The myth of mental illness.

Szasz, Thomas S.

doi:10.1037/h0046535

Cited by 832 publications

(317 citation statements)

References 2 publications

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“…He argued that "concentration on the biomedical and exclusion of the psychosocial distorts perspectives and even interferes with patient care" (p. 131) [179]. He had equally pointed criticisms for those in psychiatry who sought to deny or minimize the biological components of mental health; for example, omas Szasz, who, in his famous 1960 paper, suggested that mental illness is a "myth" [180]. Engel advocated for the rejection of the mind-body dualism at the heart of both of the above polarized viewpoints.…”

Section: Resultsmentioning

confidence: 99%

A unifying framework for depression: Bridging the major biological and psychosocial theories through stress

Roy¹,

Campbell²

2013

CIM

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A unifying framework for depression: Bridging the major biological and psychosocial theories through stress AbstractSeveral mechanisms for the development of depression have been proposed, and a comparative examination reveals considerable overlap. is paper begins by summarizing the conclusions drawn in the literature on the major biological theories: HPA-axis hyperactivity, the monoamine theory, the cytokine hypothesis/ macrophage theory, and structural changes to relevant brain regions and neurons. It then discusses the role of psychosocial stress as a bridge between the pathophysiology of depression and its predominantly psychosocial risk factors, touching upon theories o ered in psychology and in population health. is paper further proposes a unifying framework which integrates the major theories. e multiple systems involved, and the directional complexity among them, likely help to explain the wide-ranging symptoms associated with depression, and the wide variety of comorbid medical conditions. ey may also contribute to challenges in treatment, the diversity in symptoms and treatment outcomes among individuals, and the high rates of symptom persistence and relapse. e apparent bi-directionality of associations may suggest the existence of positive-feedback loops which aggravate symptoms; however, further bench research is required to con rm such phenomena. A better understanding of these interweaving associations is warranted. Additionally, given the signi cant in uence of socioeconomic and psychosocial factors on the aetiology of depression, population-level interventions that address the social determinants of health are required. Current individual-level pharmacologic approaches are designed to treat pathophysiology once it is underway, and current individual-level non-pharmacologic interventions (such as talk therapy) are designed to moderate the relationship between psychosocial stress and pathophysiology. In contrast, a key strategy for primary prevention lies in population-level interventions that address the predominantly social causes of one of depression's most notable risk factors: chronic psychosocial stress.

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Section: Resultsmentioning

confidence: 99%

A unifying framework for depression: Bridging the major biological and psychosocial theories through stress

Roy¹,

Campbell²

2013

CIM

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“…Szasz sprang to prominence in the 1960s, shortly after being made full professor of psychiatry at Syracuse University, with a book provocatively titled 'The Myth of Mental Illness' (Szasz 1960). Szasz argued that the value-laden nature of psychiatric diagnostic concepts compared with their physical medicine counterparts pointed to a difference in kind between mental disorders and bodily diseases.…”

Section: Three Interpretations Of the Value Judgements In Psychiatricmentioning

confidence: 99%

“…Diseases, he suggested, are defined by scientific norms, derived from anatomy and physiology. Mental disorders on the other hand are defined by value norms, norms which are ''psychosocial, ethical and legal'' in character (Szasz 1960). Mental disorders, then, are not part of the scientific world of medical diseases at all.…”

Section: Three Interpretations Of the Value Judgements In Psychiatricmentioning

confidence: 99%

Neuro-ethics or neuro-values? Delusion and religious experience as a case study in values-based medicine

