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The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion
Authors:Email author" target="_blank">James?PhillipsEmail author  Allen?Frances  Michael?A?Cerullo  John?Chardavoyne  Hannah?S?Decker  Michael?B?First  Nassir?Ghaemi  Gary?Greenberg  Andrew?C?Hinderliter  Warren?A?Kinghorn  Steven?G?LoBello  Elliott?B?Martin  Aaron?L?Mishara  Joel?Paris  Joseph?M?Pierre  Ronald?W?Pies  Harold?A?Pincus  Claire?Pouncey  Michael?A?Schwartz  Thomas?Szasz  Jerome?C?Wakefield  G?Scott?Waterman  Owen?Whooley  Peter?Zachar
Institution:1.Department of Psychiatry,Yale School of Medicine,New Haven,CT,USA;2.Department of Psychiatry and Behavioral Sciences,Duke University Medical Center,Durham,USA;3.Department of Psychiatry and Behavioral Neuroscience,University of Cincinnati College of Medicine,Cincinnati,USA;4.Department of History,University of Houston,Houston,USA;5.Department of Psychiatry , Division of Clinical Phenomenology, New York State Psychiatric Institute,Columbia University College of Physicians and Surgeons,New York,USA;6.Department of Psychiatry,Tufts Medical Center,Boston,USA;7.Human Relations Counseling Service,New London,USA;8.Department of Linguistics,University of Illinois, Urbana-Champaign,Urbana,USA;9.Duke Divinity School,Durham,USA;10.Department of Psychology,Auburn University Montgomery,Montgomery,USA;11.Department of Clinical Psychology,The Chicago School of Professional Psychology,Chicago,USA;12.Department of Psychiatry,Institute of Community and Family Psychiatry, SMBD-Jewish General Hospital, McGill University,Montreal,Canada;13.Department of Psychiatry and Biobehavioral Sciences,David Geffen School of Medicine at UCLA,Los Angeles,USA;14.VA West Los Angeles Healthcare Center,Los Angeles,USA;15.Department of Psychiatry,SUNY Upstate Medical University,Syracuse,USA;16.Irving Institute for Clinical and Translational Research, Columbia University Medical Center,New York,USA;17.New York Presbyterian Hospital,New York,USA;18.Rand Corporation,California,USA;19.Central City Behavioral Health Center,New Orleans,USA;20.Center for Bioethics, University of Pennsylvania,Philadelphia,USA;21.Department of Psychiatry,Texas A & M College of Medicine,Austin,USA;22.Silver School of Social Work, New York University,New York,USA;23.Department of Psychiatry,NYU Langone Medical Center,New York,USA;24.Department of Psychiatry,University of Vermont College of Medicine,Burlington,USA;25.Institute for Health, Health Care Policy, and Aging Research, Rutgers, the State University of New Jersey,New Brunswick,USA
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.
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