Diagnostic Fluidity


Book Description

Diagnostic procedures are emblematic of medical work. Scholars in the field of social studies of medicine identify diverse dimensions of diagnosis that point to controversies, processual qualities and contested evidence. In this anthology, diagnostic fluidity is seen to permeate diagnostic work in a wide range of contexts, from medical interactions in the clinic, domestic settings and other relations of affective work, to organizational structures, and in historical developments. The contributors demonstrate, each in their own way, how different agents ‘do diagnosis’, highlighting the multi-faceted elements of uncertainty and mutability integral to diagnostic work. At the same time, the contributors also show how in ‘doing diagnosis’ enactments of subjectivities, representations of cultural imaginaries, bodily processes, and socio-cultural changes contribute to configuring diagnostic fluidity in significant ways.







Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




Psychiatrization of Society


Book Description

Worldwide, there have been consistently high or even rising incidences of people classified as mentally ill, paired with increasing mental healthcare service utilization over the last decades. While psychiatric institutions have been consistently expanding, psychiatric knowledge has become increasingly dispersed and globalized, making psychiatric vocabularies and classificatory systems widely available, shaping increasing areas of life, creating powerful markets for therapeutic services of all kinds, and impacting how we understand ourselves and others. This process can be described as the psychiatrization of society. Psychiatrization is highly complex, diverse, and global, although it takes different forms in different contexts, involves various actors with largely diverging motives, and is part of a wider assemblage of the psy-disciplines.




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.







The World of Indicators


Book Description

The twenty-first century has seen a further dramatic increase in the use of quantitative knowledge for governing social life after its explosion in the 1980s. Indicators and rankings play an increasing role in the way governmental and non-governmental organizations distribute attention, make decisions, and allocate scarce resources. Quantitative knowledge promises to be more objective and straightforward as well as more transparent and open for public debate than qualitative knowledge, thus producing more democratic decision-making. However, we know little about the social processes through which this knowledge is constituted nor its effects. Understanding how such numeric knowledge is produced and used is increasingly important as proliferating technologies of quantification alter modes of knowing in subtle and often unrecognized ways. This book explores the implications of the global multiplication of indicators as a specific technology of numeric knowledge production used in governance.










Clinical Manual for the Psychiatric Interview of Children and Adolescents


Book Description

The psychiatric interview is the foundation of the psychotherapeutic process and is critically important to establish trust, elicit useful responses, assess patient behavior and psychopathology, and establish treatment goals and plans. Building on the success of its predecessor, a highly regarded guide to interviewing young patients and their families, Psychiatric Interview of Children and Adolescents, has been thoroughly updated and painstakingly revised to address emerging issues and evolving treatment strategies in an accessible, down-to-earth, and comprehensive style and structure. The book retains its comprehensive coverage of the principles of interviewing, use of the AMSIT model for mental status examinations, and evaluation of both internalizing and externalizing symptoms, as well as its coverage of neuropsychiatric assessment, psychiatric formulation, comorbidities, resistances, and countertransference. Additional features, either notable or new to this book, include: The importance of diagnostic and therapeutic engagement in establishing trust with the patient and family, and techniques for forging a positive emotional connection, which the authors view as an essential responsibility for the clinician and a linchpin of successful practice. A new chapter on the psychiatric evaluation of preschoolers and very young children, which recognizes that assessment cannot be conducted based solely on adult report, and which presents the "multiples" model: multiple sessions, multiple informants, multiple experts, multiple modes of assessment, multicultural approach, and multiaxial emphasis. Expanded coverage of bullying, including cyber bullying, which has a pervasive and potentially pernicious effect on young people steeped in social media. Recognition, both throughout the book and in a separate chapter on family assessment, that behavior problems in a child or young adult cannot be understood without the relational context of the family, and that any family member's problems are best understood as manifestations of dysfunctions within the broader family unit. Expanded coverage of the factors and issues involved in evaluating children and adolescents from special populations, including those with neurodevelopmental disorders or intellectual disabilities; those who are disadvantaged, displaced, or victims of discrimination; and those with posttraumatic stress disorder related to terrorism or burn trauma. The book's instructional aims are enhanced by the use of carefully chosen and compellingly crafted clinical vignettes that illustrate vital concepts and techniques, and key points at the end of each chapter help the reader identify and remember the most important material. Psychiatric Interview of Children and Adolescents will help clinicians master the skills and attain the insight they require to accurately assess and effectively treat this most vulnerable of patient populations.