Diagnoses in and out of time: historical and medical perspectives on the diagnoses of distress

Petteri Pietikainen; Jari Turunen

doi:10.1515/dx-2016-0013

Article

Diagnoses in and out of time: historical and medical perspectives on the diagnoses of distress

Petteri Pietikainen and Jari Turunen

Published/Copyright: February 11, 2017

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From the journal Diagnosis Volume 4 Issue 1

Abstract

Focusing on the medical approach to the subjective forms of distress, this article has a three-fold argument. First, the historical starting point of diagnosing distress was neurasthenia during the last two decades of the 19th century. Second, the diagnosis of neurasthenia that initially contained more somatic than mental symptoms was gradually replaced by the more psychologically conceptualized neuroses. Such a psychiatrization of neurosis gradually separated mental and somatic syndromes into two distinct diagnostic categories, those of mental and somatic. Third, when modern “neuroses” are seen in the framework of distress rather than disease, it provides tools for new kinds of interventions, in which the principal aim is to alleviate the subjective distress with all possible and reasonable means and methods. As the social context constitutes a crucial “etiology” to medicalized forms of distress, we need new, context-based approaches to both analyze and alleviate such distress. In our historical and medical approach to these “diagnoses of distress”, we are guided by the belief that analyzing diagnostic categories can provide important insight into the mechanisms behind our changing conceptions of health and wellbeing.

Keywords: demedicalization; distress; history; neurosis; psychiatry; social context; somatic syndromes

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-4-12

Accepted: 2017-1-3

Published Online: 2017-2-11

Published in Print: 2017-3-1

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https://doi.org/10.1515/dx-2016-0013

Keywords for this article

demedicalization; distress; history; neurosis; psychiatry; social context; somatic syndromes