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At least 19 recordsLinked to original sources
PubMed1990

A critique of the scientific status of biological psychiatry.

Biological psychiatry has four principal modes of investigation but each has been flawed by errors in procedure and inference such that the bulk of existing findings must be called into question. Pedigree studies are ruined by selective adoption, the use of "throw-away kids" to demonstrate so-called genetic effects, lack of case history data, and lapses in "blind" diagnosis. In particular, the Danish adoption studies are challenged, despite the field's insistence that this research has settled the nature-nurture controversy in schizophrenia. Pharmacological-response studies are the next line of methodology and these are marred by a spurious assumption that drugs which work must be correcting a biochemical imbalance that causes the condition. Thirdly, neuropsychological-neurophysiological studies are "heuristic" fishing-expeditions to find a presumed abnormality to account for psychopathology, without doing the prospective longitudinal research necessary to validate such theory. Lastly, biochemical correlates of emotion are treated as if each emotion must have a distinct neuronal substrate rather than possibly representing a general visceral arousal where cognition defines the feeling. All told, biological psychiatry is often more reductionist than acknowledged, does not come up to current scientific standards, and uncritically cites work which is, or should be, discredited. At the heart of the problem is an implicit ideology within biological psychiatry, with insufficient awareness of its social ramifications: "blaming the victim's body" protects the status quo by holding protoplasm at fault for maladjustment rather than the person, family, or community.

Adaptation, Psychological↗
PubMed2002

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders, Part 1: Acute and continuation treatment of major depressive disorder.

These practice guidelines for the biological treatment of unipolar depressive disorders were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal for developing these guidelines was to systematically review all available evidence pertaining to the treatment of unipolar depressive disorders, and to produce a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating patients with these conditions. The data used for developing these guidelines have been extracted primarily from various national treatment guidelines and panels for depressive disorders, as well as from meta-analyses and reviews on the efficacy of antidepressant medications and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and was then categorized into four levels of evidence (A-D). This first part of the guidelines covers disease definition, classification, epidemiology and course of unipolar depressive disorders, as well as the management of the acute and continuation-phase treatment. These guidelines are primarily concerned with the biological treatment (including antidepressants, other psychopharmacological and hormonal medications, electroconvulsive therapy, light therapy, adjunctive and novel therapeutic strategies) of young adults and also, albeit to a lesser extent, children, adolescents and older adults.

Adolescent↗
PubMed2002

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders, Part 2: Maintenance treatment of major depressive disorder and treatment of chronic depressive disorders and subthreshold depressions.

These practice guidelines for the biological treatment of unipolar depressive disorders were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal for developing these guidelines was to systematically review all available evidence pertaining to the treatment of the complete spectrum of unipolar depressive disorders, and to produce a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating patients with these conditions. The data used for developing these guidelines have been extracted primarily from various national treatment guidelines and panels for depressive disorders, as well as from meta-analyses and reviews on the efficacy of antidepressant medications and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and was then categorized into four levels of evidence (A-D). The first part of these WFSBP guidelines on unipolar depressive disorders covered the acute and continuation treatment of major depressive disorder (Bauer et al 2002). This second part of the guidelines covers the management of the maintenance-phase treatment of major depressive disorder, as well as the treatment of chronic and subthreshold depressive disorders (dysthymic disorder, double depression, minor depressive disorder and recurrent brief depression). These guidelines are primarily concerned with the biological treatment (including antidepressants, lithium, other psychopharmacological and hormonal medications, and electroconvulsive therapy) of young adults and also, albeit to a lesser extent, children, adolescents and older adults.

Adolescent↗
PubMed2002

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of bipolar disorders. Part I: Treatment of bipolar depression.

These practice guidelines for the biological, mainly pharmacological treatment of bipolar depression were developed by an international task force of the World Federation of Societies of Biological Psychiatry (WFSBP). Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of bipolar depression. The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, and from recent proceedings of key conferences and various national and international treatment guidelines. Their scientific rigor was categorised into four levels of evidence (A-D). As these guidelines are intended for clinical use, the scientific evidence was not only graded, but also commented on by the experts of the task force to ensure practicability.

Antidepressive Agents↗
PubMed1996

Biological psychiatry in perspective.

