Pregledni rad

PHILOSOPHY OF CLINICAL PSYCHOPHARMACOLOGY

Massimiliano Aragona ; Association Crossing Dialogues, Rome, Italy

Sažetak

The renewal of the philosophical debate in psychiatry is one exciting news of recent years. However, its use in
psychopharmacology may be problematic, ranging from self-confinement into the realm of values (which leaves the evidence-based
domain unchallenged) to complete rejection of scientific evidence. In this paper philosophy is conceived as a conceptual audit of
clinical psychopharmacology. Its function is to criticise the epistemological and methodological problems of current neopositivist,
ingenuously realist and evidence-servant psychiatry from within the scientific stance and with the aim of aiding psychopharmacologists
in practicing a more self-aware, critical and possibly useful clinical practice.
Three examples are discussed to suggest that psychopharmacological practice needs conceptual clarification. At the diagnostic
level it is shown that the crisis of the current diagnostic system and the problem of comorbidity strongly influence psychopharmacological
results, new conceptualizations more respondent to the psychopharmacological requirements being needed. Heterogeneity of
research samples, lack of specificity of psychotropic drugs, difficult generalizability of results, need of a phenomenological study of
drug-induced psychopathological changes are discussed herein. At the methodological level the merits and limits of evidence-based
practice are considered, arguing that clinicians should know the best available evidence but that guidelines should not be
constrictive (due to several methodological biases and rhetorical tricks of which the clinician should be aware, sometimes
respondent to extra-scientific, economical requests). At the epistemological level it is shown that the clinical stance is shaped by
implicit philosophical beliefs about the mind/body problem (reductionism, dualism, interactionism, pragmatism), and that philosophy
can aid physicians to be more aware of their beliefs in order to choose the most useful view and to practice coherently. In
conclusion, psychopharmacologists already use methodological audit (e.g. statistical audit); similarly, conceptual clarification is
needed in both research planning/evaluation and everyday psychopharmacological practice.

Ključne riječi

philosophy – epistemology – psychopharmacology - evidence-based psychiatry – pragmatism - conceptual analysis

Hrčak ID:

159097

URI

https://hrcak.srce.hr/159097

Datum izdavanja:

4.3.2013.

Posjeta: 826 *