The contribution of human sciences to the challenges of contemporary psychiatry

Messas, Guilherme; Fulford, K. W. M.; Stanghellini, Giovanni

doi:10.1590/2237-6089-2017-0111

Cited by 6 publications

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“…Natural sciences method is an interesting approach both for clinical semiology and for a disorder construct elaboration but fails to evaluate the whole complexity of illness experience, with consequences for diagnostic validity and reliability. Parnas and others defend a return to continental phenomenology as a path to improve diagnostic validity and reliability (Aboraya, et al 2005;Messas, Fulford, & Stanghellini, 2017;Parnas et al, 2013). Stanghellini also advocates the use of structural psychopathology as a better method to describe mental disorders and to summarize patients' complaints, reinforcing the contextualized comprehensive view, in Dilthey's epistemology (Stanghellini, 2010).…”

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confidence: 99%

“…A abordagem das ciências naturais é interessante tanto para a semiologia clínica quanto para a elaboração do constructo do transtorno, mas falha em acessar toda a complexidade da experiência de adoecimento, com prejuízo para a validade destes constructos. Parnas e outros autores defendem um retorno à fenomenologia continental como um caminho para melhorar a validade e a confiabilidade diagnóstica (Aboraya, et al 2005;Messas, Fulford, & Stanghellini, 2017;Parnas et al, 2013). Stanghellini também defende o uso da psicopatologia estrutural como melhor método para descrever os transtornos mentais e as queixas dos pacientes (Stanghellini, 2010), reforçando a visão compreensiva contextualizada, na epistemologia de Dilthey, mencionada acima.…”

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Phenomenological description of PTSD through a case

Neto¹,

Tomé

Messas

2021

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Post-traumatic stress disorder (PTSD) is a severe mental disorder described only by operational criteria, without a proper dialectic essential analysis. In this study, we present a typical PTSD case with psychotic features, describing his living world through the domains of Heideggerian ontological-existential constituents –spatiality, temporality, corporeity and interpersonality (being-with-others). A phenomenological reduction and diagnostic elaboration was then performed. An essence of pervasive fear, that locks all intentionality and taints the entire being-in-the-world is described as the main characteristic of PTSD. The differential diagnosis is then discussed through a temporal perspective, showing essential differences among Bipolar Disorder, Schizophrenia and Persistent Delusional Disorder. We stand for a return to phenomenology, and its use to diagnosis and disorder description as a way to improve diagnostic validity and reliability.

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Section: Introductionmentioning

confidence: 99%

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Phenomenological description of PTSD through a case

Neto¹,

Tomé

Messas

2021

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“…Decision-making relies on the individual complexities of subjective experience. This uniqueness of human experience, specific to each individual, makes the development of instruments for capturing the singular features of individual patients a new frontier in psychiatry and clinical psychology (Messas et al, 2017). Psicopatologia Fenomenológica Contemporânea -EAWE, 2018; 7(2):1-9…”

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confidence: 99%

Preface to the EAWE Portuguese version: A case for a new era of phenomenological psychopathology in psychiatry and clinical psychology

Pienkos¹,

Messas²

2018

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This special issue presents a Portuguese translation of the EAWE: Examination of Anomalous World Experience (Sass et al., this issue; original publication Sass et al., 2017). The EAWE is a semi-structured, phenomenologically-oriented interview designed to elicit descriptions of changes in the lived world, particularly those that may be more commonly found in schizophrenia spectrum disorders (though it may also be used to study disorders outside the schizophrenia spectrum). The EAWE represents an important trend in psychiatric research and practice: a growing appreciation for the role of subjectivity in understanding, explaining (Sass, 2010), classifying and treating psychiatric disorders, especially complex and heterogeneous disorders such as schizophrenia. The EAWE’s translation into Portuguese reflects several equally important developments. The ability to collect detailed information about the experience of schizophrenia and other psychiatric conditions among Portuguese-speaking participants will make it possible to study the phenomenological characteristics of schizophrenia outside of Anglophone cultures, providing important data about the intersections of individual, interpersonal, and cultural experiences in the development of the disorder. In addition, it occurs at a time of renewed energy and collaboration in phenomenological psychopathology, particularly in Brazil.

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“…In this paper, we explore the advantages of a more nuanced and dialogical measure of symptoms in mental disorders (Markov aacute & Berrios, 2009;Marková & Berrios, 2012;Parnas, Sass, & Zahavi, 2013), a system that goes beyond a rigid portrait of mental phenomena. Subjective experience is treated here as a relevant and foundational element not only because psychiatry is relational in a larger sense (Messas, Fulford, & Stanghellini, 2017) but because disturbances of subjectivity themselves carry diagnostic value Stanghellini & Broome, 2014). Such an idea is not new, and has been put forward by Jaspers (Jaspers, 1963) and by many other significant contributors who suggest that the core of several mental disorders can only be understood (studied and treated) from an ecological perspective (Fuchs, 2017).…”

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The loss of nosological validity: why and how should we consider disturbances of subjective world experience?

Madeira¹,

Filipe²,

Cavaco³

et al. 2018

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Contemporary psychiatric nosology has evolved with a primary goal of reducing the presence and influence of subjectivity by valuing objective symptoms and explanations (e.g. neurobiological models of psychopathology). However, improvements in the reliability and validity of these endeavours have fallen short of expectations, and it has been argued that one reason for these failures is the very omission or neglect of subjectivity in understanding and explaining mental illness. This paper supports the need for a paradigm shift, from researching the “what” of mental symptoms to a focus on “how” patients experience themselves and the world when undergoing a mental disorder. We review past contributions to disturbances of subjectivity, particularly in schizophrenia, which have contributed to the creation of a new bio-pheno-social model. We also discuss available tools for the systematic assessment of subjective anomalies. We pay special attention to the Examination of Anomalous World Experience (EAWE), which considers disturbances in world engagement, including the experience of atmosphere, space and objects, lived time and temporality, interpersonal relations, language, and existential concerns. Ultimately, we stress that the exploration of subjective experiences is essential, promising, and achievable in research on mental disorders.

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The contribution of human sciences to the challenges of contemporary psychiatry

Cited by 6 publications

References 6 publications

Phenomenological description of PTSD through a case

Phenomenological description of PTSD through a case

Preface to the EAWE Portuguese version: A case for a new era of phenomenological psychopathology in psychiatry and clinical psychology

The loss of nosological validity: why and how should we consider disturbances of subjective world experience?

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