The Inescapable Specificities of Psychiatry Across Research, Clinical Practice, and Medical Education

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Diogo Telles Correia
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Abstract

There is increasing evidence that psychiatric disorders have a complex causality, with components belonging to different paradigms and levels of abstraction. They are thus constructs determined by a complex and not yet fully understood interaction between biological and psychosocial factors. As a result, the classification of mental disorders is based on the presentation of symptom clusters and their progression over time and the classification of psychopathological symptoms follows a logical framework based on their mode of presentation and not on causal factors. On the other hand, psychiatric concepts are hybrid, depending not only on biology but also on psychosocial components. The study of their definition, their current meaning, the various sub-concepts they encompass, the connection between different concepts, and the evolution of concepts over time is carried out through conceptual analysis. Poorly understood and defined concepts regarding their structure and components lead to false empirical questions and poorly chosen scientific methodologies, yielding results of questionable validity. In this article, these issues are explored in detail, and a comparison is established between common medical disorders and psychiatric disorders. It is also argued that they should be considered in all research conducted in psychiatry, as well as in clinical practice and medical education in psychiatry.

精神病学在研究、临床实践和医学教育中不可避免的特殊性
越来越多的证据表明,精神疾病具有复杂的因果关系,其组成部分属于不同的范式和抽象水平。因此,它们是由复杂的、尚未完全理解的生物和社会心理因素之间的相互作用决定的。因此,精神障碍的分类是基于症状群的表现及其随时间的进展,精神病理症状的分类遵循基于其表现模式而不是因果因素的逻辑框架。另一方面,精神病学的概念是混合的,不仅取决于生物学,也取决于社会心理成分。通过概念分析来研究它们的定义、它们当前的含义、它们所包含的各种子概念、不同概念之间的联系以及概念随时间的演变。对其结构和组成部分的理解和定义不佳导致错误的经验问题和选择不当的科学方法,产生可疑的有效性结果。本文对这些问题进行了详细的探讨,并将常见的医学障碍与精神障碍进行了比较。也有人认为,在精神病学的所有研究中,以及在精神病学的临床实践和医学教育中,都应考虑到这些因素。
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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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