Da prevenção ao manejo do risco: contraste e indefinição na história recente da psiquiatria

Abstract

The purpose of this thesis is to contrast the notion of prevention developed in the United States during the 60´s with the emergence of risk as an alternative notion of preventive bias in contemporary psychiatry. Therefore, I analyze concepts and theories underpinning prevention in the 60´s, investigating how a particular way of explaining disease was articulated to professional interests and social demands, contributing to raise prevention as a fundamental action and main goal of the psychiatric field. Then I analyze recent neuroscientific concepts and theories on the formation of psychopathology and the related risk management proposals that begin to take shape as an alternative to preventive discourses that prevailed in the twentieth century. Finally, I discuss the transformations that explain the decline of prevention and the rise of risk management, connecting modifications in psychiatry to changes in health practices and in the cultural context of late twentieth and early twenty-first centuries. The objectives of the discussion are: to contrast the psychiatric discourses, considering the striking differences between the prevalence of prevention and the risk logic, as well as possible similarities; and to examine, in an exploratory way, some of the alterations that the association between psychiatric categories, risk and health practices may promote in contemporary ways of knowing, experiencing and treating mental pathology.