scholarly journals Epistemic injustice in psychiatry

2017 ◽  
Vol 41 (2) ◽  
pp. 65-70 ◽  
Author(s):  
Paul Crichton ◽  
Havi Carel ◽  
Ian James Kidd
Keyword(s):  
Mental Disorders ◽  
Subjective Experience ◽  
Psychiatric Patients ◽  
Healthy People ◽  
Epistemic Injustice ◽  
Medical Conditions ◽  
Contributory Factors

SummaryIt has been argued that those who suffer from medical conditions are more vulnerable to epistemic injustice (a harm done to a person in their capacity as an epistemic subject) than healthy people. This editorial claims that people with mental disorders are even more vulnerable to epistemic injustice than those with somatic illnesses. Two kinds of contributory factors are outlined, global and specific. Some suggestions are made to counteract the effects of these factors, for instance, we suggest that physicians should participate in groups where the subjective experience of patients is explored, and learn to become more aware of their own unconscious prejudices towards psychiatric patients.

The Clinician’s Subjective Experience during the Interaction with Adolescent Psychiatric Patients: Validity and Reliability of the Assessment of Clinician’s Subjective Experience

2021 ◽  
pp. 1-8
Author(s):  
Angelo Picardi ◽  
Sara Panunzi ◽  
Sofia Misuraca ◽  
Chiara Di Maggio ◽  
Andrea Maugeri ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Subjective Experience ◽  
Rating Scale ◽  
Mood State ◽  
Psychiatric Patients ◽  
Temporal Stability ◽  
Young Patients ◽  
Reliability And Validity ◽  
Mental States ◽  
Validity And Reliability

<b><i>Introduction:</i></b> The last decade has witnessed a resurgence of interest in the clinician’s subjectivity and its role in the diagnostic assessment. Integrating the criteriological, third-person approach to patient evaluation and psychiatric diagnosis with other approaches that take into account the patient’s subjective and intersubjective experience may bear particular importance in the assessment of very young patients. The ACSE (Assessment of Clinician’s Subjective Experience) instrument may provide a practical way to probe the intersubjective field of the clinical examination; however, its reliability and validity in child and adolescent psychiatrists seeing very young patients is still to be determined. <b><i>Methods:</i></b> Thirty-three clinicians and 278 first-contact patients aged 12–17 years participated in this study. The clinicians completed the ACSE instrument and the Brief Psychiatric Rating Scale after seeing the patient, and the Profile of Mood State (POMS) just before seeing the patient and immediately after. The ACSE was completed again for 45 patients over a short (1–4 days) retest interval. <b><i>Results:</i></b> All ACSE scales showed high internal consistency and moderate to high temporal stability. Also, they displayed meaningful correlations with the changes in conceptually related POMS scales during the clinical examination. <b><i>Discussion:</i></b> The findings corroborate and extend previous work on adult patients and suggest that the ACSE provides a valid and reliable measure of the clinician’s subjective experience in adolescent psychiatric practice, too. The instrument may prove to be useful to help identify patients in the early stages of psychosis, in whom subtle alterations of being with others may be the only detectable sign. Future studies are needed to determine the feasibility and usefulness of integrating the ACSE within current approaches to the evaluation of at-risk mental states.

scholarly journals Between Punishment and Care: Autonomous Offenders Who Commit Crimes Under the Influence of Mental Disorder

2021 ◽  
Author(s):  
Thomas Hartvigsson
Keyword(s):  
Criminal Justice ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Criminal Responsibility ◽  
Psychiatric Patients ◽  
Involuntary Treatment ◽  
Psychiatric Condition ◽  
Psychiatric Institutions

AbstractThe aim of this paper is to present a solution to a problem that arises from the fact that people who commit crimes under the influence of serious mental disorders may still have a capacity to refuse treatment. Several ethicists have argued that the present legislation concerning involuntary treatment of people with mental disorder is discriminatory and should change to the effect that psychiatric patients can refuse care on the same grounds as patients in somatic care. However, people with mental disorders who have committed crimes and been exempted from criminal responsibility would then fall outside the scope of criminal justice as well as that of the psychiatric institutions if they were to refuse care. In this paper, I present and develop a solution to how society should deal with this group of people, called Advance criminal responsibility. The basic idea being that if a person with a potentially responsibility exempting psychiatric condition refuses care, that person is responsible for any future criminal acts which are due to the mental disorder.

