From measurement to classificatory practice: improving psychiatric classification independently of the opposition between symptom-based and causal approaches

The article advances a new way of thinking about classifications in general and the classification of mental disorders in particular. By applying insights from measurement practice to the context of classification, I defend a notion of epistemic accuracy that allows one to evaluate and improve classifications by comparing different classifying methods to each other. Progress in classification arises from the mutual development of classification systems and classifying methods. Based on this notion of accuracy, the article illustrates with an example how psychiatric classifications can be improved via circumscribed comparisons of different perspectives on mental disorders, without relying on complete models of their complex aetiology. When applying this strategy, the traditional opposition between symptom-based and causal approaches is of little consequence for making progress in the epistemic accuracy of psychiatric classification.

The Delphic nature of the language of psychiatry

In this perspective piece, the language used in psychiatric classification is considered from a linguistic and anthropological perspective. It is important for psychiatrists to consider how ambiguous language can impact on their view of clinical presentations and the delivery of treatments. Ultimately, delivering care using an empathic and humane approach should always be a primary consideration when treating mental illness.

Making a good mental health diagnosis: Science, art and ethics

Background There are limitations to psychiatric classification, which affects the utility of diagnosis in general practice. Objective The aim of this article is to explore the principles of science, art and ethics to create clinically useful psychiatric diagnoses in general practice. Discussion Psychiatric classification systems provide useful constructs for clinical practice and research. Evidence-based treatments are based on the classification of mental illnesses. However, while classification is necessary, it is not sufficient to provide a full understanding of ‘what is going on’. A good psychiatric diagnosis will also include a formulation, which provides an understanding of the psychosocial factors that provide a context for illness. Experiences such as trauma and marginalisation will change the illness experience but also provide other forms of evidence that shape therapy. Diagnoses also carry ethical implications, including stigma and changes in self‑concept. The science, art and ethics of diagnosis need to be integrated to provide a complete assessment.

Philosophy of psychiatry: quarter of a century in discussions

The papers presents the discussion field of a young branch of the philosophy of science the philosophy of psychiatry. As an interdisciplinary platform in the dialogue of sciences, schools and individual professionals, it unites psychiatrists and philosophers, psychologists and social workers in discussing on crucial issues. The paper analyses a multiple field of discussion of the philosophy of psychiatry, separating two stages of its brief development: the stage of institutionalization and fixing of problems (1995‒2005) and the stage of expansion (2005 present). Modern discussions are studied on the most important thematic blocks: (1)the methodology of human research; (2)the philosophical basis of psychiatric classification; (3)psychiatric ethics. The work presents the first complete and specialized review of discussions of the philosophy of psychiatry in Russian.

Conclusion: Melancholia, Depression, and the Politics of Classification

The conclusion briefly highlights some alternative models of melancholia at the turn of the twentieth century, before turning the focus to the decline of the melancholia diagnosis and the rise of clinical depression as the new dominant mood disorder in diagnostic literature. The Conclusion considers how the developments outlined in the previous chapters have been foundational not only for the modern psychiatric concepts ‘mood disorder’ and ‘clinical depression’, but also more broadly for classification and clinical practice in twentieth- and twenty-first-century psychiatry. Finally, the book turns the spotlight to the politics of psychiatric classification, and asks what is at work, and at stake, when psychiatry tries to label, classify, and diagnose psychological distress.