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Conceptualisation of mental disorder and its personal meanings
1Kings' College London, Institute of Psychiatry, London SE5 8AF, UK. d.bolton@iop.kcl.ac.uk
Background:
Mental disorder has been conceptualised as a matter of objective scientific fact, in versions of so-called 'naturalism'.
Aims:
To elucidate the personal meanings involved in attribution of mental disorder.
Method:
Critical review of literature on the definition of mental disorder, with reference to the context of personalised medicine and healthcare.
Conclusions:
Personal meanings are not brought into focus by naturalism, but the current genetics paradigm creates space for three kinds of process: natural, social and individual, with corresponding conceptions of dysfunction. The individual conception is broadly a matter of experience and behaviour not going as the person intends, manifesting as unmanageable distress and self-identified disability. On the other hand in the problems that give rise to diagnosis of mental disorder, more than one person and their personal meanings are involved, creating need for empathy and negotiation.
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