Fulford

2004

Poiesis Prax

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Values-Based Medicine (VBM) is the theory and practice of clinical decision-making for situations in which legitimately different values are in play. VBM is thus to values what Evidence-Based Medicine (EBM) is to facts. The theoretical basis of VBM is a branch of analytic philosophy called philosophical value theory. As a set of practical tools, VBM has been developed to meet the challenges of value diversity as they arise particularly in psychiatry. These challenges are illustrated in this paper by a case study of the differential diagnosis between delusion and religious experience. In a traditional model of scientific medicine, such challenges would be expected to become less pressing with advances in medical science. Philosophical value theory suggests, to the contrary, that scientific progress, through opening up an ever-wider range of choices, will increasingly bring the full range and diversity of human values into play not just in psychiatry but in all areas of medicine. The future, then, for medicine, is an integrated model in which VBM and EBM are equal partners in a genuinely human discipline.Zusammenfassung Values-Based Medicine (VBM), eine Medizin, die auf Werte gegru¨ndet ist, ist die Theorie und Praxis klinischer Entscheidungsfindung in Situationen, wo Werte ins Spiel kommen, die aus guten Gru¨nden voneinander abweichen. VBM ist also im Verha¨ltnis zu Werten, was Evidence-Based Medicine (EBM) im Verha¨ltnis zu Fakten ist. VBM hat ihre theoretische Basis in einem KWM (Bill) FulfordZweig der analytischen Philosophie, der so genannten philosophischen Wertetheorie. VBM wurde als ein praktisches Instrumentarium entwickelt, den Herausforderungen gerecht zu werden, vor die uns besagte Wertevielfalt stellt, besonders in der Psychiatrie. Diese Herausforderungen illustrieren wir in diesem Beitrag anhand einer Fallstudie u¨ber die differentielle Diagnose von Wahnvorstellungen und religio¨ser Erfahrung. In einem traditionellen Modell wissenschaftlicher Medizin wu¨rde man erwarten, solche Herausforderungen wu¨rden durch Fortschritte in den medizinischen Wissenschaften allma¨hlich abgebaut werden. Dagegen deutet die philosophische Wertetheorie darauf hin, dass wissenschaftlicher Fortschritt das Spektrum der Mo¨glichkeiten zwar immer mehr erweitert, dabei jedoch zunehmend die ganze Breite und Vielfalt menschlicher Werte ins Spiel bringen wird, nicht nur in der Psychiatrie, sondern in allen Bereichen der Medizin. Die Zukunft der Medizin liegt also in einem integrierten Modell, in dem VBM und EBM gleichwertige Partner in einer wirklichen Humanwissenschaft sind.Re´sume´La me´decine base´e sur les valeurs (VBM, values based medicine) est une the´orie et une pratique de prise de de´cision me´dicale dans des situations faisant intervenir de fac¸on le´gitime diffe´rentes valeurs. La VBM est aux valeurs ce que la me´decine base´e sur les faits (EBM, Evidence based medicine) est aux faits concrets. La base the´orique de la VBM est une branche de la philosophie analytique appele´e The´orie des valeurs philosophiques. La VBM...

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“…He claims that a disease can be regarded as ‘genuine', provided that it can be matched with an abnormal laboratory result, a brain lesion and/or a pathological scan and that cellular pathology embodies a disease [18,19]. What justifies the diagnosis of AD according to its new conceptualization?…”

Section: Equating Ad With Amyloid Accumulation and Neural Injurymentioning

confidence: 99%

The New Conceptualization of Alzheimer's Disease under the Microscope of Influential Definitions of Disease

Alexopoulos

Kurz

2015

Psychopathology

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Background: According to its new conceptualization, Alzheimer's disease (AD) has preclinical and symptomatic phases, and biomarker abnormality justifies the diagnosis of the disease. Methods: The conceptual validity of AD is assessed on the basis of the disease definitions of T. Szasz, R.E. Kendell and J.G. Scadding, C. Boorse, K.W.M. Fulford and J.C. Wakefield, as well as of the DSM-5 classification system. Results: The new AD conceptualization could fit the Szaszian disease definition, provided that AD biomarkers reflected the pathological hallmarks of a singular disease, but it seems that they do not. Moreover, preclinical AD does not yield a biological disadvantage, being a central criterion for justifying the presence of a disease according to the disease definition of Scadding and Kendell. In addition, it remains unclear whether abnormality of biomarkers in elderly people embodies a statistical deviation from normal ageing and a pathological characteristic. Furthermore, not all stages of AD are related to experiences of failure of intentional doing, which is the criterion of the disease definition of Fulford, whilst the Wakefieldian harmful dysfunction and the DSM-5 mental disorder criteria are fulfilled only in the symptomatic phases of the disease course. Discussion: Our analytical endeavours unveiled weak sides and the fuzzy boundaries of the new conceptualization of AD. Future refinements of the criteria should address them so that the validity of the AD concept is increased.

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The myth of mental illness.

Cited by 832 publications

References 2 publications

A unifying framework for depression: Bridging the major biological and psychosocial theories through stress

A unifying framework for depression: Bridging the major biological and psychosocial theories through stress

Neuro-ethics or neuro-values? Delusion and religious experience as a case study in values-based medicine

The New Conceptualization of Alzheimer's Disease under the Microscope of Influential Definitions of Disease

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