The mind‐brain gap and the neuroscience‐psychiatry gap

Abstract

A problem underlying the mind brain gap is the complex integration among the disciplines involved in it: neurosciences, clinical psychiatry and psychology, and philosophy of science. Research in neurosciences and clinical psychiatry requires a positioning in relation to some conceptual/philosophical aspects. These are related to the models of interrelationship of the brain and the mind, to explanatory approaches in psychiatry, and to conceptual issues such as dimensionality versus categories, symptoms versus disorders, and neurobiological correlates versus clinical determination of mental disorder. In this article, we try to address some of these issues that, if taken into account, could reduce the gap between psychiatrists and neuroscientists and turn the research in this area more profitable.

Mental Disorder—The Need for an Accurate Definition

“…Psychiatric disorders are “social constructs” that do not exist independently of human effort ( 6 , 24 , 25 ). The evaluation of what is pathological or not in psychiatry is related to 1) comprehensibility (whether or not the mental state/behavior is comprehensible given the sociocultural context of the patient), 2) adaptability (adaptive or non-adaptive in the context of the patient), and 3) connection to distress and disability (whether or not they cause distress or disability) ( 26 ). The latter being the most universal criteria ( 7 , 24 ).…”

Values in mental and medical disorder concepts: Their presence is not the point, being aware of them is

“…In contrast, in medicine, causality is usually easier to find, with several paths at the same level of abstraction (biological) that intervene to explain a dysfunction. 42 The less we know about the processes, the lower the degree of agreement in relation to the values associated to the notion of dysfunction of these processes. Therefore, "identifying what has gone wrong (the dysfunction) in mental disorders is often much more difficult than it is in the rest of medicine, given the lack of knowledge about underlying psychological and biological mechanisms."…”

“…In psychiatry there is an explanatory pluralism, meaning mental diseases are influenced by different causal mechanisms (largely unknown) that act at different levels of abstraction. In contrast, in medicine, causality is usually easier to find, with several paths at the same level of abstraction (biological) that intervene to explain a dysfunction 42 …”

Psicofármacos, drogas y neuro-gubernamentalidad. Legalidad y “la clínica”. ¿Quién gobierna la prescripción?

“…Como alternativa, el pluralismo explicativo sostiene que las enfermedades psiquiátricas están influenciadas por diferentes mecanismos causales que actúan en diferentes niveles de abstracción: una actitud más realista y fructífera. Un análisis conceptual ha llamado la atención sobre la importancia de la dimensionalidad en lugar de las categorías y la evaluación simbólica en lugar de los trastornos, para obtener una imagen más válida de lo que está sucediendo con las personas que padecen trastornos mentales (Telles-Correia, 2018).…”