorry BMC Medicine 2013, 11:125 (14 May 2013)
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There is much debate on DSM-5 diagnosis in mental health, and Ian Hickie and colleagues argue for the development of new approaches that identify pathways underlying the illnesses rather than using broad categories to describe psychiatric disorders.
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Diet, a new target to prevent depression?
Almudena Sanchez-Villegas, Miguel A Martínez-González BMC Medicine 2013, 11:3 (3 January 2013)
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Depression is linked to inflammation and high lipid profiles, so recent cohort studies have focused on the effects of diet; Sanchez-Villegas and Martinez-Gonzalez discuss how diet may prevent depression, and recommend that observational studies and clinical trials can confirm the association.
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The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion
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, G Scott Waterman, Owen Whooley, Peter Zachar Philosophy, Ethics, and Humanities in Medicine 2012, 7:14 (18 December 2012)
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Moving towards a population health approach to the primary prevention of common mental disorders
Felice N Jacka, Arnstein Mykletun, Michael Berk BMC Medicine 2012, 10:149 (27 November 2012)
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Editor’s summary
Felice Jacka et al. discuss new evidence from studies on diet quality and common mental disorders, and argue that depression and anxiety be ranked amongst prevalent medical conditions influenced by lifestyle, to help develop prevention strategies.
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The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities
Micol Ascoli, Andrea Palinski, John Owiti, Bertine De Jongh, Kamaldeep S Bhui Philosophy, Ethics, and Humanities in Medicine 2012, 7:12 (28 September 2012)
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The six most essential questions in psychiatric diagnosis: a pluralogue part 3: issues of utility and alternative approaches in psychiatric diagnosis
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, G Waterman, Owen Whooley, Peter Zachar Philosophy, Ethics, and Humanities in Medicine 2012, 7:9 (23 May 2012)
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The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis
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, G Waterman, Owen Whooley, Peter Zachar Philosophy, Ethics, and Humanities in Medicine 2012, 7:8 (18 April 2012)
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Does the oxytocin receptor polymorphism (rs2254298) confer 'vulnerability' for psychopathology or 'differential susceptibility'? insights from evolution
Martin Brüne BMC Medicine 2012, 10:38 (17 April 2012)
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Editor’s summary
Martin Brune discusses gene-environment interactions as applied to psychiatric conditions, and contrasts it with the diathesis-stress perspective on environmental effects, thus exploring these implications with regard to polymorphisms.
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Differential susceptibility to plasticity: a 'missing link' between gene-culture co-evolution and neuropsychiatric spectrum disorders?
Rachel Wurzman, James Giordano BMC Medicine 2012, 10:37 (17 April 2012)
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Rachel Wurzman and James Giordano comment on Brunes concept of how genetic plasticity can be influenced by the environment, and explain how this hypothesis may provide new avenues for psychiatric research.
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Recognition rights, mental health consumers and reconstructive cultural semantics
Jennifer H Radden Philosophy, Ethics, and Humanities in Medicine 2012, 7:6 (13 January 2012)
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Towards a genuinely medical model for psychiatric nosology
Randolph M Nesse, Dan J Stein BMC Medicine 2012, 10:5 (13 January 2012)
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Editor’s summary
With the imminent release of the DSM-5, Nesse and Stein discuss the ways that classifications of disease in psychiatry still fall short of the ideal, and argue for a more medical approach to this subject.
