title: Keep calm and carry on: Mental disorder is not more "organic" than any other medical condition.
abstract: Psychiatry as a discipline should no longer be grounded in the dualistic opposition between organic and mental disorders. This non-dualistic position refusing the partition along functional versus organic lines is in line with Jean Delay, and with Robert Spitzer who wanted to include in the definition of mental disorder discussed by the DSM-III task force the statement that "mental disorders are a subset of medical disorders". However, it is interesting to note that Spitzer and colleagues ingeniously introduced the definition of "mental disorder" in the DSM-III in the following statement: "there is no satisfactory definition that specifies precise boundaries for the concept "mental disorder" (also true for such concepts as physical disorder and mental and physical health)". Indeed, as for "mental disorders", it is as difficult to define what they are as it is to define what constitutes a "physical disorder". The problem is not the words "mental" or "organic" but the word "disorder". In this line, Wakefield has proposed a useful "harmful dysfunction" analysis of mental disorder. They raise the issue of the dualistic opposition between organic and mental disorders, and situate the debate rather between the biological/physiological and the social. The paper provides a brief analysis of this shift on the question of what is a mental disorder, and demonstrates that a mental disorder is not more "organic" than any other medical condition. While establishing a dichotomy between organic and psychiatry is no longer intellectually tenable, the solution is not to reduce psychiatric and non-psychiatric disorders to the level of "organic disorders" but rather to continue to adopt both a critical and clinically pertinent approach to what constitutes a "disorder" in medicine.
authors.affiliation: Services d'explorations fonctionnelles du système nerveux, clinique du sommeil, CHU de Bordeaux, place Amélie-Raba-Leon, 33076 Bordeaux, France; USR CNRS 3413 SANPSY, CHU Pellegrin, université de Bordeaux, 33000 Bordeaux, France. Electronic address: jarthur.micoulaud@gmail.com.
authors.forename: J A
authors.initials: JA
authors.lastname: Micoulaud-Franchi
authors.affiliation: Pôle universitaire de psychiatrie adulte, centre hospitalier Charles-Perrens, 121, rue de la Béchade, 33076 Bordeaux cedex, France; Université Bordeaux Segalen, 146, rue Léo-Saignat, 33076 Bordeaux cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Quiles
authors.affiliation: Nightingale hospitals Paris, clinique du Château-de-Garches, 92380 Paris, France; Service hospitalo-universitaire, centre hospitalier Sainte-Anne, 75015 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Masson
mesh_terms: D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D004194:Disease / Q000523:psychology*; D004644:Emotions; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology*; D013577:Syndrome
keywords: Disability evaluation; Mental disorders; Physiologie; Physiology; Signes et symptômes; Signs and symptoms; Syndrome; Troubles mentaux; Évaluation du handicap