SPECIAL SESSIONS
343
LECTURES
wed, 26 nov 2014
09.00 – 10.00 h
|
Hall A8
E
U
D
Lifestyle and the aging brain
Chair:
Steffi G. Riedel-Heller, Leipzig (Germany)
Wolfgang Hoffmann, Greifswald (Germany)
Speaker:
Monique M. B. Breteler, Bonn (Germany)
thu, 27 nov 2014
13.30 – 14.30 h
|
Hall A6
E
U
D
Diagnostic systems in psychiatry: utility, use,
limitations and future prospects
Chairs:
Wolfgang Gaebel, Düsseldorf (Germany)
Fritz Hohagen, Lübeck (Germany)
Speaker:
Mario Maj, Naples (Italy)
The recent publication of the DSM-5 has revived the debate on the utility and limitations
of diagnostic systems in psychiatry. This presentation summarizes the problems with the
reliability of psychiatric diagnosis which prompted the development of the DSM-3 and ICD-
9; provides a picture of the current use of the DSM and ICD in ordinary practice worldwide;
discusses the need to assess systematically the pros and cons of the operational and proto-
type approaches to psychiatric diagnosis, with a special focus on their applicability in ordi-
nary practice and clinical utility; considers different views about what qualifies as mental
disorder and how the boundary between pathology and normality should be fixed for each
mental disorder; reviews the role of laboratory tests as applied in medicine, emphasizing
that most of them are probabilistic, not pathognomonic, markers of disease, and that their
availability has not prevented some non-psychiatric conditions which are on a continuum
with normality to become the subject of controversy as to the appropriate “threshold” for
the diagnosis. Finally, it summarizes the promise and limitations of the Research Domain
Criteria project, aiming to “transform psychiatric diagnosis”, and the currently ongoing ef-
forts to develop a dialogue between that project and the process of revision of the ICD-10.
(e.g. MMPI, NEO-PI), personality disorders (e.g. SCID-II) or the most frequent mental dis-
orders (e.g. MINI, SCID) will not cover all possibilities. Skilled psychiatrists with additional
training in psychology and neuropsychiatry have unique potentials to provide crucial infor-
mation that may help to understand extreme violence. This presentation will be illustrated
with case-stories elucidating how the mix of some of the factors mentioned above have lead
to extreme acts of violence.
