DSM diagnosis and beyond: on the need for a hermeneutically-informed biopsychosocial framework

作者：Healy Paul^*

来源：Medicine Health Care and Philosophy, 2011, 14(2): 163-175.

DOI：10.1007/s11019-010-9284-x

• Philosophy
• Psychiatry
• DSM diagnosis
• Biopsychosocial template
• Hermeneutics

While often dubbed "the bible of contemporary psychiatry" and widely hailed as providing "a benchmark" for the profession, on closer inspection the DSM is seen to be shot through with philosophical assumptions that restrict its theoretical cogency and limit it clinical efficacy. Hence, in the interests of enhanced patient-care it is important to think critically about the DSM, with a view to maximising its diagnostic strengths while minimising its weaknesses. The critical analysis undertaken in the present paper underscores the importance of not construing the DSM as a self-contained diagnostic tool but of viewing it, rather, as an indispensable component in a more comprehensive, multidimensional diagnostic process. More specifically, the contention is that the DSM's diagnostic limitations evoke a biopsychosocial framework of application as their necessary corrective, notwithstanding the entrenched tendency to construe these approaches as oppositional. Further, it is contended that a hermeneutically informed biopsychosocial template has particular advantages as an integrating framework.

• 出版日期2011-5