199:
is regarded as a sign of depression in some cultures, but not in others), the inclusion of cultural factors into diagnostic criteria is seen as a political decision, but not a scientifically founded one. The
Western viewpoint when defining mental illnesses also creates a cultural blind spot: Manuals
228:
is sometimes caused by heart problems, and the treatment is thus led by a cardiologist. In psychiatry, however, grouping mental disorders by their cause is still an unsolved problem. Psychiatric textbooks and manuals cluster disorders by symptoms, which is thought to impede the search for effective
194:
As textbooks and handbooks like DSM are usually written by
Western authors, a culturally neutral definition of mental diseases is an unsolved problem. Though newer editions of the DSM “respect” non-Western cultures by mentioning culture-specific symptom presentations (e.g. a very long time of
130:(EBM) has become the central paradigm in medical practice and research. However, debate continues around EBM and about how results obtained from large samples of patients can be applied to the individual.
291:
in a model organism, and determine the genes that are inhibited by a certain substance, and make further inferences from this data. A classical example of an unknown mechanism of action is the
251:
There are numerous diseases for which causes are not known. There are others for which the etiology is fully or partially understood, but for which effective treatments are not yet available.
62:
process, and on the other hand, there is the subjective suffering of a patient and the loss of their life quality. Both approaches do not need to match, and they can even be contradictory.
144:
489:
Loughlin, Michael; Lewith, George; Falkenberg, Torkel (2013). "Science, Practice and
Mythology: A Definition and Examination of the Implications of Scientism in Medicine".
73:
patients who will neither see suffering nor a change in his life quality, while the disease-causing process is severe and often deadly if left untreated. Similarly, many
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39:
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have covered a lot of ground when it comes to defining mental illnesses, in some disorders the reliability of diagnosis is still very poor. For example,
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69:, the doctor will not care about the specific virological and immunological process behind the clearly visible suffering. This is contrasted by many
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191:, psychiatry should identify unhealthy mental processes and treat them, and not focus on cultural norms, moral questions or legal issues.
27:. Many of the problems relate to how drugs work (the so-called mechanism of action), and to diseases with an unknown cause, the so-called
88:
was long seen as a negative but non-pathological state. The introduction of effective treatments has led to its acceptance as a disease.
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246:
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are still defined by societal and cultural norms, rather than putting the individual's well-being in focus. For example, DSM defined
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104:
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35:
264:
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should be classified as a disease if they neither cause subjective suffering in the patient, nor endanger third persons.
43:
549:
401:"Why do we always end up here? Evidence-based medicine's conceptual cul-de-sacs and some off-road alternative routes"
735:
711:
184:
112:
20:
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is often diagnosed differently by independent experts who see the same patient, with a kappa value of just 0.28.
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127:
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will be affected, and third persons can be harmed. There is also debate on whether non-normal behavior like
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is a descriptive term used in medicine to denote diseases with an unknown cause or mechanism of apparent
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cause significant subjective suffering in the patient, but do not harm third persons. On the contrary, a
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Kulkarni, Abhaya V. (2005). "The challenges of evidence-based medicine: A philosophical perspective".
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85:
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rarely discuss how
Western lifestyles and cultures may modify or hide symptoms of mental illnesses.
276:
225:
442:"Has evidence-based medicine ever been modern? A Latour-inspired understanding of a changing EBM"
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28:
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16:
List of medical problems which the scientific community has yet to find an accepted answer for
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92:
70:
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Freedman, Lewis (2013). "The
Initial Field Trials of DSM-5: New Blooms and Old Thorns".
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and may never be able to satisfy particular standards for completeness. You can help by
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300:
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233:: It allows you to identify birds, but it does not tell you why a species exists in
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279:– resulting in rapid bone loss and teeth in need of extraction – is still unknown.
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Wieringa, Sietse; Engebretsen, Eivind; Heggen, Kristin; Greenhalgh, Trish (2017).
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does not cause any suffering in the patient, though the maintenance of healthy
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81:) and the patient still feels healthy, which delays seeking treatment.
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It is sometimes unknown how drugs work. Often it is possible to study
74:
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is. On one hand, there is a scientific definition which is tied to a
603:"Striving for Coherence: Psychiatry's Efforts over classification".
417:
84:
Sometimes, cultural factors also play a role in defining "disease".
