En este ensayo reflexionamos sobre el diagnóstico en psiquiatría en base a las siguientes preguntas: ¿hasta qué punto el carácter subjetivo de las expresiones del fenómeno patológico en psiquiatría influye en el carácter científico de la disciplina, como especialidad de la medicina? ¿Cómo se construye la objetividad y cientificidad del diagnóstico en psiquiatría? ¿Cómo se expresan las relaciones sociales y culturales en el diagnóstico psiquiátrico? Como punto de partida se revisan tópicos epistemológicos y culturales de la praxis psiquiátrica, específicamente del diagnóstico y entrevista psiquiátrica, en un amplio plano de interrelación social, cultural, política y económica entre personas. Finalmente podemos avizorar que la psiquiatría se va convirtiendo en un espacio por excelencia para repensar el saber y el poder la medicina, en un proceso de mayor aproxim...

Objective: The operationalization and the role of a participatory model of diagnostic and therapeutic formulations called Foster Groups, implemented in a Community Mental Health Center in Lima, Peru, are analyzed. Material and Methods: The research was based on the participanting observation by experts in community mental health, public health, communication and social sciences, of a total of 24 Foster Group sessions held at the Nancy Reyes Community Mental Health Center in Chorrillos, Lima Peru, during the years 2018-2019. Results: The Foster Groups are structured in sequential phases that follow a logical process of diagnostic formulations and management plans, concurrently performed by professionals from different disciplines for a small group of users, thus allowing both, diagnoses as plans, to be more comprehensive. An environment of trust is generated, allowing people to share expe...

Objective: To systematize the process of diagnosis and treatment plan formulations in participatory groups of users and professionals, called Fostering Groups, as an alternative to the conventional model of individual and sequential psychiatric consults, in the field of community mental health.   Material and Methods: The study was carried out in a community mental health center (CMHC) in Lima throughout the period January-December 2018. An action-research methodology was followed, in which proposals arising from the experiences were put into action to, then, critically analyze the and adjust them successively until reaching a point of standardization or consensus among the participants. Results: The participatory model was applied in 97% of the users during the observation period and the formulation of diagnoses and treatment plans during the Foster Group session was succ...

In recognition of the great advance of psychiatry as a medical specialty, and of the global mental health movement in the clinical management of mental health problems and disorders, it is extremely important to explore the conceptual dilemmas, structural limitations, and epistemological tensions in search of clearer, broader, deeper and more consistent approaches to both the theory and practice of psychiatry. The analysis pursued in this study examines predominant paradigms, and substantiates proposals such as the inclusion of socio-cultural concepts in the diagnosis beyond its exclusive basis on manuals, the elimination of a circular etio-pathogenic thinking, the dogmatic declarations of an “evidence-based medicine”, the pretended neutrality of science, and the idealized polarization of mental health and mental illness; at the same time, the clear utility of sociocultural concepts ...

Considering the discrepancies about the quality ofBCG vaccine applied in our environment and the utility of PPD as a diagnostic method for the tuberculosis infection. We realized the present investigation to determine the tuberculine reactivity prevalence in children between 1 to 4 years old vaccinated with BCG and evaluate indirectly the PPD utility. In the city of Lambayeque we evaluated a total of 569 children between 1 to 4 years old vaccinated with BCG. They received PPD 2 UT in accordance with standarised rules of the OMS/OPS. The results show a high prevalence of negative response to PPD in 90 % of the total of children. We do not found significative difference between age groups, heaping up or nutrition degree for the tubercullne response. With this results, lt Is neccesary the reevaluatlon of the oficial international criteria about the use of PPD as a diagnostic method of natur...