Psychiatry Investig.  2013 Sep;10(3):205-217.

Is Psychiatry Scientific? A Letter to a 21st Century Psychiatry Resident

• de Leon J

Abstract

During the development of the DSM-5, even the lay press questioned psychiatr's scientific validity. This review provides 21st century psychiatry residents with ways of answering these attacks by defining the concepts and history of psychiatry (a branch of medicine), medicine and science. Psychiatric language has two levels: first, describing symptoms and signs (19th century descriptive psychopathology developed in France and Germany), and second, describing disorders (psychiatric nosology was developed in the early 20th century by Kraepelin and resuscitated by the US neo-Kraepelinian revolution leading to the DSM-III). Science is a complex trial-and-error historical process that can be threatened by those who believe too much in it and disregard its limitations. The most important psychiatric advances, electroconvulsive therapy and major psychopharmacological agents, were discovered by "chance", not by scientific planning. Jaspers's General Psychopathology is a complex 100-year-old book that describes: 1) psychiatric disorders as heterogeneous and 2) psychiatry as a hybrid scientific discipline requiring a combination of understanding (a social science method) and explanation (a natural science method). In the 21st century Berrios reminds us of psychiatry's unfortunate methodological issues due to hybrid symptoms and disorders, some of which are better understood as problems in communication between interacting human beings; in those situations neuroscience methods such as brain imaging make no sense. A new language is needed in psychiatry. East Asian psychiatry residents, who are not particularly attached to the antiquated language currently used, may be particularly equipped for the task of recreating psychiatric language using 21st century knowledge.

Keyword

Asia; Diagnostic and Statistical Manual of Mental Disorders; Europe; History, 19th century; History, 20th century; History, 21st century; Mental disorders; Psychiatry; United States

MeSH Terms

Asia
Asian Continental Ancestry Group
Diagnostic and Statistical Manual of Mental Disorders
Electroconvulsive Therapy
Europe
Far East
France
History
History, 19th Century
History, 20th Century
History, 21st Century
Humans
Mental Disorders
Methods
Natural Science Disciplines
Neuroimaging
Neurosciences
Psychiatry*
Psychopathology
Social Sciences
United States