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Alcuni recenti editoriali del British Journal of Psychiatry hanno argomentato che la psichiatria sta attraversando una crisi, e che tra le soluzioni vi sarebbe un rafforzamento della sua identita come essenzialmente "neuroscienza applicata". Senza sminuire l’importanza delle neuroscienze e della psicofarmacologia, gli Autori sostengono che la psichiatria deve superare l’attuale paradigma tecnologico dominante. Questo rifletterebbe maggiormente le evidenze empiriche e servirebbe anche a rafforzare una collaborazione piu significativa col movimento degli utenti dei servizi psichiatrici. Vengono presi in rassegna vari studi controllati randomizzati (RCT) che mostrano l’efficacia degli interventi non specifici e non tecnologici.

What makes a good psychiatrist? What particular skills are needed to practice a ‘medicine of the mind’? Although it is impossible to answer such questions fully we believe that there is mounting evidence that good practice in psychiatry primarily involves engagement with the non-technical dimensions of our work such as relationships, meanings and values. Psychiatry has thus far been guided by a technological paradigm that, although not ignoring these aspects of our work, has kept them as secondary concerns. The dominance of this paradigm can be seen in the importance we have attached to classification systems, causal models of understanding mental distress and the framing of psychiatric care as a series of discrete interventions that can be analysed and measured independent of context. 1 In recent years this Journal has published a series of editorials arguing that the profession should adopt an even more technological and biomedical identity, and that psychiatrists should focus on their mastery of technology to allow progress in the development of brain research, genetics, pharmacology and neuroradiology. 2–4 These resonate with calls in North

The validity and utility of psychiatric diagnoses have long been a bone of contention between and within different professional and patient groups. This was clearly shown by the nearly 70 rapid responses to a 2001 BMJ article that proposed that post-traumatic stress disorder was a social construct