The Tower of Babel in Psychiatry

Abstract

Both accurate diagnosis and effective treatment of mental disorders remain an unfulfilled aim, but an accurate diagnosis is not required for optimal prescribing. Psychiatrists work as balancers among patients’ requirements and misconceptions, while patients ask for actual and not stigmatized words in diagnosis and therapy language. We have to resolve the circle of misconceptions between patients, psychiatrists, other specialties, scientific institutions and journals, pharmaceutical companies, legal agencies, and media. What really needs to be changed is the way mental illness is seen by the public, and any such change will need the positive reaction of patients and carers. Isolation of psychiatry from the rest medical specialties has diminished value of diagnosis and treatment, reducing psychiatry to a nonspecific psychological support, which contributes to more increasing the stigma. In view of sosio-medical care, psychiatrists should return home to medicine, leaving non-medical interventions to non-medical practitioners. We need new neuroscientific models, such as the RDoC, having the potential to inform the development of a unified, dimensional, and biobehaviorally grounded psychiatric nosology. Renaming, redefining and reconceptualization processes, in this ‘Tower of Babel’ of mental health country, are long and challenging, but there is not serious difficulty other than our inner resistance to change.