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Philosophy of psychiatry: theoretical advances and clinical implications
World Psychiatry ( IF 73.3 ) Pub Date : 2024-05-10 , DOI: 10.1002/wps.21194
Dan J. Stein 1 , Kris Nielsen 2 , Anna Hartford 1 , Anne‐Marie Gagné‐Julien 3 , Shane Glackin 4 , Karl Friston 5 , Mario Maj 6 , Peter Zachar 7 , Awais Aftab 8
Affiliation  

Work at the intersection of philosophy and psychiatry has an extensive and influential history, and has received increased attention recently, with the emergence of professional associations and a growing literature. In this paper, we review key advances in work on philosophy and psychiatry, and their related clinical implications. First, in understanding and categorizing mental disorder, both naturalist and normativist considerations are now viewed as important – psychiatric constructs necessitate a consideration of both facts and values. At a conceptual level, this integrative view encourages moving away from strict scientism to soft naturalism, while in clinical practice this facilitates both evidence‐based and values‐based mental health care. Second, in considering the nature of psychiatric science, there is now increasing emphasis on a pluralist approach, including ontological, explanatory and value pluralism. Conceptually, a pluralist approach acknowledges the multi‐level causal interactions that give rise to psychopathology, while clinically it emphasizes the importance of a broad range of “difference‐makers”, as well as a consideration of “lived experience” in both research and practice. Third, in considering a range of questions about the brain‐mind, and how both somatic and psychic factors contribute to the development and maintenance of mental disorders, conceptual and empirical work on embodied cognition provides an increasingly valuable approach. Viewing the brain‐mind as embodied, embedded and enactive offers a conceptual approach to the mind‐body problem that facilitates the clinical integration of advances in both cognitive‐affective neuroscience and phenomenological psychopathology.

中文翻译:

精神病学哲学:理论进展和临床意义

哲学和精神病学交叉领域的工作有着广泛而有影响力的历史,并且随着专业协会的出现和文献的不断增多,近年来受到越来越多的关注。在本文中,我们回顾了哲学和精神病学工作的主要进展及其相关的临床意义。首先,在理解和分类精神障碍时,自然主义和规范主义的考虑现在都被认为很重要——精神病学的结构需要考虑事实和价值观。在概念层面上,这种综合观点鼓励从严格的科学主义转向软自然主义,而在临床实践中,这有利于基于证据和基于价值观的心理保健。其次,在考虑精神病学的本质时,现在越来越强调多元化的方法,包括本体论、解释性和价值多元化。从概念上讲,多元主义方法承认引起精神病理学的多层次因果相互作用,而在临床上它强调广泛的“差异制造者”的重要性,以及在研究和实践中考虑“生活经验” 。第三,在考虑一系列关于大脑的问题,以及躯体和精神因素如何促进精神障碍的发展和维持时,关于具身认知的概念和实证研究提供了一种越来越有价值的方法。将大脑-心智视为体现的、嵌入的和活跃的,为心身问题提供了一种概念方法,促进认知情感神经科学和现象学精神病理学进展的临床整合。
更新日期:2024-05-10
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