O problema é como você olha... : de um conjunto amorfo de sintomas não-psicóticos ao nascimento de diagnósticos clínico-psiquiátricos.

Abstract

This study aimed at analyzing the construction of diagnostic categories that are part of the interface between the medical clinic and psychiatry, taking as a case study the Common Mental Disorders and examining the possible consequences that this construction will produce. For this, a documentary analysis of secondary sources was conducted, guided by indications of key informants who contributed to the prospecting of journals, published in the Medline, LILACS and Scielo databases, for the abstraction of abstracts in annals of national and international congresses, as well as the selection of theses and dissertations on the subject in the Bank of Theses of CAPES and in the Brazilian Digital Library of Theses and Dissertations. ninety-three documents published from 1960 to 2019 were selected. The Foucaultian archaeological method and the Kuhnian paradigm concept were used to analyze them, in order to observe the irruptions that marked the production of scientific knowledge on Common Mental Disorders, its permanences and modifications, its approximations and separations. Thus, some movements were observed in the analyzed material: initially, the studies focuses on non-psychotic psychiatric manifestations that occurred in the primary care services in Great Britain, which were not being seen by general practitioners. These cases were "brought to light" by research done in the 1960s, 1970s and 1980s supported by screening instruments such as the General Health Questionnaire (GHQ). Then, health research funding and the "provision of ideas" for policymaking by international agencies, as well as studies on Global Health and the use of Global Disease Load Burden of Disease, used to analyze the health impact of mental disorders on people's daily lives around the world, have contributed to further research in the area. These movements has prepared a fertile ground for mental health actions at the beginning of the 21th century which collaborated in proposing diagnostic categories to be included in the new International Classification of Diseases for Mortality and Morbidity Statistics for Primary Health Care (ICD-11-PHC), which would be: Anxiety Depression, Body Stress Syndrome and Anxiety with Health, materializing in specific diagnostics the concept of Common Mental Disorders. As a result of the analyzes, it was considered that a new dissolution movement concerning the diagnostic boundaries of mental disorders is underway in the Diagnostic and Statistical Manual of Mental Disorders (DSM), in the International Classification of Diseases (ICD) and in its version for primary care (ICD-PHC), which can carry out a "turnabout in psychiatry, especially in its relationship with the medical clinic. Such "turnabout" would constitute a paradigm shift in the mode of elaboration of diagnostic classifications, which is not yet in force in these classificatory systems, but may take place as a future "to come" by the results of joints and sets of forces within and outside academic settings.