Medicine and the Mind — The Consequences of Psychiatry’s Identity Crisis
Abstract
Interview with Dr. Caleb Gardner on the limitations of an increasing focus on biologic knowledge in psychiatry. (11:22)Download In psychiatry, checklists of symptoms now take the place of thoughtful diagnosis, and trial-and-error “medication management” dominates practice. We face stark limitations of biologic treatments, while finding less time to work with patients on difficult problems.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The role of social factors points to explanatory pluralism in psychiatry, a foundational question of clear ethical relevance for the debate about psychiatric EAS.
“The role of social factors points to the key issue of explanatory pluralism in psychiatry (Gardner & Kleinman, 2019; Kendler, 2019) – a foundational question of clear ethical relevance for the debate about psychiatric EAS.”
From Irremediability in psychiatric euthanasia: examining the objective standard (2023) · cites this paper as Gardner & Kleinman, 2019
Cites
Still being checked.
Cited by
Sorted by citations
Bornovalova, M. A., Choate, A. M., Fatimah, H., Petersen, K. J., & Wiernik, B. M. (2020) · Biological Psychiatry · doi:10.1016/j.biopsych.2020.01.013 · Cited by 216 · see citing works
Modeling psychopathology: From data models to formal theories.
Haslbeck, J. M. B., Ryan, O., Robinaugh, D. J., Waldorp, L., & Borsboom, D. (2021) · Psychological Methods · doi:10.1037/met0000303 · Cited by 222 · see citing works
Conceptual Competence in Psychiatry: Recommendations for Education and Training
Aftab, A., & Waterman, G. S. (2020) · Academic Psychiatry · doi:10.1007/s40596-020-01183-3 · Cited by 60 · see citing works
Wand, T., Glover, S., & Paul, D. (2021) · International Journal of Mental Health Nursing · doi:10.1111/inm.12947 · Cited by 46 · see citing works
Schleim, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.943049 · Cited by 38 · see citing works
Precision psychiatry: Complex problems require complex solutions
Salagre, E., & Vieta, E. (2021) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2021.07.003 · Cited by 37 · see citing works
Shaping therapeutic trajectories in mental health: Instructive vs. permissive causality
Branchi, I., & Giuliani, A. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.12.001 · Cited by 31 · see citing works
Irremediability in psychiatric euthanasia: examining the objective standard
Nicolini, M. E., Jardas, E., Zarate, C. A., Gastmans, C., & Kim, S. Y. H. (2023) · Psychological Medicine · doi:10.1017/s0033291722002951 · Cited by 31 · see citing works
“The role of social factors points to the key issue of explanatory pluralism in psychiatry (Gardner & Kleinman, 2019; Kendler, 2019) – a foundational question of clear ethical relevance for the debate about psychiatric EAS.”
van Os, J., Scheepers, F. E., Milo, M., Ockeloen, G., Gülöksüz, S., & Delespaul, P. (2023) · Clinical Practice and Epidemiology in Mental Health · doi:10.2174/0117450179271206231114064736 · Cited by 33 · see citing works
Messaging in Biological Psychiatry: Misrepresentations, Their Causes, and Potential Consequences
Dumas-Mallet, E., & Gonon, F. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000276 · Cited by 30 · see citing works
Plasticity in mental health: A network theory
Branchi, I. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104691 · Cited by 30 · see citing works
Suresh, V., Mills, J. A., Croarkin, P. E., & Strawn, J. R. (2020) · Depression and Anxiety · doi:10.1002/da.23064 · Cited by 30 · see citing works
Cipriani, A., Seedat, S., Milligan, L., Salanti, G., Macleod, M. R., Hastings, J., Thomas, J., Michie, S., Furukawa, T. A., Gilbert, D., et al. (2023) · BMJ Mental Health · doi:10.1136/bmjment-2023-300759 · Cited by 29 · see citing works
Galanter, M. S., Hansen, H., & Potenza, M. N. (2021) · Substance Abuse · doi:10.1080/08897077.2021.1941514 · Cited by 28 · see citing works
Bottaccioli, A., Bologna, M., & Bottaccioli, F. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23073932 · Cited by 23 · see citing works
Branchi, I. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104678 · Cited by 26 · see citing works
Martínez‐Arán, A., & Vieta, E. (2021) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2021.10.771 · Cited by 24 · see citing works
Epistemic injustice and the psychiatrist
Kious, B. M., Lewis, B. R., & Kim, S. Y. H. (2023) · Psychological Medicine · doi:10.1017/s0033291722003804 · Cited by 27 · see citing works
Schleim, S. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01762 · Cited by 24 · see citing works
Mind-Brain Dualism in Psychiatry: Ethical Implications
Glannon, W. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00085 · Cited by 20 · see citing works
Veldmeijer, L., Terlouw, G., van Os, J., Meerman, S. T., Veer, J. V. ‘., & Boonstra, N. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1426475 · Cited by 20 · see citing works
Recovery-oriented psychiatry: oxymoron or catalyst for change?
