Psykiatrisk sygdomsforståelse - En teoretisk undersøgelse af ændringer i sygdomsforståelse ifm. diagnosemanualerne samt psykofarmakaindustriens indvirkning herpå

Abstract

The aim of this thesis was to gain knowledge about the conception and understanding of mental illness in Denmark through the following research question; In which ways is the conception and understanding of mental illness expressed in relation to the psychiatric discipline, and how does respectively the diagnostic manuals and the psychopharmacological industry affect upon this? Build upon a theoretical exploration, and through several systematic literature reviews, this study contains a humanistic perspective dealing with a historical-hermeneutical approach and is qualitatively oriented. The initial motive behind forming this paper derived from a wonder about the degree of fragility concerned with the way we understand and define mental illness, and an interest in examining some of the potential components influencing this matter. This was done through examination and discussion of three related and supplementing components: the main component was the conception and understanding of mental illness and this was explored in relation to psychiatric diagnostic manuals and the psychopharmacology industry. The first examination regards how the conception and understanding of mental illness is described in a historical and a current perspective. We have created an insight into essential aspects of the historical perspective, as well as considered the complexity in a current context, and can hereby conclude that extensive changes have taken place over the years. Furthermore, we found that there has been, and continues to be, disagreement regarding the way mental illness should be defined and understood as well as pathology and normality are dictated by time and culture. The conception and understanding regarding mental illness is a phenomenon with extensive complexity and it seems to continue this way. The second component, psychiatric diagnostic manuals, was found to have had significant influence over time, and at present, on the way in which mental illness is understood and defined. In particular, the current dominant approach is a biomedical understanding dealing with mental illness as neural dysfunctions and in this regard it is argued that the psychopharmacology industry has contributed to an extension of this approach which was further examined, regarding the last component: the psychopharmacology industry. In this concern, we found several arguments that the industry seems to influence the conception and understanding of mental illness in Denmark. It was discussed that the industry has contributed to the development of psychiatric drugs, which can be seen as a prerequisite for the expansion of some psychiatric diagnoses, as well as for the development of the psychiatric diagnostic manuals. Furthermore, it was found that the connection between the industry and doctors seems to influnce the doctor's understanding of illness in some respect and also some parts of the diagnostic practice. By relating the components, we found a strong degree of reciprocal influence across all three components. There was a clear connection between the conception and understanding of mental illness, the psychiatric diagnostic manuals and the psychopharmacology industry, confirming our initial hypothesis. This could be seen, among other things, by the fact that the manuals dictate how diagnostic practice are to be performed and thus also which understanding of mental illness the practitioner should take; that the biomedical understanding expressed in the manuals has affected the number of diagnoses, as well as the fact that the conception of normality and pathology depends on the given time and culture, which represents a point of criticism regarding the biomedical anchoring of the manuals. Furthermore, we have discussed, that the increasing demands of today's society can lead to an expansion of the inquiry for psychiatric drugs, as well as the industry, by times, develop drugs prior to the definition and notion of a diagnosis in the manuals and by this, the industry seems to be a potential influence dictating what is normal and what is pathological. As to this regard it stands clear that the three components combined has contributed to the fact that conditions that were previously considered to be within the norm are currently pathologized and, as an effect, that the number of diagnoses in the manuals has increased as well as the use and development of psychiatric drugs has elevated, which we see as a problematic development that the psychiatric professionals needs more awareness about. On the behalf of this thesis it was concluded that the relation between the way we understand and define mental illness and how this is influenced is quite complex. Through this thesis we have confirmed the initial hypothesis that the conception and understanding regarding mental illness is influential from several potential areas as well as in constant development and dictated by the given time and culture. This fragility and affectivity is an area that extensively lacks scientific exploration, especially in a Danish context, which underlines the relevance and importance of this thesis.

A master thesis from Aalborg University

Psykiatrisk sygdomsforståelse - En teoretisk undersøgelse af ændringer i sygdomsforståelse ifm. diagnosemanualerne samt psykofarmakaindustriens indvirkning herpå

[Psychiatric disease conception - A theoretical examination of ways in which the conception of mental illness is expressed and how this is affected by the diagnostic manuals and the psychopharmacological industry]