Foundations for a realist ontology of mental disease

Abstract

While classifications of mental disorders have existed for over one hundred years, it still remains unspecified what terms such as 'mental disorder', 'disease' and 'illness' might actually denote. While ontologies have been called in aid to address this shortfall since the GALEN project of the early 1990s, most attempts thus far have sought to provide a formal description of the structure of some pre-existing terminology or classification, rather than of the corresponding structures and processes on the side of the patient.We here present a view of mental disease that is based on ontological realism and which follows the principles embodied in Basic Formal Ontology (BFO) and in the application of BFO in the Ontology of General Medical Science (OGMS). We analyzed statements about what counts as a mental disease provided (1) in the research agenda for the DSM-V, and (2) in Pies' model. The results were used to assess whether the representational units of BFO and OGMS were adequate as foundations for a formal representation of the entities in reality that these statements attempt to describe. We then analyzed the representational units specific to mental disease and provided corresponding definitions.Our key contributions lie in the identification of confusions and conflations in the existing terminology of mental disease and in providing what we believe is a framework for the sort of clear and unambiguous reference to entities on the side of the patient that is needed in order to avoid these confusions in the future.

Interdisciplinary perspectives on the development, integration, and application of cognitive ontologies

“…Just as the Foundational Model of Anatomy (FMA, Rosse and Mejino, 2003) contains terms for arm and leg, but not for amputation stump or shriveled arm, ontologies that represent canonical mental processes would contain terms for visual and aural perception, but not for synaesthesia or tinnitus. Terms like these would belong in extension ontologies relating to specific types of mental or neurological disease (Ceusters and Smith, 2010). By focusing on the canonical case, perceptual processes (for example) can safely be defined as representing objects and involving beliefs about those objects.…”

Le jardinier et le botaniste. Proposition d’une organisation minimale de la sémiologie psychiatrique pour l’étudiant en médecine

“…1) [46], c'est-à-dire à l'interface de deux ensembles terminologiques cohérents [11] : celui des neurosciences (et de la physiopathologie) et celui des nosographies psychiatriques (et de l'épidémiologie). Les enjeux historiques et théoriques qu'une telle proposition minimale soulève inévitablement n'ont été abordés que sous l'angle d'une nécessaire cohérence pédagogique permettant de favoriser un enseignement de sémiologie dans la perspective de l'enseignement de la nosographie dans le cadre du référentiel des ECN [1].…”

“…En effet, en l'absence d'un tel travail d'harmonisation sémantique, l'étudiant pourrait avoir une impression d'accumulation de termes tous plus hermétiques les uns que les autres comme dans le poème de Lewis Carrol, « Soulier-Bateaux-Cachets et seaux-Monarques-Salade de choux ». Une organisation des termes s'impose donc tant d'un point de vue sémiologique (i.e « étude des signes et des symptômes » [30]) que nosographique (i.e « distribution méthodique dans laquelle les maladies sont groupées par classes » [11,30] [5,16,55], concernant le travail de classification de la sémiologie des crises épileptiques réalisé par l'International League Against Epilepsy (ILAE). Il soulignait ainsi la nécessité d'une organisation sémiologique en épileptologie.…”

Health as a clinic‐epidemiological concept

“…Disease is not a predicative adjective like healthy . The predicative adjective we use to deny that someone is healthy is sick . Barry Smith and Werner Ceusters maintain that diseases are dispositions [26]. Arp and Smith define disposition as ‘a realizable dependent continuant that typically causes a specific process in the object in which it inheres when the object is introduced into certain specific circumstances’ ([33] p. 3).…”