Speyer, H., Roe, D., & Slade, M. (2025) · The Lancet Psychiatry · doi:10.1016/s2215-0366(25)00092-6 · Cited by 18 · see citing works
van Os, J., & Köhne, A. C. J. (2021) · Psychological Medicine · doi:10.1017/s0033291721000167 · Cited by 18 · see citing works
Amendola, S., Hengartner, M. P., Ajdacic‐Gross, V., Angst, J., & Wulf Rössler, A. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.01.101 · Cited by 20 · see citing works
Potential Impact of Climate Change on Human Trafficking
Sheu, J. C., Torres, M. I. M., Gordon, M., Nguyen, P. T., & Coverdale, J. (2021) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001312 · Cited by 17 · see citing works
The cultural politics of mental illness: toward a rights-based approach to global mental health
Cosgrove, L., Morrill, Z., Karter, J. M., Valdes, E., & Cheng, C.-P. (2021) · Community Mental Health Journal · doi:10.1007/s10597-020-00720-6 · Cited by 16 · see citing works
The Soteria model: implementing an alternative to acute psychiatric hospitalization in Israel
Friedlander, A., Bitan, D. T., & Lichtenberg, P. (2022) · Psychosis · doi:10.1080/17522439.2022.2057578 · Cited by 16 · see citing works
Conceptualizations of Mental Disorder at a US Academic Medical Center
Aftab, A., Joshi, Y. B., & Sewell, D. D. (2020) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001227 · Cited by 15 · see citing works
Schizophrenia as a symptom of psychiatry’s reluctance to enter the moral era of medicine
van Os, J., & Gülöksüz, S. (2022) · Schizophrenia Research · doi:10.1016/j.schres.2021.12.017 · Cited by 15 · see citing works
From the patients’ perspective: what it is like to suffer from eating disorders
Stanghellini, G., Daga, G. A., & Ricca, V. (2020) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-020-00913-8 · Cited by 15 · see citing works
To Overcome Psychiatric Patients’ Mind–Brain Dualism, Reifying the Mind Won’t Help
Schleim, S. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00605 · Cited by 13 · see citing works
Clinician and patient perspectives on the ontology of mental disorder: a qualitative study
Köhne, A. C. J., de Graauw, L. P., der Maas, R. L.-V., & van Os, J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1081925 · Cited by 13 · see citing works
Schenk, P. M., Hastings, J., Santilli, M., Potts, J., Kennett, J., Friedrich, C., & Michie, S. (2024) · Wellcome Open Research · doi:10.12688/wellcomeopenres.20701.2 · Cited by 12 · see citing works
Bottaccioli, A. G., Bologna, M., & Bottaccioli, F. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26062759 · Cited by 13 · see citing works
‘The Explanation You Have Been Looking For’: Neurobiology as Promise and Hermeneutic Closure
Davis, J. E. (2021) · Culture Medicine and Psychiatry · doi:10.1007/s11013-021-09737-2 · Cited by 11 · see citing works
The Modern Psychiatrist’s Guide to Contemporary Practice
Kelly, B. (2024) · Routledge eBooks · doi:10.4324/9781003378495 · Cited by 10 · see citing works
Design for mental health: can design promote human-centred diagnostics?
