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When I began my psychiatric residency training in Boston in the late 1950s, sociologists and other social scientists were active members of many major academic departments of psychiatry. Collaboration between psychiatrists and sociologists and anthropologists was widespread and had considerable influence on theory and clinical practice. NIMH had established its Laboratory of Socio-Environmental Studies under the leadership of John Clausen. Sociologists and anthropologists were active in policy-making and research activities at NIMH and at many foundations. The influential works of Stanton and Schwartz (1954), Hollingshead and Redlich (1958), and Greenblatt, Levinson, and Williams (1957) reflect this period of collaboration. Over the subsequent three decades, the relationship between sociology and psychiatry changed considerably. Now relatively few academic departments of psychiatry have social scientists on their full-time faculty. Interaction between psychiatrists and social scientists, in many instances, has become adversarial. This adversarial quality, I believe, is reflected in the paper by Mirowsky and Ross. Their paper illustrates a genre of social science criticism of psychiatry which challenges the scientific validity of the concept of mental illness and raises important issues in measurement. Mirowsky and Ross, however, go beyond the scientific issues; they offer a social criticism of recent changes in psychiatry which they perceive to be the "legacy of nineteenth-century epidemiology and microbiology." Mirowsky and Ross are correct in their perception that significant shifts have occurred within psychiatry over the past decade. Yet their historical reconstruction of those changes and their understanding of the scientific basis for current research and clinical practice are seriously limited; they reflect their ideological commitment more than an appreciation of the increased sophistication of recent theoretical discourse and empirical research in psychiatry. In my commentary I will attempt to correct this imbalance by reconstructing the recent history and by explicating the rationale behind the current approach to psychiatric diagnostic categories. [ABSTRACT FROM AUTHOR]

This paper examines the process of psychiatric diagnosis in a community mental health center walk-in clinic. The results indicate a great deal of conflict and contradiction in the psychiatric evaluation. This is discussed in light of several tensions: (1) mixed agendas surrounding diagnosis; (2) conflict between training and professional practice; (3) conflict created when a public facility is staffed by an elite medical school; (4) conflict between providing mental health services while serving the needs of other public agencies and mandates; and (5) conflict between an ascendant biopsychiatric model and the daily work of clinical therapeutic service. [ABSTRACT FROM AUTHOR]

Objective: The aim of this review was to explore the current evidence for conversational agents or chatbots in the field of psychiatry and their role in screening, diagnosis, and treatment of mental illnesses.Methods: A systematic literature search in June 2018 was conducted in PubMed, EmBase, PsycINFO, Cochrane, Web of Science, and IEEE Xplore. Studies were included that involved a chatbot in a mental health setting focusing on populations with or at high risk of developing depression, anxiety, schizophrenia, bipolar, and substance abuse disorders.Results: From the selected databases, 1466 records were retrieved and 8 studies met the inclusion criteria. Two additional studies were included from reference list screening for a total of 10 included studies. Overall, potential for conversational agents in psychiatric use was reported to be high across all studies. In particular, conversational agents showed potential for benefit in psychoeducation and self-adherence. In addition, satisfaction rating of chatbots was high across all studies, suggesting that they would be an effective and enjoyable tool in psychiatric treatment.Conclusion: Preliminary evidence for psychiatric use of chatbots is favourable. However, given the heterogeneity of the reviewed studies, further research with standardized outcomes reporting is required to more thoroughly examine the effectiveness of conversational agents. Regardless, early evidence shows that with the proper approach and research, the mental health field could use conversational agents in psychiatric treatment. [ABSTRACT FROM AUTHOR]

The article is a rejoinder to comments regarding an article on the assessment of mental and emotional problems published in the "Journal of Health and Social Behavior". The claims equate assessment of a person's specific type of health problem categorical assessment. The authors believe that these errors are encouraged by the traditional concepts of medicine, in which symptoms are manifestations of specific, unseen organisms or lesions. There are few objective bases for the cut points and concatenation rules that define the categories of DSM-III and the DIS psychodiagnostic measures. Yet they insist that a categorical typology is essential for precise assessment. None gives a single reason why a uniform typology is superior to a uniform set of indexes representing the dimensions of interest, such as the degree of depression, paranoia, schizophrenia and social functioning.

The Mirowsky-Ross article "Psychiatric Diagnosis as Reified Measurement" is most remarkable for its derisive attitude toward clinical psychiatrists and their fellow travelers among the ranks of social workers, psychologists, nurses, and even sociologists. The emotional thrust of this article seems to be that psychiatrists have foisted the "language of categories" on unwitting co-workers, patients, and the nosologic field, constructing "mythical entities" for the "social construction of the need for mental health services." Thus the language of categories is the language of the psychiatric guild. Unfortunately, the hortatory message of the article promulgates its own guild polemic. We are hard pressed to discern where the authors stand on the existence of these "mythical entities." Are they suggesting that mental illnesses and the need for treatment are themselves myths or mere social constructions? If this was not intended, it should be made absolutely clear: there truly are mentally ill people with tormented families who do not give a hoot about measurement but who care a great deal that we are slowly, too slowly, finding effective somatic and psychological treatments for these "entities. [ABSTRACT FROM AUTHOR]