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Psychopharmacological enhancement: a conceptual framework
Dan J Stein Philosophy, Ethics, and Humanities in Medicine 2012, 7:5 (13 January 2012)
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The removal of pluto from the class of planets and homosexuality from the class of psychiatric disorders: a comparison
Peter Zachar, Kenneth S Kendler Philosophy, Ethics, and Humanities in Medicine 2012, 7:4 (13 January 2012)
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The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis
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, G Scott Waterman, Owen Whooley, Peter Zachar Philosophy, Ethics, and Humanities in Medicine 2012, 7:3 (13 January 2012)
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A brief historicity of the Diagnostic and Statistical Manual of Mental Disorders: Issues and implications for the future of psychiatric canon and practice
Shadia Kawa, James Giordano Philosophy, Ethics, and Humanities in Medicine 2012, 7:2 (13 January 2012)
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Working towards a new psychiatry - neuroscience, technology and the DSM-5
Sabina Alam, Jigisha Patel, James Giordano Philosophy, Ethics, and Humanities in Medicine 2012, 7:1 (13 January 2012)
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Editor’s summary
In response to the forthcoming release of the DSM-5, James Giordano and colleagues discuss the movement towards a new psychiatry resulting from influences of economic and socio-cultural forces and advances in diagnostic techniques and neurotechnology.
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Novel pharmacotherapeutic treatments for cocaine addiction
Daryl Shorter, Thomas R Kosten BMC Medicine 2011, 9:119 (3 November 2011)
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Shorter and Kosten review recent clinical trials and pre-clinical studies in cocaine addiction treatment, highlighting the potential for future therapeutic developments.
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Advances in understanding and treating ADHD
Kevin M Antshel, Teresa M Hargrave, Mihai Simonescu, Prashant Kaul, Kaitlin Hendricks, Stephen V Faraone BMC Medicine 2011, 9:72 (10 June 2011)
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Antshel and colleagues review the advances over the past decade in the understanding and treatment of Attention Deficit Hyperactivity Disorder (ADHD), which comprise both tailored stimulant formulations and cognitive behavioral interventions.
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Should We Treat Depression with drugs or psychological interventions? A Reply to Ioannidis
John M Davis, William J Giakas, Jie Qu, Pavan Prasad, Stefan Leucht Philosophy, Ethics, and Humanities in Medicine 2011, 6:8 (10 May 2011)
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Would the field of cognitive neuroscience be advanced by sharing functional MRI data?
Kristina M Visscher, Daniel H Weissman BMC Medicine 2011, 9:34 (8 April 2011)
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Visscher and Weissman argue that greater sharing and synthesis of raw functional MRI data will advance cognitive neuroscience by allowing researchers to compare and validate findings, improving our understanding of brain-behaviour relationships at a far greater rate.
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Defining mental disorder. Exploring the 'natural function' approach
Somogy Varga Philosophy, Ethics, and Humanities in Medicine 2011, 6:1 (21 January 2011)
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What should be done with antisocial personality disorder in the new edition of the diagnostic and statistical manual of mental disorders (DSM-V)?
Morten Hesse BMC Medicine 2010, 8:66 (27 October 2010)
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Editor’s summary
In this commentary for BMC Medicine, Morten Hesse discusses how proposed changes in the criteria for diagnosis of antisocial personality disorder in the forthcoming DSM-V may improve initial diagnostics and also treatment of patients with this psychopathic disorder.
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A diagnosis of conflict: theoretical barriers to integration in mental health services & their philosophical undercurrents
Nathan M Gerard Philosophy, Ethics, and Humanities in Medicine 2010, 5:4 (4 February 2010)
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On the ontological assumptions of the medical model of psychiatry: philosophical considerations and pragmatic tasks
Tejas Patil, James Giordano Philosophy, Ethics, and Humanities in Medicine 2010, 5:3 (28 January 2010)
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Nosologomania: DSM & Karl Jaspers' Critique of Kraepelin
S Nassir Ghaemi Philosophy, Ethics, and Humanities in Medicine 2009, 4:10 (23 July 2009)
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Ethical psychiatry in an uncertain world: conversations and parallel truths
Alexander M Carson, Peter Lepping Philosophy, Ethics, and Humanities in Medicine 2009, 4:7 (25 June 2009)
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Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?
John PA Ioannidis Philosophy, Ethics, and Humanities in Medicine 2008, 3:14 (27 May 2008)
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