The Inescapable Specificities of Psychiatry Across Research, Clinical Practice, and Medical Education
1Clínica Universitária de Psiquiatria e Psicologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
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There is increasing evidence that psychiatric disorders have a complex causality, with components belonging to different paradigms and levels of abstraction. They are thus constructs determined by a complex and not yet fully understood interaction between biological and psychosocial factors. As a result, the classification of mental disorders is based on the presentation of symptom clusters and their progression over time and the classification of psychopathological symptoms follows a logical framework based on their mode of presentation and not on causal factors. On the other hand, psychiatric concepts are hybrid, depending not only on biology but also on psychosocial components. The study of their definition, their current meaning, the various sub-concepts they encompass, the connection between different concepts, and the evolution of concepts over time is carried out through conceptual analysis. Poorly understood and defined concepts regarding their structure and components lead to false empirical questions and poorly chosen scientific methodologies, yielding results of questionable validity. In this article, these issues are explored in detail, and a comparison is established between common medical disorders and psychiatric disorders. It is also argued that they should be considered in all research conducted in psychiatry, as well as in clinical practice and medical education in psychiatry.
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