title: Universal cures for idiosyncratic illnesses: A genealogy of therapeutic reasoning in the mental health field.
abstract: Over the past decades, there has been a significant increase in prescriptions of psychotropic drugs for mental disorders. So far, most of the explanations of the phenomenon have focused on the process of medicalization, but little attention has been cast towards physicians' day-to-day clinical reasoning, and the way it affects therapeutic decision-making. This article addresses the complex relationship between aetiology, diagnosis and drug treatment by examining the style of reasoning underlying prescribing practices through an historical lens. A genealogy of contemporary prescribing practices is proposed, that draws significant comparisons between 19th-century medicine and modern psychiatry. Tensions between specific, standardized cures and specific, idiosyncratic patients have been historically at play in clinical reasoning - and still are today. This inquiry into the epistemological foundations of contemporary drug prescription reveals an underlying search for scientific legitimacy.
authors.affiliation: University of Montreal, Canada johanne.collin@umontreal.ca.
authors.forename: Johanne
authors.initials: J
authors.lastname: Collin
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D000066491:Clinical Decision-Making; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007722:Health Knowledge, Attitudes, Practice; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000266:history*; D008603:Mental Health / Q000266:history*; D010820:Physicians / Q000266:history* / Q000523:psychology; D010818:Practice Patterns, Physicians'; D013850:Thinking
chemical_list: D014150:Antipsychotic Agents
keywords: 19th-century medicine; clinical reasoning; prescription; psychiatry; therapeutics