Institutionalised otherness : Patients references to psychiatric diagnostic categories

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Weiste , E , Peräkylä , A , Valkeapää , T , Savander , E & Hintikka , J 2018 , ' Institutionalised otherness : Patients references to psychiatric diagnostic categories ' , Social Science & Medicine , vol. 207 , pp. 71-79 . https://doi.org/10.1016/j.socscimed.2018.04.048

Title: Institutionalised otherness : Patients references to psychiatric diagnostic categories
Author: Weiste, Elina; Peräkylä, Anssi; Valkeapää, Taina; Savander, Enikö; Hintikka, Jukka
Contributor: University of Helsinki, Department of Finnish, Finno-Ugrian and Scandinavian Studies
University of Helsinki, Faculty of Social Sciences
University of Helsinki, Department of Finnish, Finno-Ugrian and Scandinavian Studies
University of Helsinki, HYKS erva
University of Helsinki, HYKS erva
Date: 2018-06
Language: eng
Number of pages: 9
Belongs to series: Social Science & Medicine
ISSN: 0277-9536
URI: http://hdl.handle.net/10138/329523
Abstract: Diagnosis is integral part of the way medicine organises illness: it is important for identifying treatment options, predicting outcomes and providing an explanatory framework for clinicians. Previous research has shown that during a medical visit not only the clinician but also patients provide explanations for the causes of their symptoms and health problems. Patients' lifeworld explanations are often differentiated from the diagnostic explanations provided by clinicians. However, while previous conversation analytic research has elaborated the ways in which diagnostic and lifeworld explanations are interactionally structured in somatic medicine, there is little research on how these explanations are organised in psychiatry. Psychiatric diagnosis is particularly interesting because in mental disorders illness itself is not determined by any objective measurement. Understanding of the patient's problem is constructed in interaction between the patient and clinician. The focus of this research will be patients' references to diagnosis in psychiatry and the functions of these references. The findings are based on conversation analysis of 29 audio-recorded diagnostic interviews in a psychiatric outpatient clinic. Our results demonstrate that patients can utilise diagnostic categories in several ways: disavowing a category to distance their symptoms from it, accounting for their life experiences being rooted in psychiatric illnesses and explaining their illnesses as being caused by certain life experiences. We argue that these explanations are important in patients' face-work - in constructing and maintaining a coherent and meaningful view of the patient's self.
Subject: Conversation analysis
Diagnosis
Explanation
Lifeworld
Psychiatry
Self
CHRONIC ILLNESS
SOCIOLOGY
METAPHOR
3124 Neurology and psychiatry
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