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The distinction between mental and physical illness

  • R. E. Kendell (a1)
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References
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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Andreasen, N. C. Scheftner, W. Reich, T. et al (1986) The validation of the concept of endogenous depression – a family study approach. Archives of General Psychiatry, 43, 246251.
Canter, A. (1972) Changes in mood during incubation of acute febrile disease and the effects of pre-exposure psychologic status. Psychosomatic Medicine, 34, 424430.
Delgado, P. L. Charney, D. S. Price, L. H. et al (1990) Serotonin function and the mechanism of antidepressant action: reversal of antidepressant-induced remission by rapid depletion of plasma tryptophan. Archives of General Psychiatry, 47, 411418.
Gowers, W. R. (1893) A Manual of Diseases of the Nervous System, Vol. I. Reprinted 1970. New York: Hafner.
Griesinger, W. (1845) Pathologie und Therapie der Psychischen Krankheiten. Reprinted (1867) as Mental Pathology and Therapeutics (trans. C. L. Robertson & J. Rutherford). London: The New Sydenham Society.
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Kendler, K. S. Neale, M. C. Kessler, R. C. et al (1992) A population-based twin study of major depression in women: the impact of varying definitions of illness. Archives of General Psychiatry, 49, 257266.
Porter, R. (1987) Mind-forg'd Manacles, p. 39. London: Athlone Press.
Reynolds, J. R. (1855) The Diagnosis of Diseases of the Brain, Spinal Cord, Nerves and their Appendages. London: Churchill.
Rush, B. (1812) Medical Inquiries and Observations upon the Diseases of the Mind. Philadelphia, PA: Kimber & Richardson.
World Health Organization (1992) International Statistical Classification of Diseases and Related Health Problems. Geneva: WHO.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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The distinction between mental and physical illness

  • R. E. Kendell (a1)
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eLetters

Anti-psychiatry , despite it is short comings , is still upon us!

Tarek M. Shahrour, Consultant Liaison Psychiatrist
02 September 2013

As suggested by the author in the public attitude section of the editorial that the mere distinction between body and mind is a cause of stigma attached to psychiatry. However, Many psychiatrists would argue that physical forms of treatment in psychiatric practice, for example ECT, are often perceived to be stigmatizing by patients and families, especially when compared to less intrusive forms of therapy eg; psychotherapy. In my practice, by and large, it is much easier to persuade patients to undergo psycho therapy than to take a pill, when talktherapy option is available. The argument in favor of a duality view mind/brain gets even more credencewhen non-physical forms of treatment(psychotherapy) is found to be effective in treating some psychiatric disorders, the likes of anxiety andphobias. The anti-psychiatry movement has continued to promote the idea that psychiatric disorders don't exist, simply because all illnesses are physical albeit neurology would suffice. The question here are we by emphasizing the lack of difference between mind and body playing into suchideas.

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Conflict of interest: None declared

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Mind-brain monism and medical training

Mayowa Oyesanya, Medical Student
05 December 2012

Perhaps a way to dispel the idea of 'mental illness' as being separate and distinct from physical illness, is to incorporate the principles of mind brain monism into medical training, more forcefully and with more purpose. There should be an emphasis on the idea that the 'mind' is a construct that allows us to discuss the activity of the brain more easily, rather than being an entirely different entity. Psychiatry and Neurology rotations could even be more explicitly integrated within clinical rotations that take place within medical school.

I can say from experience that this approach might work, since I am currently in a clinical rotation where psychiatry and neurology are taught together. This has allowed me to make more explicit links between the two specialties, and has helped to prevent me from falling into the trap of believing that there is a clear distinction between mental and physical illness.
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Conflict of interest: None declared

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Rephrasing the whole psychiatric terminology.

Padmaja Chalasani, SpR in Psychiatry.
18 January 2006

Kendell raised very important issues that are very relevant not only to the practice and image of psychiatry but would have huge impact on the lives of the patients. It is high time to make concerted international effort to change the terminology to make sure the mind-body dualism doesn't exist in practice. The training of future psychiatrists should be firmly rooted in physiologyand neurology. Psychiatry trainess should stop receiving a confusing account of psychology and social sciences as the 'subjects basic to psychiatry'. The importance of those subjects that are perpetuating the idea of dualismshould be unambiguously limited as aids to recognising what is not a 'disorder' in physiological meaning but is a manifestation of social or psychological distress presented in Psychiatry settings.Perhaps the phrase "The Physiological Disorders with predominant behavioural and psychological manifestations" may be considered to rename the disorders that are treated by psychiatrists. ... More

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