Findings
The functional-organic distinction is a way to separate mental and neurological disorders based on whether they have clear biological causes or not. This separation is crucial in how doctors diagnose and treat patients. However, there is disagreement among clinicians about what these terms really mean and to which conditions they should be applied. The study aimed to understand how clinicians in psychiatry and neurology make sense of this distinction in their work.
We interviewed ten doctors and ten psychologists who work in psychiatry and / or neurology services.
The findings showed that clinicians often found the distinction didn’t match how they view their patients’ issues. They saw organic causes as clear, identifiable, and directly causing problems, while functional causes were invisible and had to be guessed through discussion. Other factors, like cultural assumptions, service demands, patient needs, and colleagues’ opinions, influenced how the distinction was used.
Clinicians acknowledged that the functional-organic distinction wasn’t perfect in theory and might be replaced in the future. However, they still had to use it in their decision-making to communicate medical issues, navigate services, make psychological explanations more acceptable, fight stigma, offer hope, and connect patients with illness identity. The study revealed that moral concerns at both individual and societal levels played a significant role in how clinicians thought about and applied this distinction, and they actively navigated these concerns in their work.
In essence, there’s a gap between the functional-organic distinction as a theoretical concept and how it’s used in actual healthcare settings. Ambiguity and contradictions in its application were seen as both challenges and advantages, and strategic considerations were crucial in deciding when to rely on this distinction.
Completion date
The study was completed in June 2022.
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