The Six Most Essential Questions in Psychiatric Diagnosis: a Pluralogue
Phillips et al. Philosophy, Ethics, and Humanities in Medicine 2012, 7:14 http://www.peh-med.com/content/7/1/14 REVIEW Open Access The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion James Phillips1*, Allen Frances2, Michael A Cerullo3, John Chardavoyne1, Hannah S Decker4, Michael B First5, Nassir Ghaemi6, Gary Greenberg7, Andrew C Hinderliter8, Warren A Kinghorn2,9, Steven G LoBello10, Elliott B Martin1, Aaron L Mishara11, Joel Paris12, Joseph M Pierre13,14, Ronald W Pies6,15, Harold A Pincus5,16,17,18, Douglas Porter19, Claire Pouncey20, Michael A Schwartz21, Thomas Szasz15, Jerome C Wakefield22,23, G Scott Waterman24, Owen Whooley25 and Peter Zachar10 Abstract In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. General conclusion issues in DSM-5 [16,17]. (Vol 17, No 1 of the AAPP Bul- In concluding this multi-part article, let me begin once letin will be referred to as Bulletin 1, and Vol 17, No 2 again with a brief review of what we have already cov- will be referred to as Bulletin 2.
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