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Free Content Is a Correct Psychiatric Diagnosis Possible? Major Depressive Disorder as a Case in Point

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The desire on the part of American psychiatry in the 1970s to "rejoin medicine" resulted in DSM–III and subsequent editions. The form of medical conditions is imitated as closely as possible by listing criteria symptom sets for supposedly discrete, autonomous clinical entities, although relevant biological phenomena remain conspicuously lacking. As in somatic medicine, symptoms are unconnected to social background, history, context, and so on. But the necessity to interpret what people say and to depict behavior as the basis for diagnosis inevitably leads to intractable problems of meaning and evidence, as illustrated by a close examination of Major Depressive Episode. Plausible description and understanding of personal problems requires patient-supplied depiction of the nature and scope of the problem, history, and context, and when these are fleshed-out clinical entities and the usefulness of mental disorder disappear.

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Keywords: ANTI-PSYCHIATRY; CONTEXT; MEANING; MENTAL DISORDER; PSYCHIATRIC DIAGNOSIS; STORY

Document Type: Research Article

Publication date: 01 August 2009

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