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Epidemiologia e psichiatria: considerazioni di metodo(1)

Published online by Cambridge University Press:  07 August 2014

Paolo Vineis*
Affiliation:
Servizio di Epidemiologia dei Tumori, USL 8, Torino

Summary

Psychiatry has been, among medical disciplines, the one showing the highest conflict between a «positivist» model and the «hermeneutic» tradition. In particular, in recent years several authors have suggested that both the scientific method and a scientific mentality should be introduced in psychiatric practice and research. They claim that criteria like a strong correlation among clearly defined signs and symptoms, a high predictive value towards the outcome and therapeutical response, and a clearly defined relationship between the symptoms and etiology are necessary to accept a diagnositc entity. Since in the case of e.g. schizofrenia such requirements are not met, some authors even suggest that the concept of schizofrenia should be abandoned. The present paper aims to show that such problems are not unique to mental disease, but are common to several branches of medicine. For example, the definition and classification of cancer follow a «polythetic» criterion which is similar to the concept of «family resemblances». Also, diagnostic reproducibility is often low in other medical disciplines. The paper examines how such methodological problems could be dealt with using the tools of epidemiology.

Type
Articoli
Copyright
Copyright © Cambridge University Press 1995

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Footnotes

(1)

Relazione tenuta al Primo Congresso Nazionale della Società Italiana di Epidemiologia Psichiatrica (Genova 7-9 ottobre 1993).

References

BIBLIOGRAFIA

Balestrieri, M. & Zimmermann-Tansella, Ch. (1993). Placebo, effetto placebo e fattori aspecifici nel trattamento farmacologico e in psicoterapia. In Gli Psicofarmaci nella Pratica Terapeutica, 3 ed. (ed. Bellantuono, C. e Tansella, M.). Il Pensiero Scientifico Editore: Roma.Google Scholar
Bellodi, L., Battaglia, M., Migone, P., Pallanti, S. & Bonora, I. (1993). I disturbi di personalità. In Trattato Italiano di Psichiatria (ed. Cassano, G.B.et al.), pp. 19812034. Masson: Milano.Google Scholar
Day, R. (1989). Schizofrenia. In Life Events and Illness (ed. Brown, G.W. and Harris, T.O.), pp. 113138. Unwin Hyman: London.Google Scholar
Bentall, R.P., Jackson, H.F. & Pilgrim, D. (1988). Abandoning the concept of schizofrenia. British Journal of Clinical Psychology 27, 303324.CrossRefGoogle Scholar
Grünbaum, A. (1984). The Foundations of Psychoanalysis: a Philosophical Critique. University of California Press: Berkeley.Google Scholar
Hunt, G. (1990). Schizofrenia and indeterminacy: the problem of validity. Theoretical Medicine 11, 6178.CrossRefGoogle Scholar
Mann, D.W. (1991). Theoretical issues in psychiatry. Theoretical Medicine 12, 16.CrossRefGoogle ScholarPubMed
Pickering, G. (1979). Therapeutics - Art or Science? Journal of American Medicinal Association 242, 649653.CrossRefGoogle ScholarPubMed
Toulmin, S. (1993). Knowledge and art in the practice of medicine. In Science, Technology, and the Art of Medicine (ed. Delkeskamp-Hayes, C. and Cutter, M.A. Gardell). Kluwer: Dordrecht.Google Scholar
van Os, J., Galdos, P., Lewis, G., Bourgeois, M. & Mann, A. (1993). Schizofrenia sans frontieres: concepts of schizofrenia among French and British psychiatrists. British Medical Journal 307, 489492.CrossRefGoogle Scholar
Vineis, P. (1991). L'Osservazione Medica. Garzanti: Milano.Google Scholar
Vineis, P. (1993). Definition and classification of cancer: monothetic or polythetic? Theoretical Medicine 14, 249256.CrossRefGoogle ScholarPubMed
Vineis, P. (1994). La promozione dell'epidemiologia clinica per la razionalizzazione delle scelte sanitarie. L'Arco di Giano 5, 147156.Google Scholar
Von Wright, G.H. (1971). Explanation and Understanding. Cornell University Press: Ithaca.Google Scholar
Wittgenstein, L. (1967). Ricerche Filosofiche. Einaudi: Torino.Google Scholar