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date: 15 November 2019

Abstract and Keywords

Psychiatric diagnosis and prognosis is fraught with important philosophical and conceptual problems. This chapter focuses on some epistemological issues (What evidence justifies the belief that a course of treatment is effective?) and moral issues (What is a just distribution of scarce psychiatric resources given the many people with psychiatric conditions whose suffering could be alleviated with treatment?) that arise in contemporary psychiatric practice. It examines various clinical and actuarial techniques for psychiatric diagnosis, ordered very loosely in terms of how "structured" or "automated" they are (or, put another way, ordered according to how much freedom the individual clinician has in carrying out the diagnostic method). The chapter makes the case for assessing psychiatric treatments with controlled experiments, raises several epistemological dangers that arise from relying on uncontrolled investigations, and considers some of the unique methodological and ethical issues that arise when trying to assess talk therapy.

Keywords: actuarial, clinical, cognitive behavioral therapy, controlled experiments, diagnosis, prognosis, placebo, symptom, talk therapy, treatment

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