Interventionism and Intelligibility: Why Depression Is Not (Always) a Brain Disease.

IF 1.3 3区 哲学 Q3 ETHICS Journal of Medicine and Philosophy Pub Date : 2024-03-14 DOI:10.1093/jmp/jhae004
Quinn Hiroshi Gibson
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Abstract

Major depressive disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a "brain disease." What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of MDD to the claim that brain dysfunction causes the symptoms of MDD. I argue that this consequence of the brain disease conception of MDD is false. It incorrectly rules out genuine instances of content-sensitive causation between adverse conditions in the world and the characteristic symptoms of MDD. Empirical evidence shows that the major causes of depression are genuinely psychological causes of the symptoms of MDD. This rules out, in many cases, the "brute" causation required by the brain disease conception. The existence of cases of MDD with non-brute causes supports the reinstatement of the old nosological distinction between endogenous and exogenous depression.

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干预主义与可理解性:为什么抑郁症不是(总是)一种脑部疾病?
重度抑郁障碍(MDD)是一种严重的疾病,其疾病负担很大。人们常说 MDD 是一种 "脑部疾病"。MDD 是一种脑部疾病意味着什么?我认为,对这一说法的最佳解释是,它为抑郁症综合征的病因提供了一个实质性的经验假设。这种疾病的综合征因果概念与 MDD 是一种大脑疾病的观点相结合,使 MDD 的大脑疾病概念成为大脑功能障碍导致 MDD 症状的主张。我认为,多发性硬化症脑病概念的这一后果是错误的。它错误地排除了世界上不利条件与 MDD 特征性症状之间真正的内容敏感因果关系。经验证据表明,抑郁症的主要病因是导致 MDD 症状的真正心理原因。这在许多情况下排除了脑部疾病概念所要求的 "粗暴 "因果关系。存在非 "粗暴 "原因的 MDD 病例,支持恢复内源性抑郁和外源性抑郁之间的旧有分类学区别。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
30
期刊介绍: This bimonthly publication explores the shared themes and concerns of philosophy and the medical sciences. Central issues in medical research and practice have important philosophical dimensions, for, in treating disease and promoting health, medicine involves presuppositions about human goals and values. Conversely, the concerns of philosophy often significantly relate to those of medicine, as philosophers seek to understand the nature of medical knowledge and the human condition in the modern world. In addition, recent developments in medical technology and treatment create moral problems that raise important philosophical questions. The Journal of Medicine and Philosophy aims to provide an ongoing forum for the discussion of such themes and issues.
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