Biological psychiatry is a technical term that denotes physiological and biochemical approaches to psychiatric aetiology and, despite the usual wider meaning of the word biological, excludes psychosocial approaches. 'Biological' causes of severe psychiatric disorder have been suspected from the earliest times, and in some periods an excessive focus upon them has led to neglect of psychological and social approaches to treatment, to the detriment of patients. It is important that current research into biological psychiatry should be carried forward in conjunction with the important advances that have been made in psychological and social research. The causes of psychiatric illness are complex and it is unlikely that any single approach, biological or psychosocial, will be sufficient on its own. The great potential of biological psychiatry will be realized only if it is viewed within these wider historical and scientific perspectives.

Biological Psychiatry↗
PubMed2006

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: long-term treatment of schizophrenia.

These guidelines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal during the development of these guidelines was to review systematically all available evidence pertaining to the treatment of schizophrenia, and to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating people with schizophrenia. The data used for developing these guidelines have been extracted primarily from various national treatment guidelines and panels for schizophrenia, as well as from meta-analyses, reviews and randomised clinical trials on the efficacy of pharmacological and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into four levels of evidence (A-D). This second part of the guidelines covers the long-term treatment as well as the management of relevant side effects. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication, other pharmacological treatment options, electroconvulsive therapy, adjunctive and novel therapeutic strategies) of adults suffering from schizophrenia.

Antipsychotic Agents↗
PubMed2005

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, Part 1: acute treatment of schizophrenia.

These guide lines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBO). The goal during the development of these guidelines was to review systematically all available evidence pertaining to the treatment of schizophrenia, and to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating people with schizophrenia. The data used for developing these guidelines have been extracted primarily from various national treatment guidelines and panels for schizophrenia, as well as from meta-analyses, reviews and randomised clinical trials on the efficacy of pharmacological and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into four levels of evidence (A-D). This first part of the guidelines covers disease definition, classification, epidemiology and course of schizophrenia, as well as the management of the acute phase treatment. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication, other pharmacological treatment options, electroconvulsive therapy, adjunctive and novel therapeutic strategies) of adults suffering from schizophrenia.

Acute Disease↗
PubMed1979

[Continuing Education Course of the Swiss Society for Psychiatry. Biological aspects of psychiatry. Introduction].

The author traces the prestigious history of the Burghölzli, cradle of Swiss psychiatry. He also describes the outstanding role played by Zurich as the city in which integration took place between the developing psychiatry, psycho-analysis, psychodynamics and biological research. The author shows how psychiatry, which had been faced with the mechanistric and philosophical dilemma of an epoch, could disengage from the dangers of a reductive approach thanks to Freud's influence, as well as the knowledge produced by biological and psychopathological discoveries. A new equilibration was, thus, found and a multidimensional model came into being. Today psychiatrists may choose to become either clinicians, or psychoanalysts, or devote themselves to research. Contract has become essential as well as the recognition of these different domains, this in order to improve the understanding of mental disorder.

Academic Medical Centers↗
PubMed2004

The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders, part III: maintenance treatment.

As with the two preceding guidelines of this series, these practice guidelines for the pharmacological maintenance treatment of bipolar disorder were developed by an international task force of the World Federation of Societies of Biological Psychiatry (WFSBP). Their purpose is to supply a systematic overview of all scientific evidence relating to maintenance treatment. The data used for these guidelines were extracted from a MEDLINE and EMBASE search, from recent proceedings from key conferences and various national and international treatment guidelines. The scientific justification of support for particular treatments was categorised into four levels of evidence (A-D). As these guidelines are intended for clinical use, the scientific evidence was not only graded, but also reviewed by the experts of the task force to ensure practicality.

Anticonvulsants↗
PubMed2003

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders, Part II: Treatment of Mania.

Identical to the preceding guidelines of this series, these practice guidelines for the biological, mainly pharmacological treatment of acute bipolar mania were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute mania. The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, from recent proceedings of key conferences, and from various national and international treatment guidelines. Their scientific rigor was categorised into four levels of evidence (A-D). As these guidelines are intended for clinical use, the scientific evidence was finally not only graded, but has also been commented by the experts of the task force to ensure practicability. Key words: bipolar disorder, mania, acute treatment, evidence-based guidelines, pharmacotherapy, antipsychotics, mood stabiliser, electroconvulsive therapy.