Veldmeijer, L., Terlouw, G., Veer, J. V. ‘., van Os, J., & Boonstra, N. (2023) · Design for Health · doi:10.1080/24735132.2023.2171223 · Cited by 10 · see citing works
Patient satisfaction with mental and physical health services: Findings from a UK-wide online survey
Kirkham, E., Fletcher‐Watson, S., Beange, I., Chan, S. W. Y., & Lawrie, S. M. (2022) · Wellcome Open Research · doi:10.12688/wellcomeopenres.17973.1 · Cited by 9 · see citing works
Dalgalarrondo, P., Oda, A. M. G. R., Campos, R. T. O., & Banzato, C. E. M. (2023) · SSM - Mental Health · doi:10.1016/j.ssmmh.2023.100262 · Cited by 11 · see citing works
The multi-disciplinary arena of psychosomatic medicine – Time for a transitional network approach
Leue, C., van Schijndel, M. A., Keszthelyi, D., van Koeveringe, G. A., Ponds, R., Kathol, R. G., & Rutten, B. P. F. (2020) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2020.02.003 · Cited by 9 · see citing works
Khantzian, E. J. (2021) · American Journal on Addictions · doi:10.1111/ajad.13111 · Cited by 9 · see citing works
Rebooting Late-Life Mental Health Innovation and Entrepreneurship With Convergence Science
Smith, E., Au, R., Mossé, M., Lavretsky, H., Forbes, M., & Eyre, H. A. (2020) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2020.03.003 · Cited by 8 · see citing works
There is no health without mental health: Challenges ignored and lessons learned
Lai, A. G., & Chang, W. H. (2022) · Clinical and Translational Medicine · doi:10.1002/ctm2.897 · Cited by 8 · see citing works
Good Mental Health Care: What It Is, What It Is Not & What It Could Be
Kleinman, A., & Gardner, C. (2023) · Daedalus · doi:10.1162/daed_a_02042 · Cited by 7 · see citing works
Self-citationCalling to Action Our Personal Behaviors in Mitigating Climate Change
Coverdale, J., Seritan, A. L., & Brenner, A. M. (2022) · Academic Psychiatry · doi:10.1007/s40596-022-01626-z · Cited by 7 · see citing works
Smith, K., Downs, J. L., Robinson, E. S. J., Malhi, G. S., Potts, J., Tonia, T., Salanti, G., & Cipriani, A. (2025) · The British Journal of Psychiatry · doi:10.1192/bjp.2025.10457 · Cited by 6 · see citing works
Bottaccioli, F., Bottaccioli, A., Marzola, E., Longo, P., Minelli, A., & Abbate-Daga, G. (2021) · Endocrines · doi:10.3390/endocrines2030022 · Cited by 6 · see citing works
Konsman, J. P. (2023) · Studies in History and Philosophy of Science Part A · doi:10.1016/j.shpsa.2023.12.002 · Cited by 5 · see citing works
Schenk, P. M., Hastings, J., & Michie, S. (2024) · Wellcome Open Research · doi:10.12688/wellcomeopenres.20701.1 · Cited by 5 · see citing works
Let's fail better: Using philosophical tools to improve neuroscientific research in psychiatry
Abalo‐Rodríguez, I., & Blithikioti, C. (2024) · European Journal of Neuroscience · doi:10.1111/ejn.16552 · Cited by 5 · see citing works
Psychiatry’s Identity: Scope, Complexity, and Humility
Brenner, A. M., Coverdale, J., Morreale, M. K., Guerrero, A. P. S., Aggarwal, R., Balon, R., Beresin, E. V., & Louie, A. K. (2021) · Academic Psychiatry · doi:10.1007/s40596-021-01412-3 · Cited by 5 · see citing works
Mind-Body dualism and medical student attitudes toward mental illness in Saudi Arabia
Tayeb, H. O., Alsawwaf, Y., Kokandi, S., Baduwailan, A. O., Al‐Zaben, F., Butt, N. S., Hassan, A. N., & Koenig, H. G. (2022) · The International Journal of Psychiatry in Medicine · doi:10.1177/00912174221099341 · Cited by 5 · see citing works
Defensive rhetoric in psychiatry: an obstacle to health and human rights