65:
For example, when a patient seeks medical help because of a severe
707:
547:
Green, Richard (2002). "Is pedophilia a mental disorder?".
341:
Chiong, Winston (2001). "Diagnosing and defining disease".
229:
treatments. This has been compared to an ornithologist's
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if the condition is caused by a cancer metastasis in the
54:
There is no overarching, clear definition of what a
275:. Another example is that the cause of aggressive
204:Still no causal classification of mental disorders
77:in their very early stages are asymptomatic (e.g.
263:origin. Examples of idiopathic diseases include:
679:"Aggressive periodontitis: The unsolved mystery"
91:Even more difficulties arise when it comes to
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8:
167:Cultural issues in defining mental disorders
139:Lack of reliable diagnoses in some disorders
726:
712:
704:
446:Journal of Evaluation in Clinical Practice
465:
416:
322:List of unsolved problems in neuroscience
224:is a secondary consideration. Likewise,
333:
7:
648:10.1093/acref/9780199557141.001.0001
366:Medicine, Health Care and Philosophy
317:List of unsolved problems in biology
269:Idiopathic intracranial hypertension
273:Idiopathic pulmonary haemosiderosis
247:Category:Ailments of unknown cause
14:
351:10.1001/jama.285.1.89-JMS0103-2-1
181:American Psychiatric Association
293:mechanism of general anesthesia
179:as a mental illness, until the
19:This article discusses notable
590:10.1146/annurev.psych.51.1.377
534:10.1176/appi.ajp.2012.12091189
526:American Journal of Psychiatry
405:Journal of Primary Health Care
183:decided otherwise in 1973. As
1:
634:Martin, Elizabeth A. (2010).
265:Idiopathic pulmonary fibrosis
582:Annual Review of Psychology
550:Archives of Sexual Behavior
399:Greenhalgh, Trisha (2012).
241:Diseases with unknown cause
187:pointed out in a review on
171:Some mental illnesses like
113:interpersonal relationships
850:
829:Lists of unsolved problems
686:Quintessence International
640:Concise Medical Dictionary
244:
33:
743:
503:10.1007/s10728-012-0211-6
378:10.1007/s11019-004-7345-8
161:major depressive disorder
134:Psychiatry and psychology
613:10.1001/jama.293.20.2526
143:Though manuals like the
109:impulse-control disorder
559:10.1023/a:1020699013309
149:inter-rater reliability
128:Evidence-based medicine
123:Evidence-based medicine
50:Definition of "disease"
295:. Other examples are
245:Further information:
155:is very high, with a
105:narcissistic disorder
491:Health Care Analysis
283:Mechanisms of action
86:Erectile dysfunction
40:adding missing items
694:10.3290/j.qi.a37387
226:renal insufficiency
220:; a treatment by a
29:idiopathic diseases
783:Information theory
212:is referred to an
816:
815:
736:unsolved problems
677:Clark, Danielle.
458:10.1111/jep.12752
208:A patient with a
101:anxiety disorders
79:pancreatic cancer
21:unsolved problems
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642:(8th ed.).
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301:antidepressants
289:gene expression
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159:of 0.78, while
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71:hemochromatosis
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5:
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497:(2): 130–145.
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452:(5): 964–970.
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372:(2): 255–260.
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151:in cases of
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36:dynamic list
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788:Mathematics
734:Well-known
411:(2): 92–7.
297:paracetamol
261:spontaneous
231:field guide
222:neurologist
218:spinal cord
173:paraphilias
157:kappa value
117:paraphilias
97:Depressions
823:Categories
808:Statistics
778:Geoscience
663:2019-01-04
328:References
256:Idiopathic
214:oncologist
189:pedophilia
34:This is a
768:Economics
758:Chemistry
748:Astronomy
210:paralysis
793:Medicine
621:15914753
607:. 2005.
567:12462476
511:22622355
476:28508440
427:22675691
386:16215804
311:See also
197:mourning
153:dementia
25:medicine
803:Physics
753:Biology
467:5655926
305:lithium
235:biotope
75:cancers
56:disease
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271:, and
107:or an
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42:with
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507:PMID
472:PMID
423:PMID
382:PMID
343:JAMA
303:and
99:and
690:doi
644:doi
609:doi
586:doi
555:doi
530:doi
499:doi
462:PMC
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347:doi
145:DSM
67:flu
23:in
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