29^th World Psychiatrists Meet

Biography

Biography: Stergios Kaprinis

Abstract

One of the most fundamental problems in psychiatry is the difficulty in defining what is normal and what is pathological. Unlike what is the case in other medical specializations, in psychiatry the borders between health and disease are blurry. Despite the scientific progress in neuroscience and genetics, psychiatry is still bereft of any test or examining method that will yield objective, hard evidence, pointing out to the existence or not of a mental disease. It has been stated that-psychiatry is the meeting point of two subjectivities, that of the doctor and that of the patient. This statement is still as strong as it was when it was first made. There is no objective method of defining mental disease and all tests administered to the psychiatric patient are either inconclusive or subject to the patient’s perception of them and the psychiatrist’s interpretation of the whole procedure. Psychiatric thinking and consequently, psychiatric discourse has been so heavily influenced by analytical thinking and by the dissection of information to the tiniest bit, that nothing seems certain any more. Everything seems to be equally important, or unimportant. The borders between health and disease became very blurry. The borders between one disease and another are indiscernible any more. On one hand this might be good. Patients are viewed more holistically, as a person and an entity, not as objects to be tagged and be conveniently tucked away in a little box. The waning of the categorical system in favor of a more dimensional approach (which will become more apparent with the 5^th edition of the DSM) signals more degrees of freedom in our approach of the patient. More degrees of freedom, however, mean a greater degree of uncertainty, a greater degree of entropy. Are we equipped enough to navigate in this more uncertain world? Or are we going to be drifted away by the first current, the first fad that will come our way? The signs are unfortunately not good. Despite the absence of hard evidence, more and more eminent psychiatrists believe that schizophrenia and bipolar disorders are not distinct nosological entities, but rather the two ends of the same spectrum. Most of us psychiatrists have the best of intentions to help a suffering fellow human, but we have forgotten synthetical and abstract thinking and have allowed ourselves to be led astray by a hodgepodge of information that we were in no position to evaluate well enough. I believe that we need to go back to the psychopathological sources of psychiatry and re-educate ourselves to think in a different way than the way proposed by the oncoming wave of dimensionality.