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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: 18 December 2012

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.

		Review 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) Abstract \| Full text \| PDF \| PubMed
		Review 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) Abstract \| Full text \| PDF \| PubMed
		Review 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Opinion 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) Abstract \| Full text \| PDF \| PubMed \| 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.
		Commentary 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) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary 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.
		Research Recognition rights, mental health consumers and reconstructive cultural semantics Jennifer H Radden Philosophy, Ethics, and Humanities in Medicine 2012, 7:6 (13 January 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Opinion Towards a genuinely medical model for psychiatric nosology Randolph M Nesse, Dan J Stein BMC Medicine 2012, 10:5 (13 January 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 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.
		Research Psychopharmacological enhancement: a conceptual framework Dan J Stein Philosophy, Ethics, and Humanities in Medicine 2012, 7:5 (13 January 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Research 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Review 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Editorial 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Editorial 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 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.
		Review Novel pharmacotherapeutic treatments for cocaine addiction Daryl Shorter, Thomas R Kosten BMC Medicine 2011, 9:119 (3 November 2011) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Shorter and Kosten review recent clinical trials and pre-clinical studies in cocaine addiction treatment, highlighting the potential for future therapeutic developments.
		Minireview 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary 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.
		Commentary 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Debate 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary 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.
		Research Defining mental disorder. Exploring the 'natural function' approach Somogy Varga Philosophy, Ethics, and Humanities in Medicine 2011, 6:1 (21 January 2011) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Commentary 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 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.
		Commentary 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Editorial 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Review Nosologomania: DSM & Karl Jaspers' Critique of Kraepelin S Nassir Ghaemi Philosophy, Ethics, and Humanities in Medicine 2009, 4:10 (23 July 2009) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Review 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Review 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 2 comments

		Review 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) Abstract \| Full text \| PDF \| PubMed
		Review 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) Abstract \| Full text \| PDF \| PubMed
		Review 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Opinion 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) Abstract \| Full text \| PDF \| PubMed \| 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.
		Commentary 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) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary 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.
		Research Recognition rights, mental health consumers and reconstructive cultural semantics Jennifer H Radden Philosophy, Ethics, and Humanities in Medicine 2012, 7:6 (13 January 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Opinion Towards a genuinely medical model for psychiatric nosology Randolph M Nesse, Dan J Stein BMC Medicine 2012, 10:5 (13 January 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 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.
		Research Psychopharmacological enhancement: a conceptual framework Dan J Stein Philosophy, Ethics, and Humanities in Medicine 2012, 7:5 (13 January 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Research 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Review 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Editorial 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Editorial 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 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.
		Review Novel pharmacotherapeutic treatments for cocaine addiction Daryl Shorter, Thomas R Kosten BMC Medicine 2011, 9:119 (3 November 2011) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Shorter and Kosten review recent clinical trials and pre-clinical studies in cocaine addiction treatment, highlighting the potential for future therapeutic developments.
		Minireview 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary 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.
		Commentary 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Debate 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary 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.
		Research Defining mental disorder. Exploring the 'natural function' approach Somogy Varga Philosophy, Ethics, and Humanities in Medicine 2011, 6:1 (21 January 2011) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Commentary 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 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.
		Commentary 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Editorial 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Review Nosologomania: DSM & Karl Jaspers' Critique of Kraepelin S Nassir Ghaemi Philosophy, Ethics, and Humanities in Medicine 2009, 4:10 (23 July 2009) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Review 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central
		Review 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) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| 2 comments