2016
DOI: 10.1016/j.shpsc.2016.09.003
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Diagnosis and causal explanation in psychiatry

Abstract: In clinical medicine, a diagnosis can offer an explanation of a patient's symptoms by specifying the pathology that is causing them. Diagnoses in psychiatry are also sometimes presented in clinical texts as if they pick out pathological processes that cause sets of symptoms. However, current evidence suggests the possibility that many diagnostic categories in psychiatry are highly causally heterogeneous. For example, major depressive disorder may not be associated with a single type of underlying pathological … Show more

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Cited by 28 publications
(17 citation statements)
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“…Single traumatic experiences and repeated trauma can be quite distinct with regard to the neurobiological sequelae, healing and recovery [189]; the importance of understanding and differentiating repetitive trauma from other types of trauma is also reflected in the recent inclusion of 'Complex Post-Traumatic Stress Disorder' as a separate diagnostic entity in the ICD-11 [190,191]. Nevertheless, it is also important to appreciate the possibility that such disorders may not be possible to define aetiologically at a single level, but rather require considering the causal processes that interact across levels [192]. Threatening (sexual, physical abuse) versus depriving (neglect) experiences may impact on differential brain mechanisms [193].…”
Section: Discussionmentioning
confidence: 99%
“…Single traumatic experiences and repeated trauma can be quite distinct with regard to the neurobiological sequelae, healing and recovery [189]; the importance of understanding and differentiating repetitive trauma from other types of trauma is also reflected in the recent inclusion of 'Complex Post-Traumatic Stress Disorder' as a separate diagnostic entity in the ICD-11 [190,191]. Nevertheless, it is also important to appreciate the possibility that such disorders may not be possible to define aetiologically at a single level, but rather require considering the causal processes that interact across levels [192]. Threatening (sexual, physical abuse) versus depriving (neglect) experiences may impact on differential brain mechanisms [193].…”
Section: Discussionmentioning
confidence: 99%
“…In general indeed, the process of classification is often considered fundamental (and thus positive) to any science. In medical practice, a particular diagnosis is viewed as leading to a particular cause and cure [ 47 , 48 ]. It is usually beneficial to treat the root cause of a disease—for example, removing an infectious agent.…”
Section: Discussionmentioning
confidence: 99%
“…Much of the success of modern medicine is based on the disease model [ 49 ], where a specific diagnosis identifies a specific cause. In psychiatry however, current evidence underscores that a diagnostic category can have very heterogeneous causes [ 48 ]. Nevertheless, psychiatric diagnoses are also considered useful in clinical practice, for example when choosing a cure or giving a perspective on prognosis [ 50 ].…”
Section: Discussionmentioning
confidence: 99%
“…Tällä hetkellä käytössä olevat psykiatriset diagnoosit eivät kuitenkaan auta kunnolla ymmärtämään mistä havaitut tai koetut ongelmat johtuvat, sillä kyse on pitkälti oirekuvauksista (6). Havaitut oireet taas ovat oletettavasti seurausta yksilöllisistä ruumiillisis ta, psyykkisistä ja sosiaalisista prosesseista, joi den haitallisuus on määrittynyt tilanteen ja siitä tehtyjen tulkintojen mukaan (7). Psykiatristen diagnoosien voidaan katsoa näin kuvaavan enemmän seurausta kuin syytä, vaikka ihmiset toisinaan pyrkivätkin näiden avulla omaa ja muiden toimintaa selittämään.…”
Section: Näkökulma Laajenee Mielenterveysstigma Väheneeunclassified
“…Toistaiseksi ei ole olemassa luotettavia keino ja erotella normaaleja ja patologisia psyykkisiä tai sosiaalisia ilmiötä toisistaan (10), ja psykiat riset diagnoosit on eri yhteyksissä todettu tieteel lisesti epätyydyttäviksi (6,7,8,10). Pyrkimys vä hentää stigmaa rinnastamalla moniulotteiset psyykkiset ja sosiaaliset ilmiöt lääketieteellisten sairauksien kanssa saattaa entisestään heikentää psykiatristen diagnoosien erottelu ja ennusteky kyä, mikäli esimerkiksi elämäntilanteeseen näh den normaaleja reaktioita aletaan mieltämään lääketieteellistä hoitoa vaativien sairauksien oi reiksi (10,11).…”
Section: Näkökulma Laajenee Mielenterveysstigma Väheneeunclassified