Psychiatric diagnosis and interventions are based on behavioral and experiential symptoms, codified especially in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases and Related Health Problems (ICD). Mental health researchers, however, are intensively seeking to identify biological parameters – so-called biomarkers – that are supposed to supplement or replace these ‘descriptive’ diagnostic criteria.
The PhD project empirically investigates this search for biomarkers with a special focus on mood disorders. Based on ethnographic fieldwork, qualitative interviews, and document analysis, I map related expectations, hopes and fears (e.g. the vision of ‘personalized psychiatry’) and delineate epistemic strategies enacted by various actors in the fields of genomics, proteomics and brain imaging. I assume that the search for biomarkers might significantly reconfigure mental disorders and may already be transforming the knowledge infrastructure of the psy-disciplines – even though this endeavour has largely failed so far.
Psychiatric research and clinical practice are currently undergoing a transformation many observers regard as a real paradigm shift. While psychiatric interventions so far were based on the experiences, narratives and behavior of patients, they increasingly rely on biological parameters, so-called biomarkers. According to the vision of a “personalized psychiatry”, biomarkers provide for a better diagnosis, prognosis and therapy of psychiatric diseases as they indicate disease severity or susceptibility to treatment thereby allowing to “tailor” interventions to the specific bodily features and biological characteristics of individuals. Today, a few biomarker-tests are already available while others will enter clinical practice in the foreseeable future.
The proposed research project is the first to sociologically investigate this essential transformation. It starts from the thesis that the new focus on biomarkers not only changes professional practices and the disciplinary boundaries of psychiatry, but will also modify institutional structures and practices and result in new concepts of mental illness and health, psychic and corporal processes. Informed by the research design of situational analysis, the project examines the conditions, dynamics and implications of psychiatric biomarker-research using the example of depression.
For this purpose, document and media analysis, expert interviews and ethnographies of psychiatric conferences will provide insights into both the practical contexts and the technical preconditions of biomarker research and the expectations, hopes and fears within the psychiatric arena that go along with the introduction and proliferation of biomarkers for depression. The project contributes to the sociology of psychiatric knowledge by combining an analytics of government following the work of Michel Foucault with insights from Science and Technology Studies. It investigates the historical ontology of depression as a fluid and contested medical classification and seeks to conceptually sharpen the notion of biomarkerization. Beyond the scientific objectives, the research project also provides empirical insights and theoretical reflections highly relevant for the public debate on the societal implications of the vision of a personalized psychiatry.
On behalf of the Swiss Federal Office of Public Health (FOPH), Thomas Lemke and Jonas Rüppel reviewed the existing research on the societal implications of Preimplantation Genetic Diagnosis (PGD). The study identifies the following social issues: 1) the forms and fields of application of PGD have expanded, both for new medical indications and for non-medical purposes, 2) PGD tends to reinforce social inequalities and strengthens existing gender asymmetries in family life and reproductive care, and 3) PGD is contributing to a change of normative expectations promoting the idea of genetic and reproductive responsibility. Furthermore, the study delineates potential consequences of PGD for people living with chronic diseases or disabilities and assesses possible trajectories of the technology in question. The document is available for download here.
Faculty of Social Sciences
Institute of Sociology
Research Group Biotechnologies,
Nature and Society
Campus-Westend – PEG-Building
Room 3.G 007
60323 Frankfurt am Main
PEG - internal post 31
60629 Frankfurt am Main
Tel. +49 69 798 36665