How to Measure Depression: Looking Back on the Making of Psychiatric Assessment

IF 2.6 0 PHILOSOPHY Philosophy Psychiatry & Psychology Pub Date : 2023-09-01 DOI:10.1353/ppp.2023.a908275
Philippe Le Moigne
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Abstract

Abstract: This article discusses the way how change in depressed patients included in clinical trials was both conceptualized and measured in the 1970s to decide on the efficacy of the first candidate drugs for the treatment of depression. Understanding how this issue was resolved is of major interest as the protocol designed to distinguish the diagnosis of the depressive syndrome from the measurement of its evolution over time built the contours of the methodological device to which the whole of standardized evaluation in psychiatry has since referred. This paper draws on the debates in nascent psychopharmacology in both the United States and Europe and examines the protocols and findings of the research programs on depression the National Institute of Mental Health (NIMH) has developed in the United States at the same time, as well as on the writings of the main authors of the standardized evaluation. This investigation suggests that measurement of patients’ improvement could not be characterized on the basis of psychiatric inventories that were not well-suited to quantification, nor on the basis of psychometric tests which were intended for the evaluation of psychological invariants. This is why the answer given to the characterization of change in depression under therapy rather reveals a syncretism both conceptual and technical, mixing classificatory and psychometric traditions, a syncretism that the distinction endorsed by the Diagnostic and Statistical Manual of Mental Disorders , 3rd edition,between syndromes and personality disorders no longer allows us to perceive.
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如何测量抑郁症:回顾精神病学评估的制定
摘要:本文讨论了20世纪70年代临床试验中抑郁症患者的变化是如何被概念化和测量的,以确定第一批治疗抑郁症的候选药物的疗效。理解这个问题是如何解决的是一个重要的兴趣,因为该协议旨在区分抑郁综合征的诊断与测量其随时间的演变,建立了方法学设备的轮廓,整个精神病学的标准化评估从此被提及。本文借鉴了美国和欧洲新兴精神药理学的争论,并考察了美国国家精神卫生研究所(NIMH)同时在美国开展的抑郁症研究项目的协议和发现,以及标准化评估主要作者的著作。这项调查表明,对患者改善的测量不能基于不适合量化的精神病学调查,也不能基于旨在评估心理不变量的心理测量测试。这就是为什么对治疗下抑郁症变化特征的回答揭示了一种概念和技术上的融合,混合了分类和心理测量传统,这种融合被第三版《精神疾病诊断和统计手册》所认可,综合症和人格障碍之间的区别不再允许我们感知。
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来源期刊
CiteScore
3.60
自引率
4.30%
发文量
40
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The Limits of Self-Constitution How to Measure Depression: Looking Back on the Making of Psychiatric Assessment Psychodramatic Psychotherapy for Schizophrenic Individuals About the Authors Close Enemies: The Relationship of Psychiatry and Psychology in the Assessment of Mental Disorders
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