Medicalization in psychiatry: the medical model, descriptive diagnosis, and lost knowledge

Abstract

Medicalization was the theme of the 29th European Conference on Philosophy of Medicine and Health Care that included a panel session on the DSM and mental health. Philosophical critiques of the medical model in psychiatry suffer from endemic assumptions that fail to acknowledge the real world challenges of psychiatric nosology. The descriptive model of classification of the DSM 3-5 serves a valid purpose in the absence of known etiologies for the majority of psychiatric conditions. However, a consequence of the "atheoretical" approach of the DSM is rampant epistemological confusion, a shortcoming that can be ameliorated by importing perspectives from the work of Jaspers and McHugh. Finally, contemporary psychiatry's over-reliance on neuroscience and pharmacotherapy has led to a reductionist agenda that is antagonistic to the inherently pluralistic nature of psychiatry. As a result, the field has suffered a loss of knowledge that may be difficult to recover.

Keywords: Biological psychiatry; DSM-5; DSM-III; DSM-IV; Descriptive diagnosis; Medical model of psychiatry; Medicalization; Neuroscience in psychiatry; Philosophical reflections on psychiatry; Psychiatric classification; Psychiatric epistemology; Psychiatric nosology; Psychiatric residency education; Psychopharmacology.