The Person with Schizophrenia as a Person

1994 ◽  
Vol 164 (S23) ◽  
pp. 103-107 ◽  
Author(s):  
John S. Strauss
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Subjective Experience ◽  
Mental Health Field ◽  
Objective Measures ◽  
Health Field ◽  
Subjective Side

In the mental health field, the attention given to the subjective side of a person's experience is grossly inadequate. The best way to reflect the subjectivity of a person may be by means of the subjectivity of another. To take account of both subjective experience and objective measures in the course of mental disorders, a new concept is needed. This may be the person's story.

Ethical Issues Arising in Revising Classifications of Mental Disorders

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
N. Sartorius
Keyword(s):  
Mental Disorders ◽  
Ethical Issues ◽  
Task Force ◽  
Psychiatric Patients ◽  
World Health ◽  
Sufficient Evidence ◽  
Advisory Group ◽  
Diagnostic Systems ◽  
The World

The classification of mental disorders in the International Classification of Diseases (ICD) will be revised in the course of the next three years and its publication (as the 11th Revision of the ICD) will be published, after the approval of the World Health Assembly in 2014. In parallel, the American Psychiatric Association created a Task Force which has begun work on the proposals for the revision of its Diagnostic and Statistical Manual which is to be published as the DSM 5th Revision, in 2012. The World Health Organization has established a special advisory group that should assist it in developing proposals for the classification of mental disorders for the 11th Revision of the ICD and this group collaborates closely with the APA Task Force creating the DSM5 proposals.Numerous ethical issues arise in this process and need to be discussed now so as to inform the process of agreeing on the proposals for the new classifications. They include the importance of an internationally accepted classification as a protection against abuses of psychiatric patients; the need to set the threshold for the diagnosis of a mental disorder at a level ensuring that people with such disorders receive help, the need to avoid imposition of diagnostic systems or categories without sufficient evidence and others. The presentation will briefly discuss the process of constructing the proposals for the new classifications and ways in which the groups established by the WHO and the APA handle these ethical questions.

Emotion Modulation in Psychiatric Patients Through Music

2012 ◽  
Vol 31 (5) ◽  
pp. 485-493 ◽  
Author(s):  
Stefan Gebhardt ◽  
Markus Kunkel ◽  
Richard von Georgi
Keyword(s):  
Substance Abuse ◽  
Problem Solving ◽  
Mental Disorders ◽  
Personality Disorders ◽  
Reference Group ◽  
Psychiatric Patients ◽  
Applied Music ◽  
Cognitive Problem ◽  
Psychiatric Population ◽  
Degree Of Severity

This study explores differences in the use of music in everyday life among diagnostic groups of a psychiatric population (n = 180) in reference to a group of healthy subjects (n = 430). The results indicate that patients with mental disorders use music more for emotion modulation than healthy controls. In particular, patients with substance abuse and those with personality disorders used music mainly for cognitive problem solving and the reduction of negative activation, whereas patients with substance abuse in addition used music not often to stimulate themselves positively. Patients suffering from schizophrenia and personality disorders more often applied music for relaxation than the subjects of the reference group. Furthermore, the degree of severity of the psychiatric disorder correlated with the increased use of music for emotion modulation, i.e., for relaxation and cognitive problem solving. Thus, the results demonstrate an increased use of music for emotion modulation in patients with mental disorders in association with the severity of the disorder.

scholarly journals Moral Treatment: Philippe Pinel

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Mrs. Sushma. C ◽  
Dr. Meghamala. S. Tavaragi
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Social Stress ◽  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Demonic Possession ◽  
Moral Treatment ◽  
Modern Psychiatry ◽  
History Of ◽  
First Time

Philippe Pinel a pioneer, a french psychiatrist, a physician, known as father of modern psychiatry, revolutions psychiatric care of patients with mental illness by introducing concept of moral treatment. Pinel rejected the then prevailing popular notion that mental illness was caused by demonic possession and stated that mental disorders could be caused by a variety of factors including psychological or social stress, congenital conditions, or physiological injury, psychological damage, or heredity. Philippe Pinel for the first time in history of psychiatric patients treated them humanly by unchaining patients known as madmen. This historic event was done for first time in Bicêtre Hospital in 1798 a Parisian insane asylum. In this article a brief history of life and work of pioneer Philippe Pinel is mentioned.

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