Algorithms↗
PubMed2005

Forthcoming ethical issues in biological psychiatry.

Ethical issues in biological psychiatry are framed by (i) progress in the neurosciences, and (ii) a changing socio-cultural context. With regard to forthcoming neurotechniques to modify specifically defined brain functions by pharmacological substances with selective effects, by activating neuroplasticity including neurogenesis, or by implantation of neuronal tissues or computer-brain interfaces, etc., ethical problems will develop (i) at the border between therapy of diseases and enhancement of abilities in healthy people with regard to effects on society (e.g., social justice: equal access, loss of societal diversity) as well as on human value systems (e.g., personality, efforts, conditio humana), and (ii) at the border between the medical system and the wellness market with regard to financing what by whom? Ethical dilemmas in psychiatry develop (i) between the individual's best and the common good (demanded from outside medicine), (ii) among different ethical principles (inside medicine), iii) if solutions are influenced by personal reasons without observing ethical principles. Ethical guidelines are necessary for ethical orientation, but may protect against misconduct only (i) if psychiatrists are educated in ethics and (ii) if psychiatric acting is under continuous debate (by ethical review boards or the public). Thus, if we psychiatrists will become ethically sensitive by reflecting and perhaps solving our current ethical dilemmas we will be prepared to deal with forthcoming ethical issues in biological psychiatry.

Biological Psychiatry↗
PubMed1990

Towards a rationalization of biological psychiatry: a study in psychobiological epistemology.

Contemporary biological psychiatry is in a seemingly inchoate state. I assert that this state of biological psychiatry is due to its violation of an epistemological criterion of rationality, i.e., the relevance criterion; that is, contemporary biological psychiatry is irrational as it adopts a conception irrelevant to the psychobiological domain. This conception is mechanistic. The irrationality of biological psychiatry is manifest as the dominance of neurochemical explanations of psychopharmacological correlations, resulting in predictive sterility and, correspondingly, in the dominance of serendipity. I suggest a rationalization of biological psychiatry through a conception relevant to the psychobiological domain. This conception is hierarchical.

Biological Psychiatry↗
PubMed2001

Past, present and future of biological psychiatry.

These excerpts from the Presidential Address at the 7th World Congress of Biological Psychiatry, Berlin, 2001 attempt to define the term "biological psychiatry", the principle relevance of diagnostic systems for biological psychiatry and the relevance of biological psychiatry in the past and future for the development of psychiatry in general. They also cover the problem of misuse of biological psychiatry and the need for the rigorous observation of ethical standards.

Biological Psychiatry↗
PubMed1988

Biological psychiatry and ethics.

The crucial concept of biological psychiatry - comprising psycho-chemistry, psycho-physiology and psycho-pharmacology and based on a positivistic scientific view - is explanation through the demonstration of causal material connections. Conversely the central concept of the psycho-dynamic schools, based on a hermeneutic-finalistic ideology, is understanding, pertinent to the meaning of psychical symptoms. The two models are not mutually exclusive but represent complementary concepts whose mutual scientific value can only be measured through their mutual utility as basis for etiological research and for the choice of treatment. Since the age of Enlightment in the 18th century the concept of reason in the shape of an unambigous scientific attitude extensively has rendered the ethics redundant. However, our time is characterized by a reaction against this rationalistic concept about science as a substitute for morality. First of all biological psychiatry, based on the methods of the natural sciences, has been the subject of denunciation and underevaluation with deep emotional undertones. The anti-psychiatric movement, the "critical psychiatry", talks about the psychotic patient as the scapegoat, carrying the burden of the relatives conflicts on his shoulders - thus reintroducing the concept of guilt in the debate. The author claims that the relief for this guilt feeling will be found in the paradigme who regards the endogenous psychoses as biologically determined diseases and not simply as reactions to psychological and social strain. The moral-philosophical counterpart to the antagonism: positivism versus hermeneutics is found in the dualism: determinism versus indeterminism.(ABSTRACT TRUNCATED AT 250 WORDS)

Biological Psychiatry↗