Movements of Moods: Interplay Between Science, Clinical Practice and Patient in Psychiatry

    Forskningsoutput: AvhandlingDoktorsavhandlingMonografi

    Sammanfattning

    The starting point for this research in science and technology studies is the diagnostic uncertainty inherent in psychiatry. Despite the advances in the neurosciences, there are no biomarkers for mental disorders and the diagnosis is based on the descriptive classifications in diagnostic manuals. This leaves the symptoms open for interpretation. This research is an ethnographic analysis of how this diagnostic uncertainty is dealt with in psychiatric science, clinical practice and patients experiences. The research uses bipolar disorder in Finland as a case study, allowing an empirical analysis of psychiatry as a global and complex assemblage of interdependent economic, political, social and scientific endeavours. The focus is on the interplay between scientific knowledge, clinical practice and patients' experiences, as well as the mundane practices of both experts and patients in getting along with the diagnostic uncertainty inherent in psychiatry. The research draws from Annemarie Mol s work in analysing what is enacted within the practices in science, clinic and patients lives. The ideals of objectivity and translatability are enacted in bipolar disorder research. The scientists need to balance between these ideals and the variability of patients in the messy clinical reality. In clinical practice, the ideals of evidence-based medicine and the recommendations of clinical practice guidelines are put into effect. Clinicians diagnosing and treating the patients need to balance between the generalised knowledge and the individuality of the patients symptoms and life situations. Patients enact their individual genes, hormones, brains, life situations, diets, sleep rhythms and ways of experiencing bipolar disorder. Patients with bipolar disorder diagnosis need to live with the diagnostic uncertainty in their day-to-day lives of evaluating the mood swings and adjusting to the interventions attempting to cure, alleviate and control their disorder. The research concludes that the inherent diagnostic uncertainty in psychiatry is stabilised and coordinated by the help of the standardised classifications, diagnostic tools and evidence-based clinical practice guidelines. The remaining problem is: how to overcome the inconsistency between the objective universal knowledge of science and the variety of the particular patients and their subjective experiences?
    Originalspråkengelska
    Förlag
    Tryckta ISBN978-951-51-1992-6
    Elektroniska ISBN978-951-51-1993-3
    StatusPublicerad - 5 mars 2016
    MoE-publikationstypG4 Doktorsavhandling (monografi)

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