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Language in psychiatry: a bedevilling dictionary

  • Joseph M. Pierre and Allan Frances
Summary

The language of psychiatry can be ambiguous and idiosyncratic, reflecting the elastic borders of mental illness and psychiatric disorder. This problem is not unique to psychiatry, but as the medical specialty moves closer towards a 'spectrum view’ of mental illness, psychiatric terminology increasingly risks misappropriation and conflation with lay concepts of normal suffering. Deciding what words mean and how psychiatric disorders are defined requires ongoing consideration of the pragmatic consequences, both intended and unintended. Refining the lexicon of psychiatry with an eye towards precision and the minimisation of stigma requires that terms be revised and updated from time to time, but often suitable word replacements remain elusive.

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Copyright
Corresponding author
Dr Joseph M. Pierre, Schizophrenia Treatment Unit, West Los Angeles VA Medical Center, 11301 Wilshere Boulevard, Bulding 210, Los Angeles, CA 90073, USA. Email: joseph.pierre2@va.gov
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References
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American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn). APA.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn). APA.
Frances, A (2010) DSM in philosophyland: curiouser and curiouser. Association for the Advancement of Philosophy and Psychiatry (AAPP) Bulletin, 17: 3-7.
Frances, A (2014) RDoC is necessary, but very oversold. World Psychiatry, 13: 47–9.
Parker, G, Fink, M, Shorter, E et al (2010) Issues for DSM-5: whither melancholia? The case for its classification as a distinct mood disorder. American Journal of Psychiatry, 167: 745–7.
Philips, J, Frances, A, Cerullo, MA et al (2012) The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis. Philosophy, Ethics, and Humanities in Medicine, 70: 3.
Pierre, JM (2010) The borders of mental disorder in psychiatry and the DSM: past, present, future. Journal of Psychiatric Practice, 16: 375–86.
Pies, R (2007) How ‘objective’ are psychiatric diagnoses? (Guess again) Current Psychiatry, 6: 18-22.
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BJPsych Advances
  • ISSN: 2056-4678
  • EISSN: 2056-4686
  • URL: /core/journals/bjpsych-advances
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Language in psychiatry: a bedevilling dictionary

  • Joseph M. Pierre and Allan Frances
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