The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis

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• 作者：James Phillips (1)
  Allen Frances (2)
  Michael A Cerullo (3)
  John Chardavoyne (1)
  Hannah S Decker (4)
  Michael B First (5)
  Nassir Ghaemi (6)
  Gary Greenberg (7)
  Andrew C Hinderliter (8)
  Warren A Kinghorn (2) (9)
  Steven G LoBello (10)
  Elliott B Martin (1)
  Aaron L Mishara (11)
  Joel Paris (12)
  Joseph M Pierre (13) (14)
  Ronald W Pies (15) (6)
  Harold A Pincus (16) (17) (18) (5)
  Douglas Porter (19)
  Claire Pouncey (20)
  Michael A Schwartz (21)
  Thomas Szasz (15)
  Jerome C Wakefield (22) (23)
  G Scott Waterman (24)
  Owen Whooley (25)
  Peter Zachar (10)
  
• 刊名：Philosophy, Ethics, and Humanities in Medicine
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：7
• 期：1
• 全文大小：286KB
• 参考文献：1. Phillips J, Frances A, / et al.: The six most essential questions in psychiatric diagnosis: a pluralogue. part 1: conceptual and definitional issues in psychiatric diagnosis. / Philosophy, Ethics, and Humanities in Medicine 2012, 7:6. 13 January 2012 CrossRef
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  17. Phillips J (Ed): [http://alien.dowling.edu/~cperring/aapp/bulletin.htm] In / Symposium on DSM-5: Part 2. Bulletin of the Association for the Advancement of Philosophy and Psychiatry. 2010,17(2):1-5.
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  25. Phillips J: [http://www.psychiatrictimes.com/blog/DSM-5/content/article/10168/16657281] / Grief and depression: When science and terminology get confused. Psychiatric Times. 2010. (September 15, 2010)
  26. Phillips J: [http://www.psychiatrictimes.com/blog/DSM-5/content/article/10168/1696725] / DSM is a many-dimensioned thing. Psychiatric Times. 2010. (October 18, 010)
  27. Phillips J: [http://www.psychiatrictimes.com/blog/DSM-5/content/article/10168/1726976] / Science versus pragmatism in the DSM: Finding a middle ground. Psychiatric Times. 2010. (November 17, 2010)
  28. Phillips J: [http://www.psychiatrictimes.com/blog/DSM-5/content/article/10168/1766260] / The missing person in the DSM. Psychiatric Times. 2010. (December 21, 2010)
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  31. Phillips J: [http://www.psychiatrictimes.com/blog/DSM-5/content/article/10168/1842906] / DSM-5 and the NIMH research domain criteria project. Psychiatric Times. 2011. April 13, 2011)
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• 作者单位：James Phillips (1)
  Allen Frances (2)
  Michael A Cerullo (3)
  John Chardavoyne (1)
  Hannah S Decker (4)
  Michael B First (5)
  Nassir Ghaemi (6)
  Gary Greenberg (7)
  Andrew C Hinderliter (8)
  Warren A Kinghorn (2) (9)
  Steven G LoBello (10)
  Elliott B Martin (1)
  Aaron L Mishara (11)
  Joel Paris (12)
  Joseph M Pierre (13) (14)
  Ronald W Pies (15) (6)
  Harold A Pincus (16) (17) (18) (5)
  Douglas Porter (19)
  Claire Pouncey (20)
  Michael A Schwartz (21)
  Thomas Szasz (15)
  Jerome C Wakefield (22) (23)
  G Scott Waterman (24)
  Owen Whooley (25)
  Peter Zachar (10)
  
  1. Department of Psychiatry, Yale School of Medicine, 300 George St., Suite 901, New Haven, CT, 06511, USA
  2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 508 Fulton St., Durham, NC, 27710, USA
  3. Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 260 Stetson Street, Suite 3200, Cincinnati, OH, 45219, USA
  4. Department of History, University of Houston, 524 Agnes Arnold, Houston, 77204, USA
  5. Department of Psychiatry, Division of Clinical Phenomenology, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
  6. Department of Psychiatry, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA
  7. Human Relations Counseling Service, 400 Bayonet Street Suite #202, New London, CT, 06320, USA
  8. Department of Linguistics, University of Illinois, Urbana-Champaign 4080 Foreign Languages Building, 707 S Mathews Ave, Urbana, IL, 61801, USA
  9. Duke Divinity School, Box 90968, Durham, NC, 27708, USA
  10. Department of Psychology, Auburn University Montgomery, 7061 Senators Drive, Montgomery, AL, 36117, USA
  11. Department of Clinical Psychology, The Chicago School of Professional Psychology, 325 North Wells Street, Chicago, IL, 60654, USA
  12. Department of Psychiatry, Institute of Community and Family Psychiatry, SMBD-Jewish General Hospital, McGill University, 4333 cote Ste. Catherine, Montreal, QC, H3T1E4, Canada
  13. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA, 90095, USA
  14. VA West Los Angeles Healthcare Center, 11301 Wilshire Blvd, Los Angeles, CA, 90073, USA
  15. Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams St., #343CWB, Syracuse, NY, 13210, USA
  16. Irving Institute for Clinical and Translational Research, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10032, USA
  17. New York Presbyterian Hospital, 1051 Riverside Drive, Unit 09, New York, NY, 10032, USA
  18. Rand Corporation, 1776 Main St, Santa Monica, CA, 90401, USA
  19. Central City Behavioral Health Center, 2221 Philip Street, New Orleans, LA, 70113, USA
  20. Center for Bioethics, University of Pennsylvania, 3401 Market Street, Suite 320, Philadelphia, PA, 19104, USA
  21. Department of Psychiatry, Texas A&M Health Science Center - College of Medicine, 4110 Guadalupe Street, Austin, TX, 78751, USA
  22. Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA
  23. Department of Psychiatry, NYU Langone Medical Center, 550 First Ave, New York, NY, 10016, USA
  24. Department of Psychiatry, University of Vermont College of Medicine, 89 Beaumont Avenue, Given Courtyard N104, Burlington, VT, 05405, USA
  25. Institute for Health, Health Care Policy, and Aging Research, Rutgers, the State University of New Jersey, 112 Paterson St., New Brunswick, NJ, 08901, USA
  

文摘

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM -whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.