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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. Content type: Research

    Cultural congruence is the idea that to the extent a belief or experience is culturally shared it is not to feature in a diagnostic judgement, irrespective of its resemblance to psychiatric pathology. This res...

    Authors: Mohammed Abouelleil Rashed

    Citation: Philosophy, Ethics, and Humanities in Medicine 2013 8:5

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  2. Content type: Commentary

    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...

    Authors: Dan J Stein and Katharine A Phillips

    Citation: BMC Medicine 2013 11:133

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  3. Content type: Review

    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...

    Authors: Uzoezi Ozomaro, Claes Wahlestedt and Charles B Nemeroff

    Citation: BMC Medicine 2013 11:132

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  4. Content type: Review

    Depression is the most common psychiatric disorder worldwide. The burden of disease for depression goes beyond functioning and quality of life and extends to somatic health. Depression has been shown to subseq...

    Authors: Brenda WJH Penninx, Yuri Milaneschi, Femke Lamers and Nicole Vogelzangs

    Citation: BMC Medicine 2013 11:129

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  5. Content type: Debate

    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...

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

    Citation: BMC Medicine 2013 11:125

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  6. Content type: Editorial

    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...

    Authors: Michael Berk

    Citation: BMC Medicine 2013 11:128

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  7. Content type: Opinion

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

    Authors: Almudena Sanchez-Villegas and Miguel A Martínez-González

    Citation: BMC Medicine 2013 11:3

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  8. Content type: Review

    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...

    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…

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

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  9. Content type: Research

    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...

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

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

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  10. Content type: Review

    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...

    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…

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

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  11. Content type: Review

    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...

    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…

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

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  12. Content type: Commentary

    Brüne's proposal that erstwhile 'vulnerability' genes need to be reconsidered as 'plasticity' genes, given the potential for certain environments to yield increased positive function in the same domain as pote...

    Authors: Rachel Wurzman and James Giordano

    Citation: BMC Medicine 2012 10:37

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  13. Content type: Editorial

    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...

    Authors: Shadia Kawa and James Giordano

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

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  14. Content type: Opinion

    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...

    Authors: Randolph M Nesse and Dan J Stein

    Citation: BMC Medicine 2012 10:5

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  15. Content type: Research

    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...

    Authors: Dan J Stein

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

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  16. Content type: Review

    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...

    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…

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

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  17. Content type: Research

    We compare astronomers' removal of Pluto from the listing of planets and psychiatrists' removal of homosexuality from the listing of mental disorders. Although the political maneuverings that emerged in both c...

    Authors: Peter Zachar and Kenneth S Kendler

    Citation: Philosophy, Ethics, and Humanities in Medicine 2012 7:4

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  18. Content type: Review

    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...

    Authors: Daryl Shorter and Thomas R Kosten

    Citation: BMC Medicine 2011 9:119

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  19. Content type: Minireview

    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...

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

    Citation: BMC Medicine 2011 9:72

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  20. Content type: Commentary

    We reply to the Ioannidis's paper "Effectiveness of antidepressants; an evidence based myth constructed from a thousand controlled trials." We disagree that antidepressants have no greater efficacy than placeb...

    Authors: John M Davis, William J Giakas, Jie Qu, Pavan Prasad and Stefan Leucht

    Citation: Philosophy, Ethics, and Humanities in Medicine 2011 6:8

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  21. Content type: Commentary

    This paper examines the philosophical substructure to the theoretical conflicts that permeate contemporary mental health care in the UK. Theoretical conflicts are treated here as those that arise among practit...

    Authors: Nathan M Gerard

    Citation: Philosophy, Ethics, and Humanities in Medicine 2010 5:4

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  22. Content type: Editorial

    A common theme in the contemporary medical model of psychiatry is that pathophysiological processes are centrally involved in the explanation, evaluation, and treatment of mental illnesses. Implied in this per...

    Authors: Tejas Patil and James Giordano

    Citation: Philosophy, Ethics, and Humanities in Medicine 2010 5:3

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  23. Content type: Review

    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...

    Authors: S Nassir Ghaemi

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

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