Daya, I., Maylea, C., Raven, M. K., Hamilton, B. E., & Jureidini, J. N. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30534-6 · Cited by 5 · see citing works
Professionals in psychiatry need reflective competence
Denys, D. A. J. P. (2024) · World Psychiatry · doi:10.1002/wps.21196 · Cited by 4 · see citing works
Person-Centered Medicine and Psychiatry – Emerging Perspectives
Kallivayalil, R. A., & Enara, A. (2023) · Indian Journal of Social Psychiatry · doi:10.4103/ijsp.ijsp_57_23 · Cited by 4 · see citing works
Brun, C., Boraud, T., & Gonon, F. (2024) · Neurobiology of Disease · doi:10.1016/j.nbd.2024.106544 · Cited by 3 · see citing works
Unpacking how the biomedical model prioritizes the subpersonal level in mental health inquiry
Gaj, N. (2025) · Philosophical Psychology · doi:10.1080/09515089.2025.2523554 · Cited by 3 · see citing works
A new WHO roadmap for mental health policy reform
Funk, M., Drew, N., Cole, C., McGovern, P. G., & Moro, M. F. (2025) · World Psychiatry · doi:10.1002/wps.21360 · Cited by 3 · see citing works
Un nuovo paradigma per le scienze e le professioni psicologiche e psichiatriche
Bastianelli, L., Bianchi, A., Bottaccioli, F., Cardone, R., Cutrona, I. R., Palo, G., Sinibaldi, F., Stoppele, E., Tossici, G., & Vaccaro, L. (2021) · PNEI REVIEW · doi:10.3280/pnei2021-001002 · Cited by 3 · see citing works
Cotter, P., Papasileka, E., Eugster, M., Chauhan, V., Garcha, E., Kunkler, M., Brooks, M., Otvos, I., Srithar, A., Torras, I. P., et al. (2022) · Mental Health and Social Inclusion · doi:10.1108/mhsi-02-2022-0012 · Cited by 3 · see citing works
Harm Reduction, Humanistic Psychology, and the CRPD
D’Ambrozio, G., Cosgrove, L., Lilly, S., & McCarthy, T. (2022) · Journal of Humanistic Psychology · doi:10.1177/00221678221136240 · Cited by 3 · see citing works
Hirshbein, L. (2020) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001191 · Cited by 3 · see citing works
O'Sullivan, M. (2022) · International Journal of Mental Health Nursing · doi:10.1111/inm.13054 · Cited by 2 · see citing works
Toward a Change of Paradigm in Psychosis: A Contextual Phenomenological Approach
Álvarez, M. P., & García‐Montes, J. M. (2023) · Springer eBooks · doi:10.1007/978-3-031-27003-1_1 · Cited by 2 · see citing works
Conceptual competences in philosophy of psychiatry: A cross-sectional survey
Gauld, C., Aftab, A., Auriacombe, M., Fourneret, P., Arbus, C., Naudin, J., Giroux, É., Cermolacce, M., Gozé, T., & Micoulaud‐Franchi, J. (2025) · L Encéphale · doi:10.1016/j.encep.2025.02.005 · Cited by 2 · see citing works
Intervene or Innovate: a Dilemma for Psychiatrists-in-Training
Morris, N. P., & Eshel, N. (2020) · Academic Psychiatry · doi:10.1007/s40596-020-01203-2 · Cited by 2 · see citing works
Lieberman, J. A., & Dosovitz, S. M. (2020) · New England Journal of Medicine · doi:10.1056/nejmc1916446 · Cited by 2 · see citing works
Davies, E., Clark, S. R., Montagu, A., & Chur‐Hansen, A. (2025) · BMC Medical Education · doi:10.1186/s12909-025-07562-4 · Cited by 2 · see citing works
Are you weary of illness? Coping and existential positioning in life with myasthenia gravis
Missel, M., Witting, N., & Beck, M. (2026) · Medicine Health Care and Philosophy · doi:10.1007/s11019-026-10332-8 · Cited by 1 · see citing works
Beyond the brain: insights from behavior analysis for understanding psychiatric conditions
Abalo-Rodríguez, I., Pardo-Cebrián, R., Doval, S., Blithikioti, C., & Arévalo-Saiz, L. (2025) · Philosophical Psychology · doi:10.1080/09515089.2025.2597425 · Cited by 1 · see citing works
How Long Will the Identity Crisis in Psychiatry Last?
Morreale, M. K. (2019) · Academic Psychiatry · doi:10.1007/s40596-019-01164-1 · Cited by 1 · see citing works
Cleaning the House of Psychiatry
Nicola, V. D., & Stoyanov, D. (2021) · Springer eBooks · doi:10.1007/978-3-030-55140-7_8 · Cited by 1 · see citing works
Stupak, R. (2021) · Praktyka Teoretyczna · doi:10.14746/prt.2021.2.6 · Cited by 1 · see citing works
La "mitodologia" della Legge 180 e la necessità di una rivoluzione culturale
Veltro, F. (2023) · PSICOTERAPIA E SCIENZE UMANE · doi:10.3280/pu2023-002006 · Cited by 1 · see citing works
In search of a better ontology of mental disorder
Köhne, A. C. J. (2022) · doi:10.33540/1591 · Cited by 1 · see citing works
Institutional Corruption and Social Justice in Psychiatry
Aftab, A., & Cosgrove, L. (2024) · doi:10.1093/med/9780192870322.003.0018
Should the 2020s be the Psychiatric Decade of the Social? A Debate
Moffic, H. S. (2020) · World Social Psychiatry · doi:10.4103/wsp.wsp_12_20
Krisenkonzepte überwinden starre Diagnosekonzepte
Weinmann, S. (2021) · Nervenheilkunde · doi:10.1055/a-1524-8611
Perspectives and Frameworks Underpinning the Practice of Advanced Mental Health Nursing
Higgins, A., Kilkku, N., & Kristofersson, G. K. (2022) · Springer eBooks · doi:10.1007/978-3-031-05536-2_3
Investigating the Biology of Behavioural Differences
Stevenson, J. (2023) · Springer eBooks · doi:10.1007/978-3-031-45787-6_3
Iglesias, J. B., González, D. A., & Astray, A. A. (2025) · European Public & Social Innovation Review · doi:10.31637/epsir-2026-1631
Exploring the mind-brain relationship to advance mental health research and practice
Karunamuni, N. D., Wood, T., & Galante, J. (2025) · Current Psychology · doi:10.1007/s12144-025-08345-2
CHILDHOOD ABUSE AND NEGLECT: CAN IT HELP PSYCHIATRY TO HEED TRAUMA AND ITS EFFECTS ON MENTAL HEALTH?
Haliburn, J. (2023) · ASEAN Journal of Psychiatry · doi:10.54615/2231-7805.47323
Santilli, M., Schenk, P. M., Gehrke, B., West, R., Kennett, J., Kassam‐Adams, N., Crombez, G., Torous, J. B., Pine, D. S., Manji, H. K., et al. (2026) · Wellcome Open Research · doi:10.12688/wellcomeopenres.26120.1
Psychiatrie : le déclin du modèle biomédical ?
Gonon, F. (2026) · Empan · doi:10.3917/empa.141.0062
Medicine, psychotherapy, and artificial intelligence
Gardner, C., & Kleinman, A. (2026) · The Lancet · doi:10.1016/s0140-6736(26)00927-x
Self-citationLa psychiatrie n’est pas une discipline médicale comme les autres
Gonon, F. (2026) · Santé Publique · doi:10.3917/spub.hs1.2026.0229
Ätiologie und Pathogenese psychischer Störungen
Hengartner, M. P. (2026) · Angewandte Psychologie Kompakt · doi:10.1007/978-3-662-72845-1_4
Psychiatrie : le déclin du modèle biomédical ?
Gonon, F. (2026) · Journal français de psychiatrie · doi:10.3917/jfp.058.0107
- Authors
- Gardner, C., & Kleinman, A.
- Affiliations
- Cambridge Health Alliance (US)
- ORCID
- Kleinman, Arthur
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2019-10-31
- Volume
- 381
- Issue
- 18
- Pages
- 1697-1699
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2982663028
- Cited by
- 89
- References
- 0
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 8 · 2023: 13 · 2022: 17 · 2021: 15 · 2020: 18 · 2019: 1
- FWCI
- 78.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Health Professions › Medical Terminology › Medical Research and Practices
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Keywords
- biological psychiatry, symptom checklist, patient-centered care
- MeSH terms
- Mental Disorders, Humans, Physician-Patient Relations, Psychiatry, Psychotherapy, Psychotic Disorders, Biomedical Research, Checklist, Symptom Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review