¿Está la psiquiatría atrapada en el pasado?

Desde que la psiquiatría surgió como un campo independiente de la medicina, siempre ha estado a la sombra de otras especialidades, y nunca ha avanzado científicamente tan rápido como la neurología, la oncología o la cardiología. En muchos países desarrollados, la disminución en el número de hospitales psiquiátricos ha puesto a los servicios psiquiátricos en un contacto profesional mucho más cercano que nunca con esos y otros campos de la medicina. Sin embargo, la psiquiatría sigue estando en el inframundo de la medicina, clínicamente dentro de las corrientes principales y fuera de ellas científicamente.

Lo que separa a la psiquiatría de otras especialidades médicas es la falta de una base objetiva para el diagnóstico. Otras disciplinas médicas han refinado el proceso de diagnóstico hasta el punto donde los análisis computarizados de laboratorio han sustituído prácticamente al examen clínico del paciente. La psiquiatría sigue dependiendo de la interpretación de historias clínicas detalladas. Estas sólo se pueden obtener a través del examen cuidadoso y los interrogatorios directos al paciente. No hay pruebas diagnósticas universales para los padecimientos mentales más frecuentes, como la depresión, la ansiedad y la esquizofrenia.

Claro que hay programas computacionales que pueden procesar los datos derivados de los síntomas de los pacientes y generar diagnósticos psiquiátricos. No obstante, estos aplican reglas que sólo reproducen la manera en la que uno o más psiquiatras interpretan los síntomas de un paciente. Los resultados de los programas no tienen nada de absoluto, aunque por lo menos hacen lo mismo vez tras vez, cosa que no se puede decir de los psiquiatras. Después de todo, las interpretaciones de un caso pueden variar y el resultado final sólo se puede resolver apelando a la autoridad: "Yo tengo más rango y experiencia que tú, así que mi diagnóstico es el que prevalece".

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