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Jacob KS. DSM-5 and culture: the need to move towards a shared model of care within a more equal patient-physician partnership. Asian J Psychiatr. 2013;7(1):89-91doi: 10.1016/j.ajp.2013.11.012.
Jacob, K. S. (2014). DSM-5 and culture: the need to move towards a shared model of care within a more equal patient-physician partnership. Asian journal of psychiatry, 7(1), 89-91. https://doi.org/10.1016/j.ajp.2013.11.012
Jacob, K S. "DSM-5 and culture: the need to move towards a shared model of care within a more equal patient-physician partnership." Asian journal of psychiatry vol. 7,1 (2014): 89-91. doi: https://doi.org/10.1016/j.ajp.2013.11.012
Jacob KS. DSM-5 and culture: the need to move towards a shared model of care within a more equal patient-physician partnership. Asian J Psychiatr. 2014 Feb;7(1):89-91. doi: 10.1016/j.ajp.2013.11.012. Epub 2013 Dec 01. PMID: 24524720.
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Asian J Psychiatr. 2014 Feb;7(1):89-91. doi: 10.1016/j.ajp.2013.11.012. Epub 2013 Dec 01.

DSM-5 and culture: the need to move towards a shared model of care within a more equal patient-physician partnership.

Asian journal of psychiatry

K S Jacob

Affiliations

  1. Christian Medical College, Vellore 632002, India. Electronic address: [email protected].

PMID: 24524720 DOI: 10.1016/j.ajp.2013.11.012

Abstract

The universal models employed by psychiatry de-emphasise the role of context and culture. Despite highlighting the impact of culture on psychiatric diagnosis and management in the Diagnostic and Statistical Manual of Mental Disorders-5, most of the changes suggested remain in the introduction and appendices of the manual. Nevertheless, clinical and biological heterogeneity within phenomenological categories mandates the need to individualise care. However, social and cultural context, patient beliefs about causation, impact, treatment and outcome expectations are never systematically elicited, as they were not essential to diagnosis and classification. Patient experience and narratives are trivialised and the biomedical model is considered universal and transcendental. The need to elicit patient perspectives, evaluate local reality, assess culture, educate patients about possible interventions, and negotiate a shared plan of management between patient and clinician is cardinal for success. The biopsychosocial model, which operates within a paternalistic physician-patient relationship, needs to move towards a shared approach, within a more equal patient-clinician partnership.

Copyright © 2013 Elsevier B.V. All rights reserved.

Keywords: Culture; DSM-5; Mental disorders

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