title: Toward a philosophical structure for psychiatry.
abstract: This article, which seeks to sketch a coherent conceptual and philosophical framework for psychiatry, confronts two major questions: how do mind and brain interrelate, and how can we integrate the multiple explanatory perspectives of psychiatric illness? Eight propositions are proposed and defended: 1) psychiatry is irrevocably grounded in mental, first-person experiences; 2) Cartesian substance dualism is false; 3) epiphenomenalism is false; 4) both brain-->mind and mind-->brain causality are real; 5) psychiatric disorders are etiologically complex, and no more "spirochete-like" discoveries will be made that explain their origins in simple terms; 6) explanatory pluralism is preferable to monistic explanatory approaches, especially biological reductionism; 7) psychiatry must move beyond a prescientific "battle of paradigms" to embrace complexity and support empirically rigorous and pluralistic explanatory models; 8) psychiatry should strive for "patchy reductionism" with the goal of "piecemeal integration" in trying to explain complex etiological pathways to illness bit by bit.
authors.affiliation: Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA. kendler@hsc.vcu.edu
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Kendler
mesh_terms: D001689:Biological Psychiatry / Q000458:organization & administration / Q000592:standards; D015984:Causality; D005544:Forecasting; D006801:Humans; D001523:Mental Disorders / Q000209:etiology / Q000523:psychology*; D019222:Mind-Body Relations, Metaphysical; D008960:Models, Psychological; D010686:Philosophy, Medical; D011570:Psychiatry / Q000458:organization & administration* / Q000592:standards / Q000639:trends