ABSTRACT
The multi-faceted phenomenon known as globalization has a particular impact on the conceptual and practical development of mental health disciplines in general, and psychiatry in particular, across different world regions. To be theoretically and functionally effective, global psychiatry requires an integration of its different components. To such objective, and after a brief review of continental European and Anglo-Saxon contributions, this article examines the history, characteristics, and contributions of Latin/Iberian American and Spanish-speaking psychiatry, in order to substantiate its role in world psychiatry. The Latin American proper (including Portuguese-speaking Brazil), Spain, and U.S.-based Hispanic components are described, revealing an identity that is based on a humanistic tradition, a value-based, culturally-determined clinical approach to patient care, and a pragmatic adaptation of different treatment resources and techniques. These may constitute supportive elements of an instrumental inter-regional bond in the present and future of our discipline.
Subject(s)
Humans , Psychiatry/trends , Mental Health , Internationality , Spain , Hispanic or Latino , Europe , Language , Latin AmericaABSTRACT
El pluralismo de paradigmas que domina a la psiquiatría contemporánea se ha movido históricamente, sin embargo, en el ámbito de la polémica entre reduccionismo y no-reduccionismo. Este artículo examina el tema con definiciones iniciales de reducción (semántica, lógica y ontológica, segúb Nagel) y reduccionismo metodológico, ontológico y constitutivo, este último definido por Myer. Se discute el reduccionismo en biología, neurociencias y, finalmente, en psiquiatría, examinándose los aportes de Popper y sus planteamientos estratégicos para justificar la no-vigencia de un holismo "imposible", Kandel y su "materialismo no-reduccionista", Fulford y Sadler abogando por una dimensión filosófica del diagnóstico psiquiátrico en tanto que evaluación, Wakefield que enuncia a "la psiquiatría como medicina" y Kendler proponiendo un plurarismo explicativo y el alejamiento tanto del dualismo cartesiano como del modelo biopsicosocial de Engel. Se postula, finalmente, la superación de estas polémicas mediante la acepatación de leyespuente en el conocimiento y de explicación y comprensión como resultado de razones y causas, respectivamente, en todo tipo de entidades clínicas en psiquiatría.
The pluralism of paradigms that dominate contemporary psychiatry has moved historically, however, within the reductionism vs. non-reductionism polemics and debates. This article examines the topic with initial definitions of reduction (semantic, logical and ontological, according to Nagel), and of methodological, ontological and constitutive reductionism, the latter defined by Myer. Reductionism in biology, neurosciences and psychiatry is discussed, and several contributions are examined, i.e. Popper´s strategies to justify the irrelevance of an "impossible" holism, Kandel and his "non-reductionistic materialism". Fulford and Sadler advocating a philosophical dimension for psychiatric diagnosis as evaluation, Wakefield enunciating "psychiatry as medicine", and Kendler´s proposal of an explanatory pluralism urging us to take distance from both cartesian dualism and Engel´s biopsychosocial model. The suggestion is made to overcome this polemics through the adoption of bridging laws of knowledge and the acceptance of explanation and understanding as a result of causes and reasons, respectively, in every clinical entity